“We recognize that many of the public health messages being shared on COVID-19 are hard to practise when people are living outside, in a tent, in an SRO [single room occupancy], 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.”
• 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. • To minimize risk, avoid close contact and try to stay at least an arms’ length, ideally two meters (6 feet), from your buddy to avoid passing the virus. Using with a buddy is safer than using alone.• 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.• Find “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.• If you have a phone buddy, make sure they are nearby, and have them stay on the line and ask them to call 911/emergency response if you become unresponsive.• Carry naloxone and have an overdose plan. If you choose to provide rescue breaths, always use the face shield. It is unclear at this time the degree to which the face shield will protect you from COVID-19 while providing rescue breaths.
• Make sure you have naloxone.• If you're on medication-assisted treatment/opioid agonist therapies, check with your pharmacist and provider and ask what their procedures will be if you are self-isolating or they have to close.• Stock up on harm reduction supplies (new syringes and safe use supplies) as you may be self-isolating or the places you get these supplies may have limited staffing or hours. • If possible, try to stock up on your drug of choice. Be safe: Having larger amounts of drugs can be dangerous if you are stopped by police or someone desperate enough to target you for them.• Remember if you have to change dealers, to always go slowly when using from a new supplier.• If possible, test any drugs you may get from a new or unknown source.• You might lose access to your drug of choice in an outbreak. Consider alternative drugs or medications that could help. If facing potential opioid withdrawal, consider buying over-the-counter medications to make it less difficult (ibuprofen, Pepto-Bismol, Imodium). Work with your local pharmacist regarding OAT or access to other medication assisted treatment (e.g. for stimulants or benzodiazepines).• Health Canada is working on exemptions for regulated health care providers (i.e. physicians, nurse practitioners) to ensure access to OAT and other medicines for their patients. For more information health care providers can contact: firstname.lastname@example.org
• In the event of an overdose, CALL 9-1-1 and continue to follow the SAVE ME steps: Stimulate, Airways, Ventilation, Evaluate, Medicine, Evaluate:
o Stimulate - try and rouse the person, encourage them to take breaths. o If no response; call 9-1-1, give breaths to restore oxygen to the brain and administer naloxone.o Anyone not responding to the overdose should leave the room or immediate area.
o Stimulate - try and rouse the person, encourage them to take breaths.
o If no response; call 9-1-1, give breaths to restore oxygen to the brain and administer naloxone.
o 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
o Put the gloves on and use the face shield/breathing barrier to give rescue breaths. o The face shield has a one-way valve and large impermeable area which protects the responder from respiratory secretions.
o Put the gloves on and use the face shield/breathing barrier to give rescue breaths.
o 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 first and then take off the gloves and wash/clean your 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. • Recognizing that information is changing every day, please stay tuned, and continue to check the BC Centre for Disease Control’s web section: ‘People Who Use Substances’.
• BCCDC COVID-19 HR: https://sneezesdiseases.com/assets/wysiwyg/COVID%2019%20community%20resources/Final_BCCDC_COVID19_HR_Mar18.pdf • Harm Reduction Coalition: COVID19 Guidance for PWUD: https://harmreduction.org/wp-content/uploads/2020/03/COVID19-safer-drug-use-1.pdf • Harm Reduction Coalition: SSP Harm Reduction Providers: https://harmreduction.org/wp-content/uploads/2020/03/COVID19-harm-reduction-providers-1.pdf• CATIE COVID-19 Resources: https://www.catie.ca/en/covid-19-resources