Overdose prevention in a time of COVID
We are so pleased at how many people and organizations have come out of the woodwork to help ensure the safety and survival of people who use drugs in the context of COVID-19. We’ve seen a surge of interest in overdose prevention and naloxone. The new surge reminds us of the importance of remembering history and the basics. Here’s a few key bullets:
- Naloxone has been around since 1971 and the Chicago Recovery Alliance has been giving it to people who use drugs (PWUD) and those who love us since 1996- the first official overdose prevention program in the country!
- There are 3 forms of naloxone products: generic injectable, branded auto-injector, and branded nasal spray. All three are totally acceptable, but only one is totally affordable ☹. But, don’t just take our word for it, this is what the FDA says:
- There is also a persistent misunderstanding that the FDA-approved labelling for the injectable form of naloxone, the least expensive option, precludes administration outside a health care setting. This has created confusion among public health officials and community-based organizations about whether the injectable form of naloxone can be used as part of their distribution programs. The FDA-approved product labelling for the three forms of naloxone does not exclude dispensing by pharmacies or community distribution programs. All three forms of naloxone are FDA-approved and may be considered as options for community distribution and use by individuals with or without medical training to stop or reverse the effects of an opioid overdose.
- In fact, in 2019, overdose prevention programs gave out over ONE MILLION doses of generic injectable naloxone!
- Giving out naloxone to community members, people who use drugs, people in treatment for and recovery from a substance use disorder, and those of us who care about them is not only TOTALLY LEGAL, some industries in Illinois are required to address overdose prevention!
- People leaving incarceration are VERY VULNERABLE to overdose. We applaud efforts to decarcerate and reduce the prison population in the context of COVID. We must remember people’s heightened risk and equip them with tools (naloxone) and information to stay safe. Also, people leaving incarceration who have naloxone are TWICE as likely to use it on someone in their communities than have it used on them!
- Opioid agonist-based treatment for opioid use disorders is another incredibly powerful overdose prevention strategy. While there are still major treatment access hurdles that put our opioid-using friends, colleagues, and neighbors at risk, we give many thanks to our advocate friends & colleagues who have helped ease some of the draconian restrictions on access to methadone and buprenorphine.
In a recent article titled Collision of the COVID-19 and Addiction Epidemics, Nora D. Volkow, Director of the National Institute on Drug Abuse (NIDA), wrote the following:
Coronavirus disease 2019 (COVID-19) is causing untold challenges to health care and wider social structures. Among the vulnerable populations are persons who smoke or vape, use opioids, or have a substance use disorder (SUD). Because of direct challenges to respiratory health, those with SUD may be especially susceptible to infection by the virus that causes COVID-19 and associated complications. And because of impediments to delivering care to this population, persons with SUD who develop COVID-19 may find it harder to get care. Those in recovery will also be uniquely challenged by social distancing measures.
The current COVID-19 prevention strategies (physical distancing, stay inside) are the exact opposite of overdose prevention strategies (use with friends, connection is essential, not going to work if no one is there to save you). CRA emphatically encourages following state, federal, and Harm Reduction guidelines for COVID-19 prevention, but we think it is important to also acknowledge that those prevention guidelines place additional burden on PWUD to get even more creative with saving our own and others’ lives. We will get creative and we will survive. To quote our friend Daniel Raymond, we are exquisitely skilled at navigating risk.