Adapting harm reduction during a pandemic

Keeping our focus on vulnerable populations: People living with mental health and/or substance use face tremendous challenges that are often exacerbated by the pandemic. I urge all to share in the responsibility to mobilize so the right supports are in place to alleviate the pain, to protect and to save lives. The following is an article that a group of us co-authored, published in the Toronto Star on May 29. The initiative for this article came from a virtual RNAO Take your MPP to Work event with MPP and Ontario Green Party Leader Mike Schreiner to the Guelph Community Health Centre during Nursing Week (you can see the video here).

Adapting harm reduction during a pandemic

By Mike Schreiner, Doris Grinspun, Raechelle Devereaux and Adrianna Tetley

Toronto Star, Friday, May 29, 2020

Earlier this month, we met online for Nurses Week to talk about Ontario’s overdose crisis, which is worsening under the weight of COVID-19.

Overdose deaths are on the rise, with Toronto reporting 25 deaths in April, the highest number in over a year, and the pandemic has deepened existing inequities.

People dependent on substance use are more likely to have underlying conditions that put them at greater risk if they contract COVID-19. They might also be sleeping in a crowded shelter or relying on under-resourced food banks.

On top of it all, given COVID-19, when they visit an overdose prevention site, the experience is radically different than it was a few months ago.

For example, COVID-19 has imposed new barriers such as long waiting lines outside, additional screening processes, and outreach workers who have swapped their street clothes for face shields.

These measures, while necessary, are counter to a harm reduction approach that is based on a low barrier to entry — a safe space where there is no judgment and where workers build trust by meeting people where they are in life and empowering them on their recovery journey.

The risk of spreading the virus has also meant that many wraparound services like meal programs and peer support groups have had to be paused.

This all amounts to a deterrent to some people accessing harm reduction services that have kept them alive.

To make matters even worse, we’re hearing stories of more people falling victim to toxic fentanyl because their usual supplies are not available.

While isolation is saving lives from COVID-19, it can claim lives for people living with a substance use disorder.

That’s why nurses with the Guelph Community Health Centre are visiting motels and apartment buildings to check in with people, distribute naloxone kits, and offer harm reduction training.

That’s why they are distributing phones as a lifeline for people who have become even more isolated than before.

Indeed, workers are rapidly adopting new outreach strategies in the name of health equity, and we must back up their efforts with better harm reduction policies.

One common sense change is to follow British Columbia’s example and expand access to safer drug supplies under Ontario’s Drug Benefit program.

This would allow clinicians to prescribe untainted alternatives to the deadly fentanyl acquired on the street, building on pilot projects and unfunded programs already taking place.

This discussion was happening before the pandemic, and now we have even more reason to make this intervention available to people who are alone and suffering.

As we mobilize all the health care resources we can to combat COVID-19, we cannot take our eyes off the overdose crisis.

The improved health and fiscal savings, which have been demonstrated through wraparound safer drug supply programs, cannot be ignored.

Like so much else, we need to adapt to save lives.

Mike Schreiner, Leader, Green Party of Ontario; Doris Grinspun, CEO, Registered Nurses’ Association of Ontario; Raechelle Devereaux, Executive Director, Guelph Community Health Centre; Adrianna Tetley, CEO, Alliance for Healthier Communities.