Harm reduction information for people who use substances in the context of the COVID-19 outbreak.
We recognize that many of the public health messages being shared on COVID-19 are hard to practice when people are living outside, in a tent, in an SRO, or in a shelter. People who use drugs are already doing incredible work to keep communities safe and reduce the spread of infection. We need creative solutions to slow down the spread of COVID-19 and protect people who use drugs, have underlying health conditions, and/or may be elderly.
- COVID-19 is a virus that can cause a respiratory infection and other health problems.
- Fentanyl and other opioids can slow your breathing rate, so COVID-19 may increase the risk of overdose death when using opioids.
- Do not share supplies, such as cigarettes, joints, pipes, injecting equipment, containers for alcohol, utensils, and other supplies. If you have to share, wipe pipes with alcohol wipes or use new mouthpieces.
- Reduce close contact (e.g. shaking hands, hugging, kissing) and ensure condom use.
- Wash your hands or use wipes before preparing, handling or using your drugs. Prepare your drugs yourself.
- Cough or sneeze into your elbow or use tissues. Throw tissues away immediately and wash your hands thoroughly.
- Clean surfaces with soap and water, alcohol wipes, bleach or hydrogen peroxide before preparing drugs if possible.
- Carry naloxone and have an overdose plan. Please use breathing masks available in the Take Home Naloxone kits if responding to an overdose.
- Buddy up when you are using. COVID-19 is passed by droplets. Stay 2 metres (6.5 ft.) from your buddy to avoid passing the virus. Using with a buddy is safer than using alone.
- Find your “buddies” who can bring you food, harm reduction supplies, medicine, and substances so that you can stay well. You can also be a buddy to those who may need extra support. Check in on your buddies regularly.
- See if your buddy can pick up supplies including naloxone from a harm reduction site.
- Try to have the substances you need to stay well. Know that carrying large amounts may put you at risk by the police and other people looking to score. Consider alternatives to your drug of choice and prepare for potential supply disruptions.
- You may go through involuntary withdrawal if your dealer gets sick. Have backup plans and be cautious if using a new supply.
- Try to have the medications you need, re-fills may be available directly through your pharmacist or by phone without having to see your physician. If you are feeling unwell and require medications, call your pharmacy in advance.
- Health Canada is working on exemptions to ensure access to OAT and other medicines.
- For more information contact:
- Regular cleaning that already takes place at these sites will help reduce the spread of infection
- Stimulate - try and rouse the person, encourage them to take breaths.
- If no response; call 9-1-1, give breaths to restore oxygen to the brain and administer naloxone.
- Anyone not responding to the overdose should leave the room or immediate area.
- When using a take home naloxone kit or facility overdose response box
- Put the gloves on and use the face shield/breathing barrier to give rescue breaths.
- The face shield has a one-way valve and large impermeable area which protects the responder from respiratory secretions.
- After responding dispose of the face shield before taking off the gloves and wash/clean hands thoroughly.
- If chest compressions are needed, place a towel or a piece of clothing over the person’s nose and mouth to protect yourself from droplets.
- If you share a washroom with others, clean and disinfect high-touch surfaces, such as knobs, taps, and flushers with soap and water, bleach, hydrogen peroxide or alcohol-based wipes (70%) after every use. Do not mix different types of cleaning solutions.
- If you cannot wash your hands with soap or use hand sanitizer, try to access alcohol-based hand wipes
- BCCDC does not anticipate supply chain disruptions.
- Registered sites should continue to order supplies as needed weekly/monthly to avoid stock piling.
- Please continue to distribute supplies as usual, and note that if there is a specific request for supplies for an individual who requires quarantine or isolation, additional supplies may be provided for the 14-day period.
- If you are awaiting your next order to arrive and are temporarily low on any supplies, connect to your local Harm Reduction Coordinator. Individuals can also be referred to nearby existing sites by using the site finder.
- Please circulate this information to any secondary or satellite sites of your location
The Provincial Health Officer’s order of no gatherings with more than 50 people is intended to apply to one-time, entertainment, community and social events Shelters and single room occupancy housing are exempt from this order because from a public health perspective, shelters and SROs are regarded as peoples’ homes.
Overdose prevention sites and supervised consumption sites are also exempt from this order, as they are clinical spaces that provide an essential service so service delivery should continue as much as possible.
While you continue to provide essential services, you should adapt these measures wherever possible:
- Adapt your services or space arrangements to maintain physical distancing of two meters between individuals.
- Encourage respiratory etiquette (cough or sneeze into elbow sleeve, dispose tissues properly)
- Conduct frequent disinfection.