COVID-19 Crisis: Resources for Harm Reduction Providers
This page is meant to be a hub of guidelines and resources regarding the COVID-19 ("coronavirus") pandemic directed at those who provide harm reduction services to people who use drugs. We will be updating this page with more relevant links as we become aware of them. Please share, disseminate, and alter the information here as needed to fit the needs of your community.
If you have information which you believe is crucial to share here, especially in multiple languages, please send it to firstname.lastname@example.org.
For harm reduction resources directed at people who use drugs, please visit our other page here.
THE POSITION OF CORRELATION-EUROPEAN HARM REDUCTION NETWORK AND THE EURASIAN HARM REDUCTION ASSOCIATION ON THE CONTINUITY OF HARM REDUCTION SERVICES DURING THE COVID-19 CRISIS
The Correlation European Harm Reduction Network and the Eurasian Harm Reduction Association have released a joint position paper emphasising the importance of continuing harm reduction services during the crisis. The paper contains several key guidelines for service providers and recommendations for governments, and is available in the following languages:
The paper calls on local and national governments and international organisations to introduce the following safety measures:
1. Ensure the continuity and sustainability of harm reduction and other low-threshold services for PWUDs during the COVID-19 epidemic. This includes in particular Opiate Substitution Treatment (OST), Heroin Assisted Treatment (HAT), Needle and Syringe Programs (NSP), naloxone provision, and continued access to Drug Consumption Rooms (DCRs). In addition, essential basic services need to be provided, including day and night shelter, showers, clothing, food, and other services. This is of particular importance to those who experience homelessness and/or live on the streets.
2. Provide adequate funding for harm reduction and other low-threshold service providers, and supply them with adequate equipment to protect staff and clients from infections (soap, hand sanitiser, disposable face-masks, tissues etc.).
3. Acknowledge the important and critical role of harm reduction and other low-threshold services in the COVID-19 pandemic and address the specific vulnerable situation of PWUDs and other related groups.
4. Develop specific guidelines and regulations for harm reduction services, with respect to the vulnerable situation of PWUDs and related target groups. These guidelines should be developed in close cooperation with involved staff and the affected communities, and build on international WHO guidelines, recommendations, and evidence and/or national COVID-19 regulations.
5. OST and HAT should be maintained and take-home regulations should be established or extended for patients to have opportunity to come for treatment rarely then ones a week. Access through pharmacies should be ensured.
6. NSP should provide PWUDs with larger amounts of needles, syringes, and other paraphernalia to minimise the number of contacts. Special bins for needles and syringes should be provided to collect used material at home.
7. Harm reduction services should provide COVID-19 prevention material and information for staff, volunteers, and service users, including soap, alcohol-based hand sanitisers that contain at least 60% alcohol, tissues, trash baskets, and disposable face-masks (if this is requested by national regulations), for people who show symptoms like fever, coughing, and sneezing.
8. Drop-in services, day shelters, and DCRs should advise and support PWUDs in preventing COVID-19 infections. Visitors should be made to sanitise their hands when entering and should stay no longer than is absolutely necessary. Kitchens can prepare take-away food to be eaten outdoors. All necessary measures should be made to increase social distancing among visitors/ staff with all possible means, and rooms should be ventilated. Overcrowding in harm reductions services, shelters, and DCRs should be avoided, by establishing safety measures, e.g. minimising the duration of stay, maximum number of visitors, entering only once per day. People with permanent housing should be encouraged to stay at home and come only to pick up needles and other harm reduction paraphernalia and tools.
9. The health situation of PWUDs should be monitored closely. If someone shows symptoms, such as fever and coughing, face-masks should be provided and a medical check-up should be ensured. Cooperation agreements with public health services, related health units, and hospitals need to be established to ensure direct medical support, follow up care, and treatment.
10. Night shelters need to be made available for people experiencing homelessness, with a separation in place between those who are not infected and those who are infected and need to be quarantined, but do not need specific medical care and treatment in hospitals. Night shelters have to comply with the overall safety regulations for COVID-19, and people should not be exposed to additional risks for infection through overcrowding and insufficient health care.
11. Group-related services, such as meetings and consultations, should be cancelled and postponed until further notice or organised as online services. New treatment admissions should be temporarily suspended. Coercive measures (e.g treatment referrals made by court/prosecutor/police, probation officer visits etc.) should be suspended. Mandatory urine sampling should be abolished.
12. Harm reduction services should establish a safe working environment and make sure that staff are well informed and protected against infection. Service providers should identify critical job functions and positions, and plan for alternative coverage by involving other staff members in service delivery.
Some additional links and resources which may be of use to people:
The Canadian Association of People who Use Drugs (CAPUD) developed this useful, shareable infographic on procedures for drug service providers during COVID.
The UN Office on Drugs and Crime (UNODC) put out a webpage, along with infographics, on the importance of continuing and sustaining harm reduction services during the COVID-19 pandemic, including in prisons. INPUD contributed towards the development of this content.
Harm Reduction Coalition has put together a brief with information about the COVID-19 virus itself for direct service and harm reduction providers.
Drug Reporter is collecting reports from European cities regarding how the COVID-19 pandemic is affecting the functionality and availability of harm reduction services
AFEW International has two great articles summarizing mental health and psychosocial considerations during the COVID-19 outbreak, and an analysis of what COVID-19 means in regard to chemsex.
European Monitoring Centre for Drugs and Drug Addiction released an update on the implications of COVID-19 for people who use drugs and drug service providers