Coronavirus and opioids

Coronavirus poses risks to us all.

But some of us are at greater risk of serious illness if we get infected.

Risk of severe illness from coronavirus for people who use drugs, including opioids, and for people who have substance use disorder is not yet fully understood. However, there are important facts people must be aware of to minimise their risk of infection and severe illness.

Current information indicates that older adults and people with an underlying medical condition could be at increased risk of serious illness from coronavirus and are advised to take special care.

Coronavirus is a respiratory illness. Underlying medical conditions such as chronic lung disease and heart conditions increase the risk of severe illness from coronavirus. People with these medical conditions need to take particular care.

People with a weakened immune system are also considered to be at greater risk and are advised to take special care.

Risks people who use opioids might face relating to coronavirus

If you use opioids or are dependent on opioids there are things you need to know.

• A common side-effect of opioid use and particularly misuse of opioids is respiratory depression. Opioids slow down, or even stop breathing. If you experience breathing difficulties while you have coronavirus, using opioids could make the issue worse. This may increase your overdose risk.

Using opioids alone can be risky. If you overdose alone, there will be nobody there to call emergency services or administer naloxone.

• Some people cannot access their usual opioid supply during lockdown. Substituting opioids with other drugs carries risks.
• Injecting opioids with non-sterile equipment, or in a non-sterile environment, may increase your risk of coronavirus transmission and infection.

Speak to your doctor to find out more about how your opioid use might put you at risk of severe illness from coronavirus.

How coronavirus is changing healthcare for people who use opioids

Healthcare providers around the world are changing the way they provide their services as a result of the coronavirus pandemic.

Many practitioners are making greater use of telemedicine – using digital communications technologies to conduct consultations online.

This has made accessing healthcare easier and more convenient for many people, including those who need opioids.

However, traditionally, many people who use opioids – especially those who are on Medication-Assisted Treatment – have needed to visit the doctor or a dispensing clinic in person.

In response to coronavirus, some regions are relaxing or have already relaxed some restrictions about access to Medication-Assisted Treatment.

This has included:

• Making takeaway doses of opioid dependence medications, such as methadone and buprenorphine, available from pharmacies and other dispensaries.
• Making long-acting pharmacotherapy medications that do not need administering as often as medications such as methadone (which needs to be consumed every day), more available.
• Allowing a designated person like a friend or family member to pick up and deliver your opioid substitution medication to you in person (often known as third-party dispensing).
• Having a healthcare professional visit your home to provide supervised dosing.

Please note that this is not the case in all countries.

To learn if access to MAT has changed in your area, please consult your doctor.

Reducing your risk of infection

Every person has a part to play in stopping the spread of coronavirus.

When using opioids, always follow clinical guidance and the advice of your local health authorities.

In addition, try to follow this advice to reduce your risk of contracting coronavirus.

• Try to take care of your health. Get enough sleep. Follow a healthy diet. Avoid smoking, exercise safely, and stay hydrated.
• If you inject opioids, ensure you have sterile equipment available if you need it.
• Try not to use alone and always carry naloxone.
• Know ahead of time how you will access support from loved ones, healthcare providers and the community if you voluntarily or involuntarily go into withdrawal during lockdown.
• If you decide to stop taking opioids altogether, speak to your doctor first. They will advise you on the safest way to reduce your use including starting on medication assisted treatment.

If you already receive support from a health worker like a needle exchange worker, counsellor or psychologist, share any concerns you have with them.

You may also decide to seek support and information from local drug and alcohol organisations, harm reduction services and telephone counselling and helplines. Staying in contact with services can be helpful.

Don’t forget to check in with your friends and family to lessen the mental health impact of coronavirus and the lockdowns in place in many parts of the world.

Having conversations with family, friends and your medical practitioners about your drug use and treatment is an important part of staying safe during this uncertain time.