A Community Responds to the COVID-19 Pandemic: a Case Study in Protecting the Health and Human Rights of People Who Use Drugs

Abstract

Effective responses to a global pandemic require local action. In the face of a pandemic or similar emergencies, communities of people who use drugs face risks that result from their ongoing drug use, reduced ability to secure treatment for drug use and correlated maladies, lack of access to preventive hygiene, and the realities of homelessness, street-level policing, and criminal justice involvement. Herein, we document the efforts of a coalition of people who use drugs, advocates, service providers, and academics to implement solutions to reduce these risks at a municipal and state level focusing on New Haven and the State of Connecticut. This coalition identified the communities at risk: active users needing access to harm reduction services, persons in treatment needing access to their medications, the homeless and marginally housed needing improved hygiene, people engaged in sex work, and the incarcerated needing release from custody. The section describing each of the risks demonstrates how the coalition acted preemptively at early stages of the pandemic, ahead of official initiatives, to develop ameliorative risk reduction solutions. Outcomes discussed include instances in which obstacles were overcome or still remain.

The emergence of Urban Community Resilience Initiatives During the COVID-19 Pandemic: An International Exploratory Study

“…The fourth pathway comprises CRIs initiated by a horizontal network of actors resembling adaptive polycentric governance (Adger et al 2009 ; Brunner et al 2005 ). We find multiple examples of horizontal networking among NGOs, CRIs, community members and associations, bundling resources to target multiple vulnerable groups in one or more settlements (see also Michener et al 2020 and Heimer et al 2020 ). Our study findings confirm that networks can deal with a lot of technical and organisational complexity and can increase the scope for community resilience (Brandsen et al 2017 ; Lebel et al 2006 ).…”

“…It enables quick, legitimate and flexible adaptations to emerging situations (Bruner et al 2005;Lebel et al 2006;Varda 2011). Michener et al (2020) and Heimer et al (2020), for instance, report on multiple initiatives in the USA in response to COVID-19, SARS and Aids which arise out of networks.…”

Opioid Overdose–Related Emergency Department Visits and Accidental Deaths during the COVID-19 Pandemic

“…Individuals with substance use disorders, particularly those using opioids, are among vulnerable populations with an increased risk of drug-related harms and death during social distancing regulations [1,12]. The delivery of harm reduction measures is difficult during this unprecedented time-persons who use drugs are more likely to use alone, seek out new sources for drugs as supply chains are disrupted, or use unclean supplies given reduced access to needle and syringe exchange programs [8,9].…”

“…The world became aware of a novel coronavirus disease (COVID-19) in late December 2019, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 presents a heightened threat to human life with its ability to spread efficiently and at a high mortality rate to those with medical comorbidities [1,2]. Within months, the virus had spread rapidly from its origin in China to parts of Europe, namely Italy and the UK, and to the United States (US).…”

COVID-19 and the health of people who use drugs: What is and what could be?

“…The adaptive effects of COVID-19 are potentially adverse – linked to risky substance use or reduced access to services – as well as productive for health – linked to how services and interventions and policies innovate in response. Drug treatment services globally have responded with a range of changes to the provision of OAT in an effort to reduce physical interactions since COVID-19 ( Basu et al, 2020 , Crowley and Delargy, 2020 , Dunlop et al, 2020 , EHRA, 2020 , EMCDDA, 2020b , Heimer et al, 2020 ). Historically, the system for OAT provision in many countries is based on supervised daily dosing of methadone and buprenorphine treatment, with the exception of buprenorphine treatment in the United States and France ( Dunlop, et al, 2020 ).…”