COVID-19 and Substance Use



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COVID-19’s impact on the ongoing opioid overdose crisis means that healthcare, harm reduction, and other frontline service providers must support clients to address these two significant health crises. The existing evidence base about COVID-19 and its intersection with substance use disorders more generally, is limited, but new information and supports are quickly emerging.

What We Know

People who depend on substances have specific needs and may be at an increased risk of COVID-19 due to a number of physical, social, or environmental reasons. These include:

  • Compromised health as a result of their use, including smoking and vaping, and use of opioids and methamphetamine because of their effects on respiratory and pulmonary health.
  • Opioids slow breathing and have already been shown to increase mortality in people with respiratory diseases - reduced lung capacity from COVID-19 could be a problem.
  • Methamphetamine has been shown to produce significant pulmonary damage and this will likely increase the risk of negative outcomes if used during a COVID-19 infection.
  • Withdrawal symptoms can be severe and harmful for those who are not able to access the substances on which they depend due to supply issues caused by COVID-19.
  • High-risk activities for people who use substances who may be less likely or able to follow instructions around physical distancing and more likely to engage behaviours such as sharing drug equipment
  • Stigma, social marginalization and economic challenges, including a lack of access to housing and health care can add to risk during this time.

There are additional considerations for those with alcohol use disorder (withdrawal management), and added co-morbidities of Hep C and HIV.

Key messages linked to the COVID-19 pandemic for people who use substances and those providing services to this population should include information regarding: