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Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness.
Brothers, Thomas D; Leaman, Malcolm; Bonn, Matthew; Lewer, Dan; Atkinson, Jacqueline; Fraser, John; Gillis, Amy; Gniewek, Michael; Hawker, Leisha; Hayman, Heather; Jorna, Peter; Martell, David; O'Donnell, Tiffany; Rivers-Bowerman, Helen; Genge, Leah.
  • Brothers TD; Department of Medicine (General Internal Medicine & Clinician-Investigator Program), Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology & Health Care, University College London, London, UK. Electro
  • Leaman M; North End Community Health Centre, Halifax, Nova Scotia, Canada.
  • Bonn M; Canadian Association of People who Use Drugs, Dartmouth, Nova Scotia, Canada.
  • Lewer D; UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology & Health Care, University College London, London, UK.
  • Atkinson J; North End Community Health Centre, Halifax, Nova Scotia, Canada.
  • Fraser J; North End Community Health Centre, Halifax, Nova Scotia, Canada; Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Anesthesia, Pain Management & Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Sc
  • Gillis A; Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Gniewek M; Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Direction 180, Halifax, Nova Scotia, Canada.
  • Hawker L; Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Direction 180, Halifax, Nova Scotia, Canada.
  • Hayman H; North End Community Health Centre, Halifax, Nova Scotia, Canada.
  • Jorna P; Nova Pharmacy, Halifax, Nova Scotia, Canada.
  • Martell D; Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Direction 180, Halifax, Nova Scotia, Canada.
  • O'Donnell T; North End Community Health Centre, Halifax, Nova Scotia, Canada.
  • Rivers-Bowerman H; North End Community Health Centre, Halifax, Nova Scotia, Canada.
  • Genge L; North End Community Health Centre, Halifax, Nova Scotia, Canada; Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Direction 180, Halifax, Nova Scotia, Canada.
Drug Alcohol Depend ; 235: 109440, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1778085
ABSTRACT

BACKGROUND:

During a COVID-19 outbreak in the congregate shelter system in Halifax, Nova Scotia, Canada, a healthcare team provided an emergency "safe supply" of medications and alcohol to facilitate isolation in COVID-19 hotel shelters for residents who use drugs and/or alcohol. We aimed to evaluate (a) substances and dosages provided, and (b) outcomes of the program.

METHODS:

We reviewed medical records of all COVID-19 isolation hotel shelter residents during May 2021. The primary outcome was successful completion of 14 days isolation, as directed by public health orders. Adverse events included (a) overdose; (b) intoxication; and (c) diversion, selling, or sharing of medications or alcohol.

RESULTS:

Seventy-seven isolation hotel residents were assessed (mean age 42 ± 14 years; 24% women). Sixty-two (81%) residents were provided medications, alcohol, or cigarettes. Seventeen residents (22%) received opioid agonist treatment (methadone, buprenorphine, or slow-release oral morphine) and 27 (35%) received hydromorphone. Thirty-one (40%) residents received prescriptions stimulants. Six (8%) residents received benzodiazepines and forty-two (55%) received alcohol. Over 14 days, mean daily dosages increased of hydromorphone (45 ± 32 - 57 ± 42 mg), methylphenidate (51 ± 28 - 77 ± 37 mg), and alcohol (12.3 ± 7.6 - 13.0 ± 6.9 standard drinks). Six residents (8%) left isolation prematurely, but four returned. During 1059 person-days, there were zero overdoses. Documented concerns regarding intoxication occurred six times (0.005 events/person-day) and medication diversion/sharing three times (0.003 events/person-day).

CONCLUSIONS:

COVID-19 isolation hotel residents participating in an emergency safe supply and managed alcohol program experienced high rates of successful completion of 14 days isolation and low rates of adverse events.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ill-Housed Persons / Drug Overdose / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ill-Housed Persons / Drug Overdose / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article