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COVID-19 - Advice for people using drugs

We Can Do It!
People who use drugs have dealt with very serious viruses before. This leaflet provides practical information that will help us manage our health and drug use during the Covid-19 pandemic.
About the Covid-19 (also known as Coronavirus)
Covid-19 spreads from people with the virus through droplets which are coughed or breathed out of the nose or mouth. The virus can also stay alive on surfaces and be transmitted when someone touches the surface and then their face.
Precautions for People who Use Drugs
If you smoke drugs you’re going to be more at risk (while understanding injecting is not always problem-free). Tobacco smokers (including if you only use it to smoke cannabis) puts you more at risk. If you have COPD or other lung conditions you might be especially vulnerable.

Be mindful of:
  • Droplets with COVID-19 being coughed or breathed out.
  • Shaking hands and touching contaminated surfaces.
  • Handling parcels of drugs that have been carried in people’s mouths.
  • Touching your eyes, nose and mouth with contaminated hands.
  • Sharing drug equipment/paraphernalia including joints, bongs, pipes, vaporisers
Symptoms
Covid-19 feels like the flu or a really bad cold:
  • Fever
  • Cough
  • Shortness of breath/difficulty breathing
Prevent
  • Handhygien:
    • Wash your hands with soap and water for 20 seconds (sing happy birthday twice) every time you return to your living space, use the toilet, and before opening your drugs or touching your drug using equipment.
    • If no soap and water, then clean your hands with an alcohol sanitiser containing 60% alcohol.
    • Cleaning hands with an alcohol wipe is still worthwhile.
  • Follow good respiratory hygiene:
    • Cover your mouth and nose with your bent elbow when coughing or sneezing.
    • Use a tissue when you cough or sneeze and dispose of the used tissue immediately.
  • Don’t carry drugs in your mouth, rectum or vagina.
  • Don’t share drug using paraphernalia, particularly smoking, snorting and injecting equipment.
  • Keep using spaces clean:
    • Wipe down injecting spaces before and after using with a spray containing bleach or disinfectant.
    • Safely dispose of used equipment in sharps disposal bins or clear plastic water bottle – don’t fill more than 2/3 full.
  • Practice physical distancing:
    • Stay 2 metres away from people you are not living and/or socially isolating with.
  • Self-Isolation:
    • If you have symptoms or live with someone who has been diagnosed or has symptoms, you’ll need to stay home for 14 days.
Prepare
  • Needles, Syringes and other injecting kit:
    • Stock up - make sure you have enough equipment for 1 – 2 weeks for you and close peers.
    • Plan with your local harm reduction services how you will sustain the supply of sterile injecting equipment.
  • Methadone and buprenorphine and other forms of opioid substitution therapy (OST):
    • To prevent withdrawal due to disruption of drug supply, now is the time to get back on an adequate dose of OST. It should be possible to start those returning to treatment, and perhaps new starters, without urine or saliva testing.
    • OST services should be moving all but the most vulnerable clients onto at least weekly take home doses. Ask for weekly or monthly take home doses for you and your peers through this exceptional period.
    • Make sure to store your medication away from children, high up in a cupboard preferably in a locked box. Methadone and buprenorphine SHOULD NEVER be stored in your fridge.
    • Think how you will manage your dosing across the week to make sure you don’t run out of OST.
  • Overdose Management and Access to Naloxone:
    • Due to potential changes in drug supply, make sure you and your community have access to Naloxone.
    • Take care with drug mixing and avoid overdoing it with heroin and other opioids, benzodiazepines, alcohol and other downers during the lock down.
  • Prepare for a disruption to the supply chain:
    • It’s going to get more difficult to move drugs around and to raise money for drugs.
    • If you can afford to, keep a reserve or source some opioid medications in case your supply is cut.
    • Plan how you would manage a rapid detox or full withdrawals if you cannot afford or access illicit drugs or alcohol.
Respect
  • Be patient and thankful even if services are slower, limiting numbers allowed in buildings at any one time and if staff are wearing masks and gloves. This is part of keeping essential services running.
Self-Supportand Social Connectedness/Solidarity
  • Network with other local peers to help monitor and manage the situation for people who use drugs in your local area. Signal instant message groups can both be helpful coordinating tools.
  • Setting up encrypted instant message groups on the app Signal allows you to coordinate securely.
  • Network and share planning and advocacy strategies with other drug user activists via:

Original by: EuroNPUD
Swedish translation: The Swedish National Association for assistance to drug- & narcotics users RFHL and Stockholm Users Association

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