SSDP Mosaic May 2020: Supporting People Who Use Drugs through COVID-19

Note from the Intersectionality Committee

Welcome back to the SSDP Mosaic! A publication launched by the Intersectionality Committee in 2015, the SSDP Mosaics are a resource to the SSDP community providing information on issues that intersect with the War on Drugs. The Mosaic took a hiatus in 2018 but we’re thrilled to bring them back again, now publishing an issue each quarter. In the past, we’ve covered topics such as families and the War on Drugs, domestic violence, Black Lives Matter, and more. This quarter’s issue is about the unique challenges that people who use drugs are facing during this pandemic. Read through to learn about how people who use highly stigmatized drugs are uniquely affected by COVID-19, what you can do to help, and for more resources from the committee. 

How are people who use drugs, particularly those who use highly stigmatized drugs, uniquely affected by COVID-19?

Across the world, people utilize medication-assisted treatment (MAT), such as methadone. Legal restrictions around the distribution of these medications can lead to the people who use them having to visit clinics regularly or not being able to access their medication at all. Though some countries have increased the amounts of these medications that can be distributed and have introduced COVID-19 prevention measures, many have not, leading to higher risk for service participants and service workers. Other drug related services, such as safe consumption locations and syringe exchanges, face similar challenges.  

This global pandemic will likely significantly disrupt global drug manufacturing and distribution for legally sanctioned and underground drug markets. This disruption will very likely hit the underground drug market hardest, and people regularly using drugs may find that their drug of choice has either increased in price, quality and purity has fluctuated, or is now just unavailable to buy. Unavailability of a regular supply is especially dangerous for people regularly using alcohol and benzodiazepines, as sudden withdrawal after sustained periods of heavy use can be fatal. 

How are people who are experiencing homelessness going to be affected by COVID-19?

Social isolation has been considered key in curbing the spread of COVID-19. People experiencing homelessness are unable to socially isolate, and are much more likely to be exposed to diseases like COVID-19. In addition to the inability to socially isolate, recommendations to do so put people who use drugs at higher risk of overdose by decreasing the number of people available to respond to an overdose.  Many countries are having difficulties incorporating social distancing measures into government food services. Notably, this has significantly affected the migrant populations in major Indian cities. The increased law enforcement presence may lead to unwanted police attention and difficulties finding a place to rest. 

What might the long-term impact of a pandemic look like for people who use drugs?

Based on our knowledge of reduced underground market substance availability, reduced access to financial resources, and overwhelmed emergency services, we know that the most marginalized folks will be the most deeply impacted. Governments should be doing everything they can to avoid unnecessary medical intervention, including mainstreaming harm reduction practices, funding direct service organizations like syringe exchanges, eliminating drug possession arrests, and reducing barriers of access to substance use disorder treatment. 

People who are incarcerated are especially susceptible to COVID-19 infection due to overcrowding, inability to social distance, lack of hygiene supplies, lack of sufficient medical care, and gross negligence of carceral officials who do not prioritize the safety of incarcerated people. Dramatically reducing prison and jail populations can slow the spread, reduce state expense, and save lives. We already know that people are dying in prison from COVID-19. This is a human rights crisis that can only be addressed by government officials. Prison Policy Initiative is collecting data about this public health emergency, and advocates are calling for this crisis to be a wakeup call about incarceration in the United States.

What can I do to help reduce the spread of COVID-19?

  • If you can, self-isolate! If you are using drugs that put you at greater risk of overdose, make sure you have a plan in place with a friend to check on you during and after using.
  • Sterilize any baggies or drug-related paraphernalia with alcohol wipes after acquiring them. 
  • Practice good personal hygiene
  • Wear a face mask – up to 30% of people infected with COVID-19 are asymptomatic by still contagious
  • Avoid panic-buying food and other supplies! Reduced or unavailable supplies disproportionately impact low income and other marginalized folks who do not have steady access to financial resources.

What can I do to help support vulnerable populations during this time?

  • Join or start a community mutual aid group
  • Donate to local nonprofits or national organizations who are working with vulnerable populations
  • Contact your local syringe exchange program and ask how you can be supportive. This may range from creating hygiene kits to local trash clean ups, everyone has different needs, so it’s best to start by asking!

What public health measures could governments take to help people who use drugs and other vulnerable populations during this pandemic?

  • Changing methadone regulations to allow for virtual evaluations, allow all patients to take additional doses home, allow surrogates to pick up methadone for others based on need or emergency, and deliveries for people unable to come to the clinic
  • United Nations experts are urging lawmakers to protect people who use drugs during the pandemic.
  • Harm reduction leaders in Vancouver, British Columbia, Canada are directly supplying substances to people who use drugs throughout the pandemic. This public health intervention is designed to reduce a spike in overdoses related to contaminated and misrepresented substances. 
  • People of color are being disproportionately impacted by COVID-19 due to structural inequalities in healthcare access, inability to social distance due to financial instability despite overrepresentation as “essential workers,” and higher rates of air pollution exposure and related respiratory vulnerabilities. Predominantly black communities are experiencing death rates six times greater than communities that are predominantly white. 
  • Housing must be made widely available to the unhoused, with a path to permanent housing options post pandemic. “Mega shelter” complexes are an inhumane and ineffective response by local governments in response to the pandemic. Long term strategies to access stable housing must be implemented to protect unhoused people from future pandemics.

Harm Reduction Resources

Other Committee Resources

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Contributions

The SSDP Mosaic is edited by Rachel Wissner ‘11. This issue features contributions from Erica Darragh ‘14, Róisín Downes ’16, Robert Hofmann ‘15, and Kat Humphries ’10. Have an idea for the next issue of the Mosaic or want to get involved with the Intersectionality Committee? Fill out this form and/or email rachel@ssdp.org. And, join the conversation on the SSDP Intersectionality Committee Slack Channel. Feeling extra inspired? Make a gift to the committee fund here.