Thread by @rs_mcneil

Thread:

Updated harm reduction advice for people who use drugs and alcohol for #COVID19 (novel #coronavirus) pandemic from @YaleADM, @YaleGHJP, and @CrackdownPod. Adapted w/ thanks from 3D Research document.

yale.app.box.com/v/COVID19HarmR…

(French and Spanish versions forthcoming)

/1

Symptoms of withdrawal and #COVID19 are similar - like fever and muscle soreness.

If you have a persistent cough, it could be #COVID19.

/2

People who use drugs & alcohol are more likely to have health problems and thus at high risk of becoming seriously ill.

Also:

1) Opioids can impact breathing
2) Withdrawal can make breathing difficult
3) Smoking drugs impacts breathing

#COVID19 prevention is critical.

/3

What happens if you're someone who uses drugs or alcohol and you think you're getting sick?

Try not to go to your harm reduction or addiction program. Have them deliver to you.

Ask a friend to deliver supplies & take precautions - mutual aid necessary during pandemic.

/4

This is brutal:

Be ready to experience involuntary withdrawal - dealers might get sick and supply could be disrupted.

Try to have supplies on hand to manage withdrawal - meds, food, electrolyte & protein drinks (Pedialyte, Gatorade, Ensure).

/5

If you can (and this can be hard in challenging settings and in context of poverty/criminalization):

STOCK UP ON SUPPLIES NEEDED TO MANAGE YOUR SUBSTANCE USE & PRACTICE HARM REDUCTION.

/6

If you can - and this will be hard for most people - stockpile your drug of choice. Avoid bingeing on this supply.

It will be helpful to have as much access as possible in case things go sideways.

Have lots of ways to contact dealers and other folks who can provide drugs.

/7

If you are dependent on alcohol, stockpile if you can to avoid withdrawal and seizures. Try to avoid bingeing on your supply

You can manage your alcohol use by consuming an amount of alcohol equal to 1 can of beer, 1.5 ounces of rum, or 5
ounces of wine hourly as needed.

/8

Stockpile enough harm reduction supplies to last a couple of weeks - naloxone, syringes, cookers, pipes, etc.

Naloxone is important to have because EMS responses are likely to be slow.

Stockpile ≠ hoard. We want everyone to be able to be safe.

/9

If you're on a medication treatment, like methadone, buprenorphine, or slow-release oral morphine, ask if you can have take homes (carries) or longer refills.

Let your provider know if you have a pre-existing condition - like a lung or heart disease or diabetes.

/10

As always, practicing harm reduction can help keep you safe - including from #COVID19. There are also extra steps that you can take to limit your risk.

/11

Don't share your drug use supplies - keep practicing harm reduction.

This includes things like injecting equipment, pipes, etc.

But also, don't share smokes, vapes, or drinks.

/12

AVOID INJECTING ALONE - the illicit drug supply is toxic and we don't want to lose anyone to an overdose. There are a few things you can do:

(1) Stay 6 feet away from other people, cough or sneeze into your arm, avoid touching your face, and wash (20 secs w/ soap & water)

/13

AVOID INJECTING ALONE (cont.):

If you have a phone, call someone, preferably nearby, and ask them to stay on the line while you are injecting so they can act or call 9-11 if you become unresponsive.

/14

If you run out of sterile syringes, there are some things that you can do that can be helpful. These are not ideal but people have found them to work if alternatives are not available and it's not possible to use drugs in other ways.

/15

However, there are other ways that you can use drugs:

1) Snort them
2) Booty bump them
3) Swallow them
4) Smoke them

/16

If you smoke drugs, remember to clean your mouthpieces and pipe covers regularly. Use an alcohol-based cleaner or wipe (min. 60% alcohol).

/17

Clean your drug packages / wraps when you get them with an alcohol-based cleaner or wipe.

Don't put them in certain places (mouth, vagina, anus) but, if you must, clean them before and after.

/18

Wash your hands with soap and water (20 second minimum) after you come into contact with people, handle money or drugs, and after picking up drugs.

Prepare your drugs yourself - don't split - but, if you must, make sure everyone washes their hands.

/19

Let's remember that people who use drugs and people in their lives often have weaker immune systems and problems that make them more likely to get #COVID19.

Let's do what we can to keep one another safe.

(Separate thread later on some policy points)

Local info will be distributed in Hartford and New Haven area - with thanks @GHHRC for getting out the word.

And thanks to everyone assisting, including @emmabiegacki @jeff_deeney @DrAyanaJordan @DrMelissaWeimer, @gregggonsalves, SWAN New Haven, and others not on here.

/end