Practising Harm Reduction during COVID-19



As we focus our efforts around keeping ourselves and each other safe during the COVID-19 outbreak, we recognize we need to share information that focuses on how to stay safe when using substances. This information is for people that use substances, as well as their family and friends.

As the BC Centre for Disease Control (BCCDC) writes:

 “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.”

Many resources do not take into account the additional challenges that people in rural and remote communities may experience. These include lack of access to overdose prevention sites and opioid agonist therapies. The FNHA will continue to adapt and share resources as they are updated – please check the FNHA Website and the BC Centre for Disease Control links to the most current information.

It is important to know that since COVID-19 is a virus that can cause a respiratory infection and other health problems, COVID-19 may increase the risk of overdose death when using opioids, such as fentanyl, because opioids cause our breathing rate to slow down. We also know that COVID-19 is spread through droplets in the breath of those who have COVID-19, and that helping someone breathe is essential to overdose response. 

The BCCDC recommends responding to OD 

We are encouraging people to stimulate (try and rouse the person, encourage them to take breaths), call 911, wear gloves and give rescue breaths using the face shield in naloxone kits. The face shield has a one-way valve and large impermeable area that protects the responder from respiratory secretions. 

The following in a short summary of information from the BC Centre for Disease Control, Vancouver Coastal Health, the Harm Reduction Coalition, and the DTES (Downtown East Side) Collaborative, on how to stay safe(r) when using substances:

Practising safer drug use

• ​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.

For more information on safer use, please check out Vancouver Coastal Health’s pamphlet ‘Safer Use Strategies to Reduce Risk of COVID-19’, the BC Centre for Disease Control’s ‘People Who Use Substances’ web section.

Harm Reduction Supplies and Opioid Agonist Therapies (OAT)

• ​​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:​ 

Responding to Overdose

• ​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.

• ​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. 

• ​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’.

This information changes day by day, and sometimes moment by moment. This article serves as general advice with the information we have so far. Please stay updated with the most current information from reliable resources. 

The most current and accurate information and updates on COVID-19 can be found on the FNHA’s COVID-19 web portal and the BC CDC’s COVID-19 webpage. 


• ​Harm Reduction Coalition: COVID19 Guidance for PWUD: 

• ​Harm Reduction Coalition: SSP Harm Reduction Providers:

• ​​CATIE COVID-19 Resources:
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