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Harm reduction service delivery to people who use drugs during a public health emergency: Examples from the COVID-19 pandemic in selected countries.

Graham Shaw. EHRA: Vilnius, Lithuania. 

Eurasian Harm Reduction Association (2020).

http://fileserver.idpc.net/library/Harm-reduction-service-delivery-to-people-who-use-drugs-during-a-public-health-emergency.pdf

With crisis comes opportunity: Unanticipated benefits resulting from pivots to take-home naloxone (THN) programs during the COVID-19 pandemic. 

Courser MW, Raffle H. 

J Subst Abuse Treat. 2020 Dec 4:108220. doi: 10.1016/j.jsat.2020.108220. Epub ahead of print. PMID: 33309390.

https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(20)30477-3/fulltext

Considering the harms of our habits: The reflexive urine drug screen in opioid use disorder treatment. 

Khatri UG, Aronowitz SV. 

J Subst Abuse Treat. 2020 Dec 20:108258. doi: 10.1016/j.jsat.2020.108258. Epub ahead of print. PMID: 33358617.

Abstract

https://pubmed.ncbi.nlm.nih.gov/33358617/

COVID-19 in marginalised groups: challenges, actions and voices

NLO – Nobody left outside, NLO briefing paper, August 2020

https://mcusercontent.com/719c55c8a2c9fe8b230503cb1/files/71deace5-2af6-42d7-ba1a-df04317d5c8c/briefing_paper_NLO_COVID_19.pdf

VOICES OF FRONTLINE WORKERS: HARM REDUCTION RESPONSES IN THE EUROPEAN REGION DURING THE COVID-19 PANDEMIC 

(European Harm Reduction Network, Correlation (Niederlande), 2020)

https://www.correlation-net.org/wp-content/uploads/2020/10/briefing-paper_Covid-report_final.pdf

Opportunities to Offer Harm Reduction to People who Inject Drugs During Infectious Disease Encounters: Narrative Review. 

Peckham AM, Young EH. 

Open Forum Infect Dis. 2020 Oct 20;7(11):ofaa503. doi: 10.1093/ofid/ofaa503. PMID: 33241069; PMCID: PMC7676504.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676504/

A Supplemental Report on British Columbia’s Unregulated Drug Supply Amidst Dual Public Health Emergencies: Results from British Columbia’s Community Drug Checking Service, January 2020 – October 2020.

Long V, Tobias S, Lysyshyn M, Sage C, Bridgeman J, Herman D, Custance A, Patel P, Matthews J, Pearce H, Ti L.  

Vancouver: BC Centre on Substance Use. 2020.

https://drugcheckingbc.ca/wp-content/uploads/sites/2/2020/12/BCCSU_BCs_DC_Supplemental_Report.pdf

The impact of COVID-19 restrictions on needle and syringe programme provision and coverage in England. 

Whitfield M, Reed H, Webster J, Hope V. 

Int J Drug Policy. 2020 Sep;83:102851. doi: 10.1016/j.drugpo.2020.102851. Epub 2020 Jul 15. PMID: 32736959; PMCID: PMC7362866.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362866/

Syringe services program (SSP) operational changes during the COVID-19 global outbreak. 

Bartholomew TS, Nakamura N, Metsch LR, Tookes HE. 

Int J Drug Policy. 2020 Sep;83:102821. doi: 10.1016/j.drugpo.2020.102821. Epub 2020 Jun 12. PMID: 32591222; PMCID: PMC7290194.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290194/

Challenges of providing COVID-19 prevention services to homeless people who use drugs in Iran. 

Deilamizade A, Moghanibashi-Mansourieh A. Int J Drug Policy. 2020 Sep;83:102806. doi: 10.1016/j.drugpo.2020.102806. Epub 2020 Jun 3. PMID: 32513622; PMCID: PMC7266750.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266750/

The impact of COVID-19 on harm reduction in seven Asian countries 

Understanding the impact of COVID-19 on harm reduction funding and service provision is essential for informing donor and government action as well as civil society advocacy. This report compiles evidence from civil society in seven Asian countries (Cambodia, India, Indonesia, Nepal, Thailand, the Philippines and Vietnam) between January and July 2020. 

HARM REDUCTION INTERNATIONAL, November 2020

http://fileserver.idpc.net/library/HRI-COVID-Report.pdf

Webinar. What can we learn from the COVID-19 pandemic? COVID-19 and the impact on harm reduction in Europe

Since the beginning of 2020, European countries have experienced an unprecedented public health threat with the emergence of COVID-19. In response to the pandemic European countries have implemented a variety of virus containment strategies along with various service closures and reductions. People who use drugs are particularly susceptible to the changes wrought by this pandemic. Border closures cause major disruptions to drug supply chains and vital harm reduction services face potential closures and shortages of sterile supplies. PWUD can face additional risks of COVID-19 due to crowded living situations and unstable housing, sharing of drug equipment in addition to stigma and marginalization preventing health-seeking behaviors. In addition, PWUD in Europe often have underlying chronic medical conditions, such as Hepatitis C, placing them at further risk of severe respiratory illness should they fall ill with COVID-19.

