COVID 19 and Substance Users

My friend Rosie is hanging out in front of El Mercado, surveying the street. She smiles and hurries over when she sees our ambulance pull to the curb. I give her an apple, which she starts eating like it is all she has had to eat today, which it likely is. I also give her $5 bucks. I’ve been worried about how she has been coping the last week with the COVID news and the business closings and the stay at home messaging, wondering where she will get up the money to get her bag of fentanyl every four hours, much less get some food in her system. She shrugs when I ask. “Nothing’s changed, “she says. The market’s still open, the dealers are still open for business. The street is still plenty of traffic.  She is fifty years old, and not in the best health. Yes, she is worried about getting the bug, but it is not as high on her list as getting her next bag of heroin.

She’s right about not much changing yet.  Today, the dudes on the corners and the ones in the tinted windows in the cars parked just off the main way are still at it. I can still see the surreptitious handshakes, passing money for bags of dope, and the big chest bumps. The only social distancing is the usual, you stay in your territory, I’ll stay in mind. And if you are in your own territory, why not all stand together.

Overdoses, while not at their summer highs are holding constant.

I listened to a conference call the other day about how the COVID epidemic might affect those with substance use issues, and it was pretty scary.

Here are some of the main points.

1. Expect drug supplies to be disrupted, causing some users to suffer withdrawal, and other users to buy from unfamiliar dealers, exposing themselves to the danger than unfamiliar mixtures can entail.

2. Most in person recovery meetings have been cancelled and replaced by on-line virtual meetings. That’s okay for those with computers, but no so good for the have-nots.

3. The closing of outpatient mental health and substance use centers, gyms and other outlets some people rely on to help them keep from using may lead to relapses.

4. Imposed isolation on people with mental health disorders is a recipe for disaster.

5. COVID may spread wildly among homeless users.

6. Even those with mild COVID respiratory issues will be at higher risk of overdose as most drugs affect respiratory functions.

7. restricted access to syringe service programs will lead to higher rates of HIV and Hepatitis C.

8. When the corona patient overload hits the EDs, there will be less space and time for overdose patients or those seeking recovery, leading to quicker discharges and less in hospital services.

The Greater Hartford Harm Reduction Coalition has been spreading information to their clients, warning of the dangers of COVID-19.

Guidance for People who Use Substances on COVID-19

We are all in this together.

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