COVID-19 pandemic impact on harm reduction services : an environmental scan
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COVID-19 pandemic impact on harm reduction services : an environmental scan

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    The COVID-19 pandemic has profoundly worsened the overdose crisis in the U.S. and magnified disparities in access to health care, social services and other basic needs experienced by people who use drugs (PWUD) and people with substance use disorders (PWSUD). Overdose rates are rising steadily, with death rates estimated to be 22.8% higher in July 2020 compared to July 2019. For decades, harm reduction organizations have provided essential, nonjudgmental services that promote safer drug use, prevent overdose death, link people to treatment and recovery supports and support holistic health.

    To better understand the impact of the pandemic on harm reduction organizations and PWUD, the National Council for Behavioral Health, with support from the Centers for Disease Control and Prevention (CDC), conducted an environmental scan consisting of a literature review and 21 key informant interviews with staff from harm reduction organizations in the U.S. Information collected through the literature and from key informants demonstrate that the pandemic has resulted in: 1) increased health and social harms to PWUD, 2) significant disruptions to harm reduction services and operations and 3) innovative adaptations by harm reduction organizations to continue to serve the needs of participants.

    The COVID-19 pandemic has resulted in increased health and social harms among PWUD. Rates of substance use and their associated harms, such as skin and soft tissue infections due to reduced access to safer use supplies or fear of seeking medical care in emergency departments (EDs), have increased and worsened. Meanwhile, mental health and peer supports are limited, as public health guidance to isolate from others to reduce COVID-19 transmission contradicts harm reduction’s messaging to never use alone.

    There has been significant disruption to harm reduction services due to the pandemic and, in some cases, they have been suspended or terminated. Staff and volunteer hours have been reduced to limit in-person interactions in accordance with public health guidance; however, reduced staff capacity in tandem with the increased need for services has resulted in high rates of staff burnout. Disruptions in the supply chain have led some organizations to struggle to provide participants safer use supplies, while others are unable to provide HIV and hepatitis C testing due to risks of COVID-19 transmission. Further, social distancing protocols have prevented staff and participants from engaging in social activities that are integral to the harm reduction community.

    The National Council for Behavioral Health developed this environmental scan with support from the Centers for Disease Control and Prevention (CDC). The project team would like to thank all of the key informants who generously devoted their time, expertise and resources to inform this report at an incredibly challenging time during the COVID-19 pandemic.

    This publication was made possible by grant number 6 NU38OT000318-02-02 from the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $750,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

    Harm-Reduction-Environ-Scan.pdf?daf=375ateTbd56

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