An urgent impetus for action: safe inhalation interventions to reduce COVID-19 transmission and fatality risk among people who smoke crack cocaine in the United Kingdom

Harris, Magdalena

doi:10.1016/j.drugpo.2020.102829

Cited by 34 publications

(38 citation statements)

References 27 publications

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“…Stimulants (cocaine, crack) might increase the vulnerability to COVID-19 through cardio-vascular effects and greater inflammation of, and damage to, lung tissue ( Marsden et al, 2020 ). Safe inhalations interventions seem required to limit the spreading fo the SARS-CoV2 among marginalized individuals who smoke crack cocaine ( Harris, 2020 ). After lockdown, increase of use is likely, due to increased accessibility.…”

Section: Results and Observationsmentioning

confidence: 99%

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Mallet

Dubertret

Strat

2021

Progress in Neuro-Psychopharmacology and Biological Psychiatry

127

116

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Background In the context of the COVID-19 worldwide pandemic, an up-to-date review of current challenges in addictions is necessary. While large scale disasters may have an impact on substance use and addictions, the use of some substances is also likely to modify the risk of COVID-19 infection or course. Many countries have imposed lockdowns. Whether this quarantine or the end of lockdown measures will have an impact on substance use is discussed. The aim of this review is to gather knowledge for clinicians and to guide public health policies during/after lockdown. Methods PubMed was reviewed in August 6th (2020), to determine the current evidences and observations concerning the addictions and SARS-CoV2. We used all the names of the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV2 previously 2019 nCoV), the name of the coronavirus disease 2019 (COVID-19), and common substances of abuse. For the physiopathological parts, searches were conducted using key words such as “infection” or “pneumonia”. For the lockdown effects, key words such as “quarantine”, “disaster” or “outbreak” were used. Results Overall, pathophysiological data showed an increased risk of infections for individuals with Substance Use Disorders (SUD) and a possible protective role of nicotine. During lockdown, there is a substantial risk of increasing SUDs. Individuals with opioid use disorder are particularly at risk of relapse or of involuntary withdrawal. After lockdown, increase of use may be observed as far as years after. Individuals with addictions are at higher risk of multimorbidity and mortality during COVID outbreak. Conclusion This review describes useful strategies in clinical practice, including a systematic assessment of addiction comorbidity during this almost worldwide lockdown/pandemic. This review also highlights important areas for future research.

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Section: Results and Observationsmentioning

confidence: 99%

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Mallet

Dubertret

Strat

2021

Progress in Neuro-Psychopharmacology and Biological Psychiatry

127

116

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“…Studies suggest that people who smoke heroin or crack have a high and increasing burden of chronic respiratory symptoms ( Burhan et al, 2019 , Nightingale et al, 2020 ), but may often be undiagnosed, given that spirometry testing is not routine. As highlighted by Harris in this special issue, given the high prevalence of tobacco, heroin, and crack smoking, there is an urgent need to consider harm reduction services for people who smoke drugs in the time of COVID-19 ( Harris, 2020 ). Social isolation and physical distancing measures also have the potential to alter mental health ( Ballivian et al, 2020 , Pfefferbaum and North, 2020 , Sutherland et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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

Grebely

Cerdá

Rhodes

2020

International Journal of Drug Policy

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SARS-CoV-2, the virus that causes COVID-19, has changed the world as we know it, and continues to do so. How COVID-19 affects people who use drugs, the environments in which they live, and capacities of response, warrants immediate attention. This special issue begins to map how COVID-19 is altering the health of people who use drugs, including in relation to patterns of drug use, service responses, harms that may relate to drug use, interventions to reduce risk of harms, COVID-19 health, and drug policies. We emphasise the need to envisage COVID-19 and its effects as a matter of intersecting ‘complex adaptive systems’: that is, the impacts of COVID-19 extend beyond the virus and related illness conditions to encompass multiple social, cultural, economic, policy and political effects; and these affect the health of people who use drugs directly as well as indirectly by altering the risk and enabling environments in which they live. We synthesize emergent evidence on the impact of COVID-19 on the health of people who use drugs. A key concern we identify is how to sustain policy and service delivery improvements prompted by COVID-19. We need to maintain an ethos of emergent adaptation and experimentation towards the creation of safer environments in relation to the health of people who use drugs.

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“…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]. Many people who use drugs have been impacted by sudden closures of their SCS due to their inability to meet public health directives [68,69], while other SCS had to reduce their capacity to meet physical distancing requirements [70].…”

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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An urgent impetus for action: safe inhalation interventions to reduce COVID-19 transmission and fatality risk among people who smoke crack cocaine in the United Kingdom

Cited by 34 publications

References 27 publications

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

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

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

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