COVID-19 Global Harm Reduction Alert for People Who Use Drugs

This list was compiled by multiple people who wish to remain anonymous.

Note: These tips were developed with a global perspective in mind. Certain items, such as the available medication-assisted treatment supply to take home, may vary depending on your location. Please check in with your own community members and direct service providers for the most accurate information.

1) Don’t share pipes, bongs, vapes, joints, nasal tubes (for inhaling/snorting), or any injecting equipment (including sterilized water). Consider alternative methods to inhaling drugs of choice if possible, as smoke from these substances may affect your body’s ability to handle pathogens.

2) If you’ve got the money, try to stock up on your drugs of choice before things deteriorate much further.

3) If you are a client of drug substitution programs (ie: methadone maintenance/tapering, heroin, Suboxone/Buprenorphine, stimulants, cannabis, etc.), and particularly if you have a pre-existing condition that makes you more vulnerable to infection, ask your doctor if you can get a 3-month take-home prescription (meaning you don’t have to go to the pharmacy to get new doses after your first collection). Also, ask if you can skip doctor appointments and urine testing for at least the next three months.

*Right now in the US, SAMHSA is only approving 2-week take-homes, and hospitals that have the infrastructure are planning to dose methadone and suboxone out of ERs daily for people on medication-assisted treatment if clinics shut down.

4) If you are regularly using opioids and are currently using the underground market to obtain your drugs, be prepared to go through involuntary withdrawl if the person/people who sell to you get sick. Have backup plans that include increasing the number of people you can score off of, getting medical help (i.e. drug substitution programs), and make sure you have all the necessary medications, food, and drinks (especially protein-based and electrolyte boosting liquids) you will need to detox off opiates. Similar steps can be taken by those regularly using other substances.

5) Stock up on equipment needed to use your substance(s) of choice and get enough to last you at least 3 – 4 weeks (longer if you are high risk for infection and if programs can manage it).

6) Wipe down drug packages/wraps with alcohol-based cleansers once you’ve picked them up (a minimum 60% alcohol concentration has been shown to effectively kill the virus). If the people providing to you are in the habit of carrying packages in their mouths, ask them if they can change this habit during this outbreak. If they won’t, be careful handling the packages and clean them as advised above. Remember that anti-bacterial washes don’t kill viruses, but can be better than nothing, especially if they contain alcohol.

7) Avoid putting drug bags/wraps in your mouth, vagina, or anus. If you must carry it in your body, clean vigorously with an alcohol-based cleanser both before and after you take it out. If carried in your mouth, use an alcohol-based mouthwash afterward.

8) Wash your hands with soap and hot water vigorously for at least 20 seconds (but longer if you can) every time you come into contact with others, after handling money, and after you get your drugs packages. Paper towels are preferred for drying hands, or at least use a clean towel.

9) Prepare your drugs yourself and ensure that you don’t handle or touch other people’s equipment/drugs. If you can avoid it, don’t let them touch yours either.

10) If you have symptoms or think you’re getting sick, avoid going to your local harm reduction programs. Have them deliver to you if possible and tell them you are unwell so they can take the necessary precautions for their safety.

11) Be prepared for the possibility of needle exchanges and drug treatment programs closing down, including drug detoxes, and follow steps 2, 3, 4 and 5 to reduce any problems related to running out of supplies or equipment.

12) Remember that people with compromised immune systems, lung diseases, and other pre-existing conditions are more at risk of contracting COVID19. Help keep them safe by keeping yourself safe, and by following these steps.