ABSTRACT
Reply by the current author to the comments made by Kathleen M. Carroll et al. (see record 2021-06968-004), Brandon del Pozo (see record 2021-06968-005) and Anna Lembke (see record 2021-06968-006) on the original article (see record 2021-06968-003). We appreciate the authors' commentaries engaging with our perspective article on the potential roles for drug decriminalization and safe supply in response to the syndemic of HIV, hepatitis C, overdose, and COVID-19 among people who use drugs (PWUD). They have each raised some commonly expressed concerns regarding the relative benefits and risks of safe supply;however, considering the life-or-death importance of this topic, we feel it is necessary to address these arguments head-on. Here, we discuss how the crisis has changed over the last 20 years and how the urgent responses we detailed are desperately needed. We push back on the idea that harm reduction implementation needs to be done in a piecemeal way and that only certain types of treatment should be used. Last, we discuss the importance of implementing a range of responses that address the needs of PWUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
People who use drugs (PWUD) face concurrent public health emergencies from overdoses, HIV, hepatitis C, and COVID-19, leading to an unprecedented syndemic. Responses to PWUD that go beyond treatment--such as decriminalization and providing a safe supply of pharmaceutical-grade drugs--could reduce impacts of this syndemic. Solutions already implemented for COVID-19, such as emergency safe-supply prescribing and providing housing to people experiencing homelessness, must be sustained once COVID-19 is contained. This pandemic is not only a public health crisis but also a chance to develop and maintain equitable and sustainable solutions to the harms associated with the criminalization of drug use.
Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , HIV Infections/epidemiology , Hepatitis C/epidemiology , Pneumonia, Viral/epidemiology , Substance-Related Disorders/epidemiology , Syndemic , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/prevention & control , Criminals , Drug Overdose/complications , Drug Overdose/epidemiology , Drug Overdose/prevention & control , Emergency Medical Services , HIV Infections/complications , HIV Infections/prevention & control , Hepatitis C/complications , Hepatitis C/prevention & control , Housing , Humans , Pandemics/prevention & control , Pneumonia, Viral/complications , Pneumonia, Viral/prevention & control , Prescriptions , SARS-CoV-2 , Substance-Related Disorders/prevention & control , United States/epidemiology , United States Public Health ServiceABSTRACT
COVID-19 has turned the world upside down in a very short period of time. The impact of COVID-19 will disproportionately effect people who are least able to protect themselves and this will include people who use drugs. The arrival of the COVID-19 pandemic comes at time when North America is in the midst of a protracted overdose epidemic caused by a toxic illegal drug supply. Overdose deaths are likely to rise when people are isolated, social support programs are cut back, and the illicit drug supply is further compromised. Safer opioid distribution in response to a toxic street drug supply is a pragmatic and effective way to reduce overdose deaths. COVID-19 makes such an approach even more urgent and compelling.