COVID‐19 vulnerability among people who use drugs: recommendations for global public health programmes and policies

Holloway, Ian W.; Spaulding, Anne C.; Miyashita, Ayako; Randall, Laura; King, Adrian R.; Frew, Paula M.

doi:10.1002/jia2.25551

Cited by 16 publications

(18 citation statements)

References 12 publications

(11 reference statements)

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“…Similar to NSP, outreach and home delivery have been recommended for OST in a pandemic-type situation [ 15 , 25 ]. Flexibility for services to relax supervision and increase take home doses has also been suggested [ 8 , 12 , 13 , 15 , 21 ].…”

Section: Resultsmentioning

confidence: 99%

“…Much of the evidence makes recommendations around telehealth [ 14 , 25 , 32 , 33 ] as well as describing other technology that HR services could utilize, including smartphone and web-based interventions, text messaging for continuing contact and care, machine learning and wearable devices, including digital phenotyping and ecological momentary assessment, biofeedback and virtual reality [ 34 , 35 ]. Lead time and availability of technology (for both services and clients) will limit implementation of these options in the short term with text-messaging, smartphone and web-based interventions being the most simple and quick to roll-out.…”

Section: Resultsmentioning

confidence: 99%

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Rapid evidence review of harm reduction interventions and messaging for people who inject drugs during pandemic events: implications for the ongoing COVID-19 response

et al. 2020

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Background People who inject drugs are at increased health risk in a pandemic due to their greater susceptibility to severe disease and as a consequence of the restrictions put in place to halt the spread of infection. Harm reduction (HR) services, which aim to reduce the negative effects of drug use on health, are likely to be diminished in a pandemic. However, innovative HR interventions and messaging may also develop in response to such a crisis. It is vital to understand the most effective ways to deliver HR in pandemic situations so that guidance can be provided for current and future disruptions to service provision. Methods A rapid evidence review was conducted with the aim of exploring what HR interventions and messaging are most effective during a pandemic-type situation. Ten health databases were systematically searched using terms relevant to the research aim. A search was also made of grey literature, including a targeted search of HR messaging from key national and service provider websites. Results In the initial search, 121 pieces of evidence were identified which, after screening and de-duplication, resulted in 60 for inclusion. The included evidence consists mainly of non-peer reviewed, pre-publication or expert opinion pieces. The rapid findings suggest that HR services should be deemed essential during a pandemic, with staff supported to work safely and social distancing adaptations implemented. Services should be encouraged to operate more flexibly; for instance, in deciding the amounts of take-home supplies of injecting equipment and medications. The evidence on HR communication was very limited but key messages on infection control, uncertain drug supply and accessing services were identified. Conclusions This rapid evidence review identifies implications for national policy makers, commissioners and HR service providers. A person-centred rather than disease-centred approach to HR delivered by collaborating partners, as well as prioritizing tailored HR messaging, is recommended. Further research evaluating the delivery of HR services and messaging, particularly focusing on health inequalities, is urgently needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Rapid evidence review of harm reduction interventions and messaging for people who inject drugs during pandemic events: implications for the ongoing COVID-19 response

et al. 2020

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“…A concurrent concern for PWOUD is the heightened risk of COVID-19 transmission and adverse impacts of COVID-19 infection (15,16). PWOUD are more likely to have coexisting health conditions including immunosuppression, making them vulnerable to COVID-19 infection (12).…”

Section: Resultsmentioning

confidence: 99%

“…Though many sources outline measures to decrease risk of COVID-19 transmission while in treatment centres (17)(18)(19), outside of care settings PWOUD often face di culties complying with COVID-19 public health messaging (2,16). Physical distancing is especially di cult if under-housed, incarcerated, living in recovery houses, or shelters; facilities that may also have inadequate access to hand hygiene supplies and masks (15).…”

Section: Resultsmentioning

confidence: 99%

“…For instance, the Emergency Strategic Clinical Network built referral pathways between s emergency departments and addiction treatment clinics prior to the pandemic (35). At a provincial level, systems can embrace harm reduction and contextually tailored care with decriminalization of people who use substances (15,36) and clinical guidelines for safe supply (25) that systemically addresses stigma. Collaboration across systems to link patients with individualized health care and social supports is also needed (37).…”

Section: Discussion: Outcomes Of Covid-19 Disruptionsmentioning

confidence: 99%

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Opioid Use Disorder Treatment Disruptions during the COVID-19 Pandemic and Other Disasters: A Scoping Review Addressing Dual Public Health Emergencies

Henderson

McInnes

Mackey

et al. 2021

Preprint

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Background: During public health emergencies, disruptions to social landscapes and amplification of inequities for people with opioid use disorder raise important questions about reducing harms and providing treatment accountability to support this population during disasters including COVID-19. This research aims to a) identify how disasters impact persons with opioid use disorder (OUD) and their access to healthcare, with specific attention to COVID-19, and b) inform ongoing responses to the pandemic and future disaster-mitigation plans related to healthcare disruptions affecting persons with opioid use disorder (PWOUD). Methods: We conducted knowledge synthesis based on a 6-stage scoping review framework methodology. Stakeholder consultation was completed using a Nominal Group Technique with two groups, each composed of including providers in primary, emergency and community-based care. One group (n=7) represented voices from urban services, and the other (n=4) Indigenous contexts allowing for attention to healing the whole person, beyond OAT. Results: 61 scientific journal articles and 72 grey literature resources were included after full-text screening. Stakeholder NGT process revealed three contextual factors affecting system and service accountability for responsive OUD care during disaster-driven disruptions: (1) disasters focus attention on single risks and generalized solutions; (2) data-poor decision-making perpetuates stigma and produces policy inattentive to social determinants of health; and (3) harm reduction and contextually-tailored care prepare a system for future disasters. Conclusion: COVID-19 public health efforts require a coordinated systemic approach to serving PWOUD, based on accountability to patients and support for providers.

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Impact of SARS-CoV-2/COVID-19 on HIV-1-associated neurocognitive disorders

Dutta,

Liu,

Xiong

2024

HIV-Associated Neurocognitive Disorders

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COVID‐19 vulnerability among people who use drugs: recommendations for global public health programmes and policies

Cited by 16 publications

References 12 publications

Rapid evidence review of harm reduction interventions and messaging for people who inject drugs during pandemic events: implications for the ongoing COVID-19 response

Rapid evidence review of harm reduction interventions and messaging for people who inject drugs during pandemic events: implications for the ongoing COVID-19 response

Opioid Use Disorder Treatment Disruptions during the COVID-19 Pandemic and Other Disasters: A Scoping Review Addressing Dual Public Health Emergencies

Impact of SARS-CoV-2/COVID-19 on HIV-1-associated neurocognitive disorders

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