In this session, we will discuss the lessons learnt and the way forward from a diversity of perspectives.

European Harm Reduction Session WHO, EMCDDA, EuroNPud u.a. (01:58:47)

https://vimeo.com/477097376

Brasilien. Community-led advocacy (un)interrupted in Brazil
In Brazil, the efforts of the É de Lei Community Centre to promote humane drug policy and harm reduction have been seriously disrupted by the COVID-19 pandemic. Amidst severe health crises and worsening police violence, however, this work has become more important than ever. With this in mind, É de Lei has persevered, online and off-line. (IDPC, International Drug Policy Consortium, UK, 01.12.2020)

https://us7.campaign-archive.com/home/?u=863f370d75cf43192379283b8&id=4e075f1cd5

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

Wilkinson, R., Hines, L., Holland, A. et al. 

Harm Reduct J 17, 95 (2020). doi.org/10.1186/s12954-020-00445-5

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00445-5

INPUD. Peers in the Pandemic (9 November - 11 December, 2020)

COVID-19 has exposed the failure of our health systems to adequately provide the services and care people need. As is too often the case in times of crisis, people who use drugs have been particularly at risk as harm reduction services have been closed, defunded or made inaccessible in a pandemic environment. This has been particularly troublesome on peer-led programmes as lockdown measures have increased the threat of criminalisation.

Despite these barriers people who use drugs have looked after each other during the pandemic, providing essential care and services to meet the needs of communities where the state is absent. Advocacy by peer-led groups has resulted in some states adopting harm reduction policies championed by the community for decades. As we continue to navigate the realities of a COVID-19 environment, it is imperative that these reforms are maintained and expanded during the remainder of the pandemic and beyond. (INPUD, 16.11.2020)

https://www.inpud.net/en/peersinthepandemic

Irland. Needle exchange provision during Covid-19 pandemic 

The current national drugs strategy aims to reduce harms arising from substance misuse and to reduce the prevalence of blood-borne viruses among people who inject drugs (PWID) through the expansion of needle exchange. In Ireland, this service is delivered in a number of ways, including fixed-site locations, such as clinics or community pharmacies, and novel interventions, such as Backpacking Outreach programmes. (Drugnet Ireland, Issue 75, Autumn 2020)

https://hrb.newsweaver.ie/drugnet/43ov1qao8l1?lang=en

Harm reduction in the time of COVID-19: Case study of homelessness and drug use in Dublin, Ireland

AustinO'Carroll, TonyDuffin, JohnCollins,

International Journal of Drug Policy, Volume 87, January 2021, doi.org/10.1016/j.drugpo.2020.102966

https://www.sciencedirect.com/science/article/pii/S0955395920303042

Kanada. Preliminary patterns in circumstances surrounding opioid-related deaths in Ontario during the COVID-19 pandemic

Opioid-related deaths across Canada have been an ongoing public health crisis for over a decade. Between January and March 2020 alone, there were 1,018 opioid-related deaths recorded in Canada, the majority of which were accidental. In the midst of this ongoing crisis, a state of emergency was declared on March 17, 2020 due to the COVID-19 pandemic. Within Ontario, the first wave of the pandemic was managed with public health restrictions to mitigate the spread of COVID-19, which included physical distancing measures that resulted in reduced capacity for pharmacies, outpatient clinics, and harm reduction sites providing care to people who use drugs. Despite the intention to reduce the impact of COVID-19, there is concern that these measures could lead to unintended harms. (ODPRN – Ontario Drug Policy Research Network, Kanada, November 2020)

https://odprn.ca/research/publications/preliminary-patterns-in-circumstances-surrounding-opioid-related-deaths-in-ontario-during-the-covid-19-pandemic/

Caring for COVID's most vulnerable victims: a safety-net hospital responds. 

Tomanovich MM, Ruiz-Mercado G, Barocas JA. 

Res Sq [Preprint]. 2020 Oct 26:rs.3.rs-97328. doi: 10.21203/rs.3.rs-97328/v1. PMID: 33140040; PMCID: PMC7605557.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605557/

The impact of the COVID-19 pandemic on harm reduction services in Spain. 

Picchio, C.A., Valencia, J., Doran, J. et al. 

Harm Reduct J 17, 87 (2020). doi.org/10.1186/s12954-020-00432-w

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00432-w

Kanada. Alcohol harm reduction is saving lives during COVID-19

When Canada and many other countries starting locking down in March, people were advised to stay home and physically distance. But what does that look like when you don’t have a home and are dependent on alcohol? What if you lose your sources of income like panhandling or collecting bottles to earn money, the drop-in centre you frequent closes, or the local liquor store no longer accepts cash?  

“COVID-19 has exposed a lot of gaps in our society, especially for people experiencing homelessness and/or housing instability, including those with severe alcohol dependence,” says Bernie Pauly, a scientist with the Canadian Institute for Substance Use Research and Nursing professor at the University of Victoria. “While these barriers existed pre-COVID-19, loss of services during COVID 19 has resulted in an increase in alcohol-related harms.” (University of Victoria, Kanada, 06.11.2020)

https://www.uvic.ca/news/topics/2020+covid-managed-alcohol-programs+news

"I have to be around people that are doing what I'm doing": The importance of expanding the peer recovery coach role in treatment of opioid use disorder in the face of COVID-19 health disparities.

