Treating drug addiction is difficult in normal circumstances. In European countries battered by the COVID-19 crisis, its become even harder.
Strict lockdown measures intended to stop the virus are preventing drug users from reaching the support services and opioid substitutes they need to manage their addictions.
“Bureaucratically, the situation has shut down,” said Catarina Testa, a psychologist at a treatment center in Rome. “The governments inpatient centers have canceled new admissions, and people who were about to go into detox, people who had finally decided to take that crucial step, are being turned away and abandoned to their fate.”
Accessing methadone — used for opioid substitution therapy — has become an odyssey for users, a group the European Centre for Disease Prevention and Control (ECDC) considers “particularly vulnerable [to the coronavirus] because of their high level of pre-existing health problems and lifestyle factors.”
“People who are HIV positive or have hepatitis are being forced to crisscross the city daily in order to obtain their dose,” Testa said.
“Without a support network, the risk for relapse becomes enormous”— Catarina Testa, psychologist at a treatment center in Rome
“Everyone is under an immense amount of stress, trapped with flatmates and family members with whom they dont get on,” she added. “Without a support network, the risk for relapse becomes enormous, and the dealers are still out there, waiting when the users come looking for them.”
Drug delivery
In Spain, some users dont even need leave their homes to buy illegal drugs: during the first month of the countrys lockdown, police caught dealers masquerading as food delivery workers.
Alfonso Arana Marquina, president of Proyecto Hombre — Spains largest drug rehabilitation NGO — said that users overtaken by anxiety will go to any length to get their fix.
His organizations 27 centers have attempted to remain operational by limiting the number of people admitted to in-patient treatment to facilitate social distancing and also expanding phone therapy services to talk users through moments of desperation.
Spain does not have a national strategy for drug users, and regional administrations have taken different approaches. While the northern region of Navarre — where Arana Marquina is based — opened new shelters to allow homeless users to self-isolate safely, in Andalucía many outreach centers are closed.
“The collective we help has been especially hard hit by the elimination of that support,” Arana Marquina said.
Harm reduction
In Lisbon, NGOs like GAT Portugal — which works with people with HIV and viral hepatitis — have stepped in as public social services have shuttered.
GAT has kept its harm reduction centers open and taken to checking in on patients by phone, although this solution is “problematic for poorer people who dont own phones,” said Adriana Curado, coordinator of the groups mobile drug consumption project.
“We need to give users options, because if we dont, the results could be catastrophic” — Laurène Collard, coordinator at Fédération Addiction
To prevent new coronavirus infections, Curado has also limited the number of people allowed to access the van GAT operates with medical charity Médicos do Mundo, in which users can consume drugs in a supervised, sterilized environment.
Similar steps have been taken by Ares do Pinhal, an NGO that distributes methadone from vans that move throughout the city.
The lockdown in Portugal has closed restaurants and reduced opportunities to obtain money by begging or doing menial tasks, leaving many users without the cash to pay for drugs. This, said Curado, has led to a surge in demand for treatment.
In response to the crisis, the Portuguese government has taken steps to make it easier to access opioid substitution therapy and is considering loosening protocols regarding naloxone — a medication for opioid overdoses which had only been available in ambulances and hospitals.
The lockdown in Portugal has closed restaurants and reduced opportunities to obtain money by begging or doing menial tasks | Pedro Gomes/Getty Images
“Our harm reduction teams can now carry it, and were hoping to convince authorities to let us distribute it among users,” said Curado. “In a crisisRead More – Source
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