Access to Healthcare and Harm Reduction Services During the COVID-19 Pandemic for People Who Use Drugs

Abstract

Globally, there are concerns about access to healthcare and harm reduction services for people who use drugs (PWUD) during the coronavirus disease 2019 (COVID-19) pandemic. Members from the Network of Early Career Professionals working in Addiction Medicine shared their experiences of providing treatment to PWUD during the COVID-19 pandemic. Drawing on these qualitative reports, we highlight the similarities and discrepancies in access to services for PWUD in 16 countries under COVID-10 restrictions. In most countries reported here, efforts have been made to ensure continued access to services, such as mobilising opioid agonist maintenance treatment and other essential medicines to patients. However, due to travel restrictions and limited telemedicine services, several Network of Early Career Professionals working in Addiction Medicine members from lower-resourced countries experienced challenges with providing care to their patients during periods of COVID-19 lock-down. The insights provided in this commentary illustrate how the COVID-19 lock-down restrictions have impacted access to services for PWUD.

Overview of SARS-CoV-2 infection in adults living with HIV

“…People using substances might have reduced access to harm reduction and treatment services. 98 There might be disruptions in illicit drug supplies, affecting availability and cost, and increasing the risk of drug adulteration. 99 Individuals with addictions have been at higher risk of multimorbidity and mortality during the COVID-19 pandemic.…”

Pathways between COVID-19 public health responses and increasing overdose risks: A rapid review and conceptual framework

“…Secondly, we did not identify any positive consequences of COVID-19 public health responses through our search strategy, though evidence exists that some programs have started allowing take home dosing of OAT or the advent of mobile solutions ( Stowe et al., 2020 ). This may reflect how the existing drug and drug policy literature tends to focus on negative outcomes rather than positive ones.…”

Similar COVID-19 incidence to the general population in people with opioid use disorder receiving integrated outpatient clinical care

“…One of the main reasons, however, for such increased vulnerability to COVID-19 has been the reduced access to health care and recovery support services for individuals with OUD during the pandemic ( Dunlop et al, 2020 ; Radfar et al, 2021 ; Stowe et al, 2020 ). Patient accessibility to treatment services and medications for OUD have been hindered by lockdown policies and the restricted schedules of treatment centers ( Dunlop et al, 2020 ; Radfar et al, 2021 ; Stowe et al, 2020 ).…”

“…One of the main reasons, however, for such increased vulnerability to COVID-19 has been the reduced access to health care and recovery support services for individuals with OUD during the pandemic ( Dunlop et al, 2020 ; Radfar et al, 2021 ; Stowe et al, 2020 ). Patient accessibility to treatment services and medications for OUD have been hindered by lockdown policies and the restricted schedules of treatment centers ( Dunlop et al, 2020 ; Radfar et al, 2021 ; Stowe et al, 2020 ). Moreover, the adaptive capacities of the medical systems to the epidemic, reducing or closing outpatient services to redirect staff and other resources to manage acute COVID-19 cases, have resulted in suboptimal care for individuals with OUD ( Dunlop et al, 2020 ; Radfar et al, 2021 ; Stowe et al, 2020 ).…”