Put People First: Adapting Substance Use Policies and Programs in the Context of COVID-19
As COVID-19 spreads, we must take precautions so our communities can stay safe
The general recommendations are to distance ourselves or self-quarantine to help prevent the spread, but this presents particular obstacles for people who use drugs and people with substance use disorders.
As we respond to these hurdles, we cannot afford to reverse the advances we have made in addressing addiction and providing services. During this pandemic, we must continue our efforts to protect our gains and push for more progress.
This population is particularly vulnerable to COVID-19
The virus attacks the lungs, making those who smoke and vape or use opioids or methamphetamine more susceptible. Additionally, the in-person nature of opioid addiction treatment and supports like recovery groups make it difficult to practice physical distancing.
People with substance use disorders experience homelessness at greater rates, which make them more likely to be in crowded environments with limited access to soap, water, and other means of protection. Crisis situations can worsen underlying health conditions like substance use and make it harder to maintain recovery.
The criminalization of substance use means more people are crowded into jails or prisons, where inmates are at greater risk of the virus due to close-quarter conditions, lack of hygiene supplies and limited access to health care.
Lastly, due to the shame, stigma and discrimination associated with substance use, it is difficult for people to seek help. Once providers and recovery organizations are at capacity because of COVID-19, that discrimination could make it harder for people to get treatment when needed.
Harm reduction services—non-punitive supports that reduce the negative consequences associated with using drugs—are also harder to access because of COVID-19, leaving people at more risk of death. Syringe exchanges or naloxone distribution, for example, become potential sites of exposure. Isolation also disrupts a major tenant of harm reduction: If you’re going to use drugs, use with friends, don’t use alone.
Harm reductionists are finding new ways to offer their services
While many organizations have closed their drop-in centers, they continue to do mobile deliveries, set up FaceTime options and use outdoor meeting points. And it’s vital that they do: without harm reduction services in the community, we could see a spike in overdoses. The Harm Reduction Coalition has a guide for safer drug use and a guide for harm reduction operations.
The situation is also forcing other types of programs to adapt. 12-Step groups are pivoting to phone calls instead of in-person meetings. Other groups are hosting meetings through Zoom or community forums. Some people in recovery are starting their own informal groups through Facebook.
Federal agencies are also stepping up: the Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) are allowing providers to start prescribing buprenorphine over the phone instead of requiring audio-visual telehealth appointments.
These are all great strides forward, but we need more adaptation to ensure people with substance use disorders get the services they need as COVID-19 tears through our communities.
Advocating for these policy changes is a good start
Expand telehealth for substance use disorders
Ensure recovery community organizations can access funds to provide peer based recovery services virtually.
Improve access to prescription drugs
Make sure that people are able to safely access prescription drugs that normally require multiple, in-person visits.
Expand mental health and substance use disorders services
Increase funding for comprehensive and crisis services, including services tailored for young people and pregnant individuals.
Support recovery housing
States should provide funding to support a full range of recovery housing for people with substance use disorders and to keep the facilities open even if residents can’t afford to pay rent.
In these uncertain times, we must create policies that keep everyone healthy and safe: whether it’s opening up new lines of funding or expanding on existing programs, it is imperative that we continue to advocate and push for modified treatment and services—lives are at stake. We have the opportunity to come out of this better. We cannot squander it.