COVID-19 compounds challenges for people who use drugs – and we know the solution

COVID-19 compounds challenges for people who use drugs – and we know the solution

by Adeeba Kamarulzaman, IAS President

Recently, I had the honour of addressing the Plenary of the 64th session of the Commission on Narcotic Drugs. This was against the backdrop of a rising number of new HIV infections among people who inject drugs, currently accounting for 10% of new HIV infections globally in 2020. As the prime United Nations policy-making body on narcotic drugs, the commission plays a crucial role in deciding policy and setting the agenda on matters related to illicit drug use globally.

For people who use drugs, COVID-19 has added to an already difficult situation marked by widespread violations of human rights, criminalization and disproportionate use of force by law enforcement. Violence, stigma and discrimination, high prevalence of HIV and viral hepatitis and high rates of overdose have compounded the challenges for a group of already marginalized people.

Additionally, as a result of criminalization of drug use in many countries, people who use drugs make up a disproportionately large number of prisoners globally. Overcrowding and difficulties in implementing even basic COVID-19 measures have resulted in COVID-19 outbreaks in many prisons around the world. To date, more than 500,000 cases have been reported in prisons, pointing to 5.5 times more risk for infection and an estimated 3.5 times more risk for death than the general population.    

We have known the solution for many years: fully implementing harm reduction and protecting and promoting the human rights of people who use drugs. However, in many countries, COVID-19 prevention measures have actually resulted in the closure or restriction of harm reduction services.

Despite these challenges, many countries and communities did manage to get harm reduction services to adapt to more flexible models of service delivery, such as simplified prescribing requirements, take-home opioid agonist therapy, access to naloxone and integrated mobile COVID-19 and harm reduction services. As is so often the case, community-led organizations proved creative and resilient, finding solutions to protect people who use drugs.

After extensive consultations with scientists and community leaders reviewing the impact of COVID-19 on harm reduction, I called on the representatives convened by the 64th session of the Commission on Narcotic Drugs to consider harm reduction services as essential public health interventions.