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News: NHS Tayside Advice for People Who Use Drugs Around CORONAVIRUS (COVID-19)

ADVICE FOR PEOPLE WHO USE DRUGS AROUND CORONAVIRUS (COVID-19)

What is coronavirus?

Coronavirus (COVID-19) is a virus first discovered in late 2019. COVID-19 affects your lungs and airways and can lead to health complications such as pneumonia (a lung infection that causes inflammation).

The symptoms of coronavirus are a cough, fever (high temperature) and/or shortness of breath. But these symptoms do not mean you have the illness as the symptoms are similar to other viruses like the cold and flu.

The best ways to prevent spreading the virus are to:

  • Cover your mouth and nose with a tissue or sneeze/cough into your elbow – bin any tissues straight away
  • Wash your hands with soap and water often – washing them for at least 20 seconds. Soap and water is best but if not available – use alcohol-based hand gel
  • Try to avoid close contact with people who are unwell and limit your own contact with other people if you have any of the symptoms (at least 7 days)
  • Avoid touching your face and clean and disinfect any frequently touched objects and surfaces – including your phone!

Worried about coronavirus?

Viruses (such as the common cold, flu and hep C) and bacteria (such as E. coli and Staph), can be spread when people take drugs with unclean or shared equipment. To help prevent the spread you should:

  • Wash your hands for at least 20 seconds before and after you handle, prepare or take drugs
  • Clean surfaces with alcohol wipes before preparing drugs – you can get them free with your equipment!
  • Crush substances down as fine as possible before use to reduce damage to your skin (cuts can increase the likelihood of disease transmission)

Cutting down on or avoiding tobacco can also help keep your lungs prepared to fight off any illness. Your local Stop Smoking Service (free from community pharmacies) can offer resources and advice if you want to stop or cut down.

How are you taking drugs – Injecting?

  • Only use clean needles and supplies. Free, clean needles are available from needle exchange services
  • Wash injection sites (before and after)
  • Avoid sharing equipment (including needles, filters, containers, spoons and water) – use coloured coded equipment so you don’t get mixed up
    Smoking?
  • Inhaling drugs can damage the mouth, throat and lungs and can cause breathing difficulties which can make any infection worse and slow down healing
  • If smoking from foil, use clean foil each time
  • Keep all pipes and bongs clean and disinfect them regularly
  • Avoid sharing pipes, joints, cigarettes and vapes
    Snorting?
  • Avoid sharing snorting tools
  • Avoid using notes or keys which can harbour viruses and bacteria – use a clean straw, post-it or piece of paper and bin it after use
  • Rinse your nose out with clean water at the end of a session

What are the risks of using drugs if I have COVID-19?
If you have COVID-19 it will affect your lungs and airways. Any drugs that slow down your breathing (for example heroin, methadone, diazepam and gabapentin) will make it harder for your body to maintain your breathing when it is already fighting off the infection. It is important that you have a naloxone kit that can temporarily reverse the effects of opioids if your body is struggling. If you need to self-isolate remember that using alone is risky. If you are alone, use less to reduce your risk of overdose and try to let someone else know what you are taking.

Where can I get Naloxone?
Naloxone is available at a number of services across Tayside but during an outbreak supplies will be maintained at:
Dundee – