COVID-19 and people who use drugs: a call for action

Jozaghi, Ehsan; Maynard, Russ; Hamm, Dave; Marsh, Samona

doi:10.17269/s41997-020-00326-1

Cited by 13 publications

(8 citation statements)

References 1 publication

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“…However, the current emphasis on innovative solutions to the overdose crisis [ 65 ] highlights the need for SCS to be responsive to the needs of their participants. Furthermore, the current COVID-19 pandemic has also demonstrated the importance of flexibility in response to the evolving needs of SCS participants [ 66 ]. People who smoke illegal drugs may be particularly at risk for complications associated with respiratory illness [ 67 ].…”

Section: Discussionmentioning

confidence: 99%

To what extent do supervised drug consumption services incorporate non-injection routes of administration? A systematic scoping review documenting existing facilities

et al. 2020

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Background Most of the existing research on supervised consumption services (SCS) is focused on injection drug use. Less is known about the applicability of SCS for people who consume drugs orally, intranasally, or through inhalation. This is problematic because people who use drugs through modes other than injection are also at risk of overdose death and other harm, and experience barriers accessing health and social services. We aimed to describe existing SCS models that accommodate these alternate routes of drug consumption, and synthesize available information on characteristics of program participants. Methods We conducted a systematic scoping review of 9 peer-reviewed and 13 grey literature databases on SCS that incorporate non-injection routes of consumption. We screened 22,882 titles, and excluded 22,843 (99.8%) articles. We ultimately included 39 (0.2%) full-text articles; 28 (72%) of these articles explicitly identified SCS that permit alternate routes of consumption and 21 (54%) discussed characteristics of participants who consume drugs through non-injection routes. Data on study characteristics, terms and definitions, and site and program participant characteristics were extracted and double-coded. Extracted data were analyzed using descriptive statistics and narrative synthesis. Results Included articles describe 48 SCS that permit non-injection routes of consumption, most of which were located in Germany. The majority of these SCS were legally sanctioned and had models of care that were largely comparable to supervised injection services. Notable differences included physical infrastructure such as ventilated rooms or outdoor areas to accommodate inhalation, and shorter time limits on non-injection drug consumption episodes. Program participants engaging in non-injection forms of consumption were typically men over the age of 30 and structurally vulnerable (e.g., experiencing homelessness or unstable housing). Conclusions Extant academic and grey literature indicates that site characteristics and demographics of program participants of SCS that permit non-injection routes of consumption largely reflect those of supervised injection services. Further research on the range of existing SCS that incorporate non-injection routes of consumption is needed to ensure high quality service provision, and improved health outcomes for people who consume drugs via oral, intranasal, and inhalation routes.

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Section: Discussionmentioning

confidence: 99%

To what extent do supervised drug consumption services incorporate non-injection routes of administration? A systematic scoping review documenting existing facilities

et al. 2020

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“…These strategies [ 5 ]—permitting physicians to prescribe other substituting therapies (such as hydromorphone and dextroamphetamine)— have not been successful in reducing the overdose mortalities in the Province of B.C. , as the latest figures show an average of over 5 deaths per day linked to drug overdoses [ 4 – 7 ]. In reality, these efforts at creating alternative prescribing have yet to be implemented anywhere near consistently or on a scale that reflects the scale of the epidemic; particularly in rural or other parts of the province [ 8 , 9 ].…”

Section: Drug Overdose Deaths During Covid-19 Pandemicmentioning

confidence: 99%

The drug war must end: The right to life, liberty and security of the person during the COVID-19 pandemic for people who use drugs

Maynard

Jozaghi²

2021

Harm Reduct J

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Since the start of the opioid epidemic in 2016, the Downtown Eastside community of Vancouver, Canada, has lost many pioneering leaders, activists and visionaries to the war on drugs. The Vancouver Area Network of Drug Users (VANDU), the Western Aboriginal Harm Reduction Society (WAHRS), and the British Columbia Association People on Opiate Maintenance (BCAPOM) are truly concerned about the increasing overdose deaths that have continued since 2016 and have been exacerbated by the novel coronavirus (SARS-COVID-19) despite many unique and timely harm reduction announcements by the British Columbia (B.C.) government. Some of these unique interventions in B.C., although in many cases only mere announcements with limited scope, are based on the philosophy of safe supply to illegal street drugs. Despite all the efforts during the pandemic, overdose deaths have spiked by over 100% compared to the previous year. Therefore, we urge the Canadian federal government, specifically the Honorable Patty Hajdu, the federal Minister of Health, to decriminalize simple possession immediately by granting exemption under the Controlled Drugs and Substances Act. The Canadian federal government has a moral obligation under Sect. 7 of the Canadian Charter of Rights and Freedoms to protect the basic human rights of marginalized Canadians.

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“…Predominantly, the epidemic is associated with the emergence of fentanyl analogues within the illicit drug supply, notably altering what was once the heroin supply 4 . COVID‐19 is potentially intensifying risk factors as harm reduction services are limited, people who use drugs are more isolated, and due to possible disruptions in the drug supply that may limit availability and increase variability and uncertainty 5–7 . It is within this context that drug checking has been emerging as a potential harm reduction measure to be included within the overall response to the public health crises 8,9 …”

Section: Introductionmentioning

confidence: 99%

“…With the emergence of COVID‐19, community drug checking is facing new and unique challenges in what is referred to as a context of dual public health crises 7 . People who use drugs face increased barriers to access services, greater isolation and overall COVID‐19 has exacerbated existing structural inequities that intensify risks and harms 5,36,37 .…”

Section: Introductionmentioning

confidence: 99%

“…21,28 With the emergence of COVID-19, community drug checking is facing new and unique challenges in what is referred to as a context of dual public health crises. 7 People who use drugs face increased barriers to access services, greater isolation and overall COVID-19 has exacerbated existing structural inequities that intensify risks and harms. 5,36,37 The International Network of People who Use Drugs (INPUD) and others are also calling the pandemic an opportunity to enact a "new normal" for people who drugs as COVID-19 presents an opportunity to end the war on drugs and enact a new social contract based on rights and dignity rather than stigma and criminalization.…”

mentioning

confidence: 99%

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Implementing an integrated multi‐technology platform for drug checking: Social, scientific, and technological considerations

Wallace

Hills

Rothwell

et al. 2021

Drug Testing and Analysis

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The illicit drug overdose crisis in North America continues to devastate communities with fentanyl detected in the majority of illicit drug overdose deaths. The COVID-19 pandemic has heightened concerns of even greater unpredictability in the drug supplies and unprecedented rates of overdoses. Portable drug-checking technologies are increasingly being integrated within overdose prevention strategies. These emerging responses are raising new questions about which technologies to pursue and what service models can respond to the current risks and contexts. In what has been referred to as the epicenter of the overdose crisis in Canada, a multi-technology platform for drug checking is being piloted in community settings using a suite of chemical analytical methods to provide real-time harm reduction. These include infrared absorption, Raman scattering, gas chromatography with mass spectrometry, and antibody-based test strips. In this Perspective, we illustrate some advantages and challenges of using multiple techniques for the analysis of the same sample, and provide an example of a data analysis and visualization platform that can unify the presentation of the results and enable deeper analysis of the results. We also highlight the implementation of a various service models that co-exist in a research setting, with particular emphasis on the way that drug checking technicians and harm reduction workers interact with service users. Finally, we provide a description of the challenges associated with data interpretation and the communication of results to a diverse audience.

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COVID-19 and people who use drugs: a call for action

Cited by 13 publications

References 1 publication

To what extent do supervised drug consumption services incorporate non-injection routes of administration? A systematic scoping review documenting existing facilities

To what extent do supervised drug consumption services incorporate non-injection routes of administration? A systematic scoping review documenting existing facilities

The drug war must end: The right to life, liberty and security of the person during the COVID-19 pandemic for people who use drugs

Implementing an integrated multi‐technology platform for drug checking: Social, scientific, and technological considerations

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