Coronavirus and drug harm reduction.

Most drug using behaviours can increase the risks of Covid-19 transmission - whether you are smoking a joint, snorting cocaine, or injecting heroin - but basic precautions can reduce these risks. It’s all common sense, but worth reinforcing; essentially combining existing Covid-19 transmission prevention advice with established harm reduction practices (that already seek to prevent virus/bacterial transmission more generally).

The following advice has been compiled from advice circulated by the US Harm Reduction Coalition, Crew2000, Russell Newcombe (@TheNewImpostor), and @drugsmeter

General Health

Eating well, getting enough sleep, staying hydrated - can all boost your immune system. As @drugsmeter also note: ‘big nights out and regular use of many drugs can suppress your immune system and make you more vulnerable to infections so this might be a good time to cut back’. Healthy living, moderation and periods of abstinence, and looking out for your friends are obviously good ideas more generally.

People over 65 and people with certain pre-existing medical conditions (including heart disease, respiratory illness, diabetes, or people who are immuno-compromised) are much more vulnerable to coronavirus and should take these precautions very seriously. People less vulnerable to the effects of Covid19 still have a responsibility to not help spread it.

If you think you may have Covid-19 - self-isolate and seek medical advice (for UK info see here)

Smoking & drinking

Covid-19 can be spread via saliva, and via hard surfaces, hand to mouth - so for the time being, avoid sharing cigarettes, joints, pipes, bongs, vapes, glasses, cups and bottles. Just because alcohol is in hand sanitiser does not mean drinking it will protect you.

Snorting drugs

Harm reduction around drug snorting is often neglected - but it is more important than ever with Covid-19.

• Wash your hands with soap, or at least use hand sanitiser - every time - before handling, preparing, or using drugs.
• Clean surfaces before preparing lines - with a damp soapy cloth and/or alcohol wipe. This is especially important for hard surfaces that come into contact with hands/people - including phone screens, and pretty much anywhere in clubs, bars, toilets etc.
• Avoid sharing snorting equipment (including spoons, keys etc); use your own straw (different colours to avoid mix ups), or rolled paper (then throw away after use - so avoid using banknotes which are more likely to get re-used).
• Sharing snorting equipment can also spread other viruses (colds and flu), infections, and HepC, so this is sensible longer term harm reduction
• Avoid sharing / passing around stash bag or box, and avoid dabbing powder with fingers
• Chop powders as finely as possible before snorting- this reduces risk of soft tissue abrasions that can increase likelihood of transmission. This (and having a nasal douche after snorting) also reduces likelihood of irritation that can cause runny-nose and sneezing later (people could think you have coronavirus even if you don’t!)
• And no, cocaine most definitely does not kill coronavirus

Opioids and Injecting drugs

People who use opioids or inject drugs are at greater risk.

• Follow established harm reduction guidance to avoid blood borne virus transmission, but take additional care with general hygiene and hand washing, when handling preparing or using drugs, and avoiding sharing of injecting equipment
• Covid-19 infection can compromise the respiratory system - making respiratory failure/crisis more likely in opioid overdose.
• Smoking heroin may also be difficult with Covid-19 related respiratory issues - explore OST options, or alternative methods of administration
• If you are smoking heroin - avoid sharing or re-using foil
• Be mindful of potential impacts of the crisis on drug markets, drug and hospital services and pharmacy provision - make plans for likely disruption and potential drug shortages; stock up on drugs, medication, hygiene supplies etc

Social distancing

Current advice is to minimise or avoid close contact with others - especially those who are diagnosed with Covid-19 or have symptoms. This is basically impossible in most club, party and social settings - and on much public transport. Definitely avoid social interactions if you have any flu or cold like symptoms.

Even if commercial venues, parties and festivals are not temporarily closed or cancelled (as many already are) it’s probably a good moment to reign in partying for a while. Try something else; read a book, meditate, paint some watercolours of eerily deserted streets - whatever floats your boat.

Sex

Coronavirus can certainly be transmitted by close contact and kissing - so its also a good time to ease off on rampages of sex/snogging, and failing that, always practice safe sex.

More information:

Crew 2000

CoronaVirus: general hygiene and harm reduction tips

Harm reduction Coalition

COVID-19 Guidance for People Who Use Drugs and Harm Reduction Programs

Steve Rolles, Senior Policy Analyst at Transform Drug Policy Foundation.

12/03/20