Emergency preparedness planning: lessons from COVID-19 and the opioid crisis in rural Ohio

The COVID-19 pandemic amplified existing public health emergencies, including the overdose crisis, with the effect of emergency preparedness planning on local responses in rural areas being unknown. A study conducted 52 semi-structured interviews with 28 people who use drugs (PWUD) and 24 local stakeholders in two rural counties in southern Ohio. Findings indicated that existing emergency preparedness plans were often inadequate for the needs of PWUD and required updates and additional perspectives from them. Both groups reported widespread service disruptions, such as reduced hours, understaffing, and limited access to supplies. Communication was inconsistent, contributing to challenges in maintaining trust and ensuring access to accurate information. Heightened stigma and law enforcement protocols further discouraged the use of essential services. Despite these challenges, community-driven solutions emerged, including peer distribution networks and a rapid transition to telehealth services. The study emphasizes the need to ensure continuity of essential services, strengthen communication channels, and integrate PWUD perspectives into future emergency preparedness plans.