Developing a digital health strategy for people who use drugs: Lessons from COVID-19

Abstract

COVID-19 has significantly exacerbated negative health and social outcomes for people who use drugs (PWUD) around the world. The closure of harm reduction services, ongoing barriers to employment and housing, and pre-existing physical and mental health conditions have increased harms for diverse communities of PWUD. Adapting current models of health and human service delivery to better meet the needs of PWUD is essential in minimizing not only COVID-19 but also drug-related morbidity and mortality. This article draws on research, practice, and advocacy experiences, and discusses the potential for digital health tools such as remote monitoring and telecare to improve the continuum of care for PWUD. We call for a digital health strategy for PWUD and provide recommendations for future program development and implementation.

The impact of the novel coronavirus disease (COVID-19) pandemic on drug overdose-related deaths in the United States and Canada: a systematic review of observational studies and analysis of public health surveillance data

“…phone calls, video calls) or technological innovations (e.g. smart phone applications) can be drawn upon when using drugs alone, an intervention where substances are consumed under observation and emergency services are alerted in the event of unresponsiveness [ 38 , 39 ]. Wider availability of naloxone is similarly imperative in the current context, which has been shown to increase drug overdose emergency visits and decrease drug overdose deaths [ 40 ].…”

Increased COVID-19 infection risk, COVID-19 vaccine inaccessibility, and unacceptability: Worrisome trio for patients with substance abuse disorders

“…Access to technology at addiction care centers, or temporary housing in hotels can be an incentive for overdosing individuals to get vaccinated. In absence of direct care from physicians, digital applications are being used to track vaccine signups, withdrawal symptoms and extend therapy through videocalls, as in British Columbia [ 17 ]. However, implementation of digital strategies is difficult in developing countries where drug abusers often do not have access to Wi-Fi.…”

COVID-19 and the opportunity for gender-responsive virtual and remote substance use treatment and harm reduction services

“…Despite the contribution to increased opioid-related morbidity and mortality across North America ( Centre for Disease Control and Prevention., 2021 ; Government of Canada, 2021 ), COVID-19 has also provided an opportunity to incorporate virtual and remote delivery methods into substance use services, a field that has previously been reluctant to use such practices. In many cases, technology, including telephone, texting, and videoconferencing is now being used for intake and assessment, counselling and treatment, case management, and in Canada and the United States for supervising opioid agonist treatment (OAT) administration, and prescribing safer opioid supply ( Bach, Robinson, Sutherland, & Brar, 2020 ; Bandawar, Narasimha, & Chand, 2018 ; Bertholet et al, 2020 ; Bruneau et al, 2020 ; Patton, Saia, & Stein, 2021 ; Perri, Guta, et al, 2021 ).…”

“…The rapid expansion of virtual and remote services provides an opportunity to reflect on current substance use treatment and harm reduction service delivery (henceforth referred to as substance use services) and adapt them in more inclusive and effective ways. The use of virtual and remote services may mitigate persistent barriers in accessing face-to-face substance use services faced by people who use drugs ( Bach et al, 2020 ; Perri, Guta, et al, 2021 ). For example, virtual OAT services during COVID-19 have improved access by reducing wait times and increasing the efficiency of service delivery ( Crowley & Delargy, 2020 ; Patton et al, 2021 ).…”