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Galvin, Brian (2020) Impact of Covid-19. Drugnet Ireland, Issue 73, Spring 2020, pp. 1-3.

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Covid-19 pandemic presents particular challenges for people who are using drugs and for those providing services to vulnerable populations. Social distancing requirements are hampering effective operation of services and many treatment centres are temporarily closed. Many national and international organisations have highlighted the additional dangers faced by users of drugs services and have produced guidelines for drug treatment and harm reduction practitioners.

Services have recognised that they have to adapt frontline services very quickly to prioritise and support the public health response to Covid-19. Tony Duffin, CEO of Ana Liffey Drug Project, which provides low threshold harm reduction support in Dublin and Limerick, explains:

We closed our drop-in services and stopped all group work as we could not maintain a safe physical distance for clients and staff. We focussed our efforts on working on outreach in the streets explaining Covid-19, providing our Needle & Syringe Programme and explaining how to stay safe on both counts. In the very early days of the Covid-19 crisis many of the people we met on outreach simply did not know about Covid-19, i.e. no knowledge of the latest advice, what the restrictions were or how the service provision landscape had changed. Our team spent a lot of time explaining the situation, supporting people around their fears & frustrations and getting them linked into treatment and housing options.1

The Health Service Executive (HSE) has published guidelines for general practitioners and pharmacies providing services in regard to people who are at greater risk at this time.2 These include those who have not yet commenced opiate substitution treatment; those who are homeless or in insecure accommodation; those at risk of overdose having acquired a greater than usual amount of drugs; or those who are using drugs alone. There are also increased risks from polydrug use, including alcohol and non-prescription medications, and practitioners have particular concerns in regard to failures to attend a prescriber or pharmacy as planned.

The HSE guidelines suggest how the assessment process for potential opiate substitution treatment clients can be shortened and how assessments, clinical reviews, and prescription management can if necessary be undertaken remotely. Assistance for those who present with benzodiazepine or alcohol withdrawal symptoms is also covered. The guidelines also provide advice on what factors should be considered when doctors are making choices about medication and administration of naloxone, a drug that reverses the effects of opioid overdose. Merchants Quay Ireland, which manages low threshold services, are running brief sessions in its Dublin city centre premises, providing instructions on how to administer naloxone.

It will be some time before the full impact of the global pandemic on people who use drugs will be fully known. It is important that we create a detailed picture of the changes in patterns of drug use and an understanding of how people are managing with reduced services. This population will have had to face a very distressing situation and threats to their physical and mental health. Our understanding of this will help to ensure that this population receives the attention it needs when preventive measures, such as vaccination programmes, are being put in place to avoid a recurrence of the Covid-19 catastrophe.

1. The Amsterdam-based Correlation network has compiled accounts from harm reduction services in many parts of Europe, including one provided by the Ana Liffey Drug Project. Available online at: https://www.correlation-net.org/sharing-experiences/

2. Health Service Executive (2020) Guidance on contingency planning for people who use drugs and COVID-19. Dublin: Health Service Executive. https://www.drugsandalcohol.ie/31804/

Item Type
Article
Publication Type
Irish-related, Open Access, Article
Drug Type
All substances
Issue Title
Issue 73, Spring 2020
Date
May 2020
Page Range
pp. 1-3
Publisher
Health Research Board
Volume
Issue 73, Spring 2020
EndNote

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