Helping people who use substances during the COVID-19 pandemic

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Risks for people who use substances during the COVID-19 pandemic

The COVID-19 pandemic is adding to the ongoing public health crisis related to high rates of opioid overdose and deaths, as well as acute substance use harms. These crises are made worse in communities where there is chronic overcrowding, including a shortage of housing or other shelters.

At the intersection of these public health crises, people who use substances are likely to experience a number of increased risks:

To address these issues, we are taking a number of targeted actions to reduce the risk of harm for people who use substances.

Health Canada and the Public Health Agency of Canada have been working with provinces, territories and other partners, including researchers, advocates and people with lived and living experience. The goal of this work is to help make sure that people who use(d) substances can continue to access treatment, harm reduction and other substances during the pandemic.

Improving access to overdose prevention services

For a limited time, Health Canada is allowing each province and territory to establish new temporary spaces within existing supervised consumption sites, shelters or other temporary sites as needed. These temporary spaces will:

Provinces and territories can allow municipalities to exercise this authority on their behalf.

Facilitating access to a safer supply of medication-assisted treatment

Access to a safer supply of medication-assisted treatment and harm reduction measures during the pandemic will:

1) Health Canada has asked provinces and territories and regulatory colleges to:

2) Health Canada issued a class exemption to allow pharmacists to:

These exemptions also ensure continued access to pharmacotherapy for addiction treatment and management of other health conditions such as chronic pain.

3) Health Canada has allowed prescribers to issue verbal prescriptions for narcotics. This allows patients with chronic medical needs to follow social distancing and self-isolation guidance.

4) The Minister of Health has sent a letter to Provincial and Territorial Ministers of Health and regulatory colleges. This letter encourages action at all levels to better provide people who use drugs with a full spectrum of options for receiving care from practitioners, including safer supply prescribing.

Providing guidance and awareness on changes to accessing medication

We are providing guidance and leadership on prescribing, dispensing and delivery of opioids and other narcotics during the pandemic. We will ensure that provinces, territories and health professionals are aware of the changes made to facilitate access to medication for people who use substances.

Canadian Research Initiative in Substance Misuse (CRISM) guidelines

Through funding from the Canadian Institutes of Health Research, the Canadian Research Initiative in Substance Misuse (CRISM) has developed a series of national guidance documents related to substance use in the context of COVID‑19.

All 6 are complete:

  1. Telemedicine Support for Addiction Services
  2. Supporting people who use substances in shelter settings during the COVID 19 pandemic
  3. Supporting people who use substances in acute care settings during the COVID-19 pandemic
  4. Medications and other clinical approaches to support physical distancing for people who use substances during the COVID-19 pandemic
  5. Strategies to reduce SARS-CoV-2 transmission in supportive recovery programs and residential treatment services – version 1
  6. Harm reduction worker safety during the COVID-19 global pandemic – version 1

Guidelines are published at https://crism.ca/projects/covid.

Health Canada Toolkit: COVID-19 and substance use

Health Canada has developed and distributed a toolkit to service providers to support people who use drugs to physically distance and self-isolate and stay safe.

The toolkit provides a summary of the exemptions now in place for health care providers to facilitate flexible models of care during the pandemic. The toolkit includes:

Providing information on the impacts of COVID-19 on substance use

Health Canada provides funding to organizations like the Canadian Centre on Substance Use and Addiction (CCSA), which has developed an Impacts of COVID-19 on Substance Use online information hub. The hub includes publications from CCSA experts and links to other resources about substance use and COVID-19.

Supporting those who are most vulnerable during the pandemic

We are:

Addressing the urgent needs in Indigenous communities

We are establishing a $305 million new distinctions-based Indigenous Community Support Fund to address immediate needs related to COVID-19 in First Nations, Inuit and Metis Nation communities. This fund could be used for measures such as:

To support Indigenous women and children fleeing violence, we:

Indigenous Services Canada’s First Nations and Inuit Health Branch (ISC-FNIHB) efforts include the new listing of Sublocade (buprenorphine extended-release injection) in the Non-Insured Health Benefits (NIHB) Program.

Effective April 27, 2020, NIHB listed Sublocade (buprenorphine extended-release injection) as a limited use benefit with the following criteria:

Supporting mental wellness during and after the COVID 19 pandemic is an essential service. There is a wide range of virtual resources available to help Indigenous communities with their mental wellness. Counselling, cultural supports, and other forms of treatment are available through telehealth and on-line platforms.

Connecting Canadians with mental health and substance use supports

The Minister of Health launched a new portal dedicated to mental health and substance use. Wellness Together Canada Portal provides free:

On March 29, 2020, the Prime Minister announced an investment of $7.5 M to Kids Help Phone to expand crisis supports for children and youth during the COVID-19 pandemic.

The Canadian Pain Task Force has assembled a list of resources, which people living with pain and their partners in care may find helpful during this time. The list has been shared with stakeholders and posted to the Canadian Pain Task Force website.

Allowing community organizations to mobilize resources to protect themselves

Health Canada is working with community organizations funded through the Substance Use and Addictions Program (SUAP) to re-direct funding to support the COVID-19 response. For example:

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