p.14 4.5. Substance Misuse
People who use drugs or have alcohol dependency face specific challenges during COVID-19. The use of drugs and alcohol can lead to health complications, such as a reduced lung capacity and a weakened immune system, making them more vulnerable to the virus. In addition, the mode for consuming drugs can increase their risk of infection, due to sharing or reduced availability of equipment. Other social factors, such as homelessness, can also be a risk factor. Beyond that, COVID-19 has impacted on the delivery of services for people who use drugs or have alcohol dependency, including those in recovery.

The Department of Health is working with the HSE and drug and alcohol task forces to ensure that services and supports continue to be provided for those with problem drug and alcohol use. Task forces have been asked to prioritise the continuity of services and supports to vulnerable groups and individuals in their areas during the pandemic. HSE community-based drug and alcohol services continue to operate on an outreach basis. Services are also provided via telephone and video platforms.

The Department of Health and the HSE have produced a number of harm reduction posters for people who use drugs, people with alcohol-related problems, and people at risk of overdose. The HSE drugs website, drugs.ie, is regularly updated with guidance on addiction issues.

The HSE has prioritised access to and delivery of Opioid Substitution Services and to ensure everybody waiting commenced appropriate treatment. Guidance has been developed for services working with people who use drugs on:
• the commencement and maintenance of treatment and on the safe supply of medicines during COVID-19. This includes the delivery of opioid substitution treatment (OST) to individuals who were in self-isolation or cocooning,
• the provision of OST to inpatients in the Acute Hospital sector, and
• overdose prevention, Naloxone and needle exchange during COVID-19.

In April 2020 there were an additional 514 people in receipt of OST compared with January 2020. Separately, the HSE has put in place measures to maximise access to OST for homeless people who use drugs. Over 70 new homeless clients have signed up for treatment. For new and existing clients, special arrangements are being put in place to ensure continuity of supply during the crisis.

The Department of Health is undertaking a rapid assessment of the impact of COVID-19 on people who use drugs and on the provision of drug and alcohol services. The assessment will be presented to the national oversight committee for the National Drugs Strategy.