Kleinman MB, Felton JW, Johnson A, Magidson JF.

J Subst Abuse Treat. 2020 Oct 21:108182. doi: 10.1016/j.jsat.2020.108182. Epub ahead of print. PMID: 33160763; PMCID: PMC7577312.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577312/

Coordination, cooperation, and creativity within harm reduction networks in Iran: COVID-19 prevention and control among people who use drugs. 

Alavi M, Moghanibashi-Mansourieh A, Radfar SR, Alizadeh S, Bahramabadian F, Esmizade S, Dore GJ, Sedeh FB, Deilamizade A. 

Int J Drug Policy. 2020 Aug 17:102908. doi: 10.1016/j.drugpo.2020.102908. Epub ahead of print. PMID: 32819776; PMCID: PMC7430297.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430297/

Integrating harm reduction and clinical care: Lessons from Covid-19 respite and recuperation facilities. 

Kimmel SD, Bazzi AR, Barocas JA. 

J Subst Abuse Treat. 2020 Nov;118:108103. doi: 10.1016/j.jsat.2020.108103. Epub 2020 Aug 12. PMID: 32972644; PMCID: PMC7419278.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419278/

Substance use and related harms in the context of COVID-19: Aa conceptual model. 

Enns A, Pinto A, Venugopal J, Grywacheski V, Gheorghe M, Kakkar T, Farmanara N, Deb B, Noon A, Orpana H. 

Health Promot Chronic Dis Prev Can. 2020 Sep 16;40(11-12). English, French. doi: 10.24095/hpcdp.40.11/12.03. Epub ahead of print. PMID: 32936071.

https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-40-no-11-12-2020/substance-use-related-harms-covid-19-conceptual-model.html

USA. NY Harm Reductionists Face Pandemic Shortage of Syringes and Other Supplies

The COVID-19 crisis has taken so much away from people who use drugs in New York. An historic number of lives have been lost to skyrocketing, preventable fatal overdoses; New York City subways, one of the few warm spaces to ride out the cold weather while maintaining social distancing, now ban rough sleepers; more barriers have emerged to already-inaccessible addiction medications.

Across the state, access to safer use supplies and harm reduction organizations—especially those outside of New York City—is at risk of joining the list. (Filter, USA, 20.10.2020)

https://filtermag.org/new-york-harm-reduction-syringe-shortage/

Schweiz. Coronavirus: Bundesrat passt Kriterien zur Abgabe von medizinischem Heroin an 

Bern, 25.09.2020 - Der Bundesrat hat an seiner Sitzung vom 25. September 2020 beschlossen, Artikel 13 der Betäubungsmittelsuchtverordnung (BetmSV) zu ändern. Zur Minimierung der Risiken einer Infektion mit COVID-19 können Patientinnen und Patienten aufgrund strikter Kriterien bis zu sieben Tagesdosen medizinischen Heroins mitgegeben werden. Diese Änderung bleibt bis zum 31. Dezember 2021 in Kraft. (Schweizerische Eidgenossenschaft, Der Bundesrat, 25.09.2020)

https://www.admin.ch/gov/de/start/dokumentation/medienmitteilungen.msg-id-80511.html

UK. NSPdirect: postal equipment supply

NSPdirect is a great new way for UK drug services to deliver an online postal needle exchange service to their clients via the Exchange Supplies webshop.

Designed to work alongside traditional needle and syringe exchange channels, NSPdirect offers commissioners and drug services the means to enable people who inject drugs in their area to directly access equipment via a postal needle and syringe service, online, setting up an account with a voucher code. (NSPdirect, UK, September 2020)

https://www.exchangesupplies.org/shopdisp_nspdirect.php

Schweiz. Wegen Corona: Heroinabhängige können sieben Dosen aufs Mal mitnehmen

Der Bundesrat lockert wegen der Pandemie die Bestimmungen des Betäubungsmittelgesetzes. Schwerstsüchtige erhalten die Wochendosis nun auf ein Mal und müssen nicht mehr täglich vorsprechen. (Luzerner Zeitung, Schweiz, 25.09.2020

https://www.luzernerzeitung.ch/news-service/inland-schweiz/wegen-corona-heroinabhaengige-koennen-sieben-dosen-aufs-mal-mitnehmen-ld.1261095

Kanada. B.C. moves to dramatically increase access to safe alternatives to illicit drugs

(…) “We know the pandemic has only made the street drug supply in B.C. more toxic than ever, putting people who use drugs at extremely high risk for overdose,” Dr. Henry said in a statement. “Giving physicians and nurse practitioners the ability to prescribe safer pharmaceutical alternatives has been critical to saving lives and linking more people to treatment and other health and social services.” (The Globe and Mail, Kanada, 17.09.2020)

https://www.theglobeandmail.com/canada/british-columbia/article-bc-moves-to-dramatically-increase-access-to-safe-alternatives-to/