Changes in social work practice and support for people who use drugs during the Covid-19 pandemic – a case study of Malmö, Sweden

The Covid-19 pandemic entails major challenges in maintaining access to and quality of treatment and support for people who use drugs (PWUD) due to the demands for physical distancing. This study analyses how social work and support for PWUD has been affected during the early stages of the Covid-19 pandemic.

A mixed methods approach was used which included an online survey (n=81), and three qualitative focus group sessions with social workers in Malmö, Sweden, working within the field of addiction.

Two central themes are presented: 1) significant changes in organization and day-to-day social work practice that reduced access to services and increased stress among both social workers and clients, and 2) altered practices concerning client meetings that negatively affect assessments, treatment, possibilities to build working alliances as well as enjoyment and motivation in social work practice.

Although the social workers mainly experienced negative consequences of the Covid-19 pandemic, there were also examples of new practices and lessons learned, for example, the introduction of 'walks and talks' with clients, and an increased knowledge of how and when to use digital tools for communication.

The demand for physical distancing challenges important principles of social work such as social closeness, trust and accessibility, and has led to a difficult work environment and fewer opportunities to conduct qualitative social work, as well as reduced support for vulnerable PWUD.

Limited access to services and meeting places, as well as limited digital capital among some PWUD increase the pressure on frontline social workers. They became the 'last outpost' when other services shut down, and 'digital bridges' between clients and other social workers or services. Social workers faced a difficult trade-off between protecting themselves and clients from the risk of infection and providing help and support to a vulnerable group.