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

Grebely, Jason; Cerdá, Magdalena; Rhodes, Tim

doi:10.1016/j.drugpo.2020.102958

Cited by 77 publications

(93 citation statements)

References 125 publications

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“…On the other hand, concomitant antiretroviral therapy-(ART) non-adherence and decreased confidence in attending HIV follow-up visits have also been reported to be growing [21]. Rising evidence is also corroborating the potential surge in opioid overdose among PWID and decrease in bystander rescue during the pandemic [21][22][23] which can also potentially be due to medication unavailability. This pool of dynamics, coupled with the closure of substance abuse clinics and the reallocation of services to support COVID-19 efforts, could result in deleterious effects on HIV prevention efforts and HIV transmission [21].…”

Section: Discussionmentioning

confidence: 96%

The Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals

et al. 2021

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The COVID-19 pandemic has necessitated restrictive orders and programmatic changes that may be associated with disruptions in services, including those for opioid-dependent people who inject drugs (PWID). This study aims to assess the impact of COVID-19 pandemic on access to and utilization of various HIV prevention services among PWID with opioid use disorder (OUD). We interviewed 110 PWID enrolled in medication for opioid use disorder (MOUD) treatment (e.g., methadone) between May and October, 2020 to identify if this sample experienced changed in access to the following services due to the COVID-19 pandemic: (a) HIV or sexually transmitted infection (STI) testing, (b) pre-exposure prophylaxis (PrEP) services, (c) HIV counselor or doctor appointments, and (d) clean injection equipment. A majority of the sample reported that COVID-19 had not changed their access to HIV testing or access to STI testing. Almost half of the sample reported that getting an appointment with a doctor decreased due to COVID-19. Participants reported that access to a lab or blood testing, access to injection equipment, and sessions with a case manager or counselor decreased. One-fourth of the 32 participants who were taking PrEP before the onset of COVID-19 reported that they had trouble getting their PrEP prescription due to COVID-19, and some reported that they had difficulty getting the PrEP prescription filled at their pharmacy. Our results indicate that PWID did not experience reduced access to HIV or STI testing, but difficulties in obtaining appointments with HIV counselors or doctors and limited access to PrEP were presented. Innovative strategies are needed to reduce the adverse effects of COVID-19 on HIV prevention among PWID.

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Section: Discussionmentioning

confidence: 96%

The Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals

et al. 2021

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“…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 36,38 . Indeed, the pandemic has prompted rapid policy responses such as access to safer supply raising questions of how to sustain such momentum to pursue this “new normalcy” for people who use drugs 39 …”

Section: Introductionmentioning

confidence: 99%

“…36,38 Indeed, the pandemic has prompted rapid policy responses such as access to safer supply raising questions of how to sustain such momentum to pursue this "new normalcy" for people who use drugs. 39 This perspective presents a pilot project utilizing a multitechnology platform utilizing a suite of instruments for pointof-contact drug checking as a harm reduction service integrated within community sites. The Vancouver Island Drug Checking Service operates as part of a program of research led by investigators at the University of Victoria, Canada, that provides community drug checking within the context of a declared public health emergency as overdose rates exceeded 30 deaths per 100,000.…”

mentioning

confidence: 99%

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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“…Though these restrictive orders were intended to slow the spread of the COVID-19, and indeed they have shown considerable reduction of new infections in Malaysia, there is a concern that for people who use drugs (PWUDs), including those with substance use disorders (SUDs), the various types of measures to control or restrict peoples' movement, distancing or limiting social contacts, or restricting access to various social and healthcare facilities may have created particularly challenging hindrances to receiving social support or accessing healthcare and other supportive services (4)(5)(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Impact on Healthcare and Supportive Services for People Who Use Drugs (PWUDs) in Malaysia

et al. 2021

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Background: Restrictive orders and temporary programmatic or ad hoc changes within healthcare and other supportive systems that were implemented in response to the COVID-19 epidemic in Malaysia may have created hindrances to accessing healthcare and/or receiving other supportive services for people who use drugs (PWUDs).Design: A primarily qualitative study has been conducted to evaluate how service providers and recipients were adapting and coping during the initial periods of the COVID-19 response.Settings: The study engaged several healthcare and non-governmental organizations (NGOs) in the peninsular states of Penang, Kelantan, Selangor, and Melaka.Participants: Medical personnel of methadone maintenance treatment (MMT) programs (n = 2) and HIV clinics (n = 3), staff of NGO services (n = 4), and MMT patients (n = 9) were interviewed using a semi-structured format.Results: Interviewed participants reported significant organizational, programmatic, and treatment protocols related changes implemented within the healthcare and support services in addition to nationally imposed Movement Control Orders (MCOs). Changes aimed to reduce patient flow and concentration at the on-site services locations, including less frequent in-person visits, increased use of telemedicine resources, and greater reliance on telecommunication methods to maintain contacts with patients and clients; changes in medication dispensing protocols, including increased take-home doses and relaxed rules for obtaining them, or delivery of medications to patients' homes or locations near their homes were reported by the majority of study participants. No significant rates of COVID-19 infections among PWUDs, including among those with HIV have been reported at the study sites.Conclusions: Although the reported changes presented new challenges for both services providers and recipients and resulted in some degree of initial disruption, generally, all participants reported successful implementation and high levels of compliance with the newly introduced restrictions, regulations, and protocols, resulting in relatively low rates of treatment disruption or discontinuation at the study sites.

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

Cited by 77 publications

References 125 publications

The Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals

The Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals

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

COVID-19 Impact on Healthcare and Supportive Services for People Who Use Drugs (PWUDs) in Malaysia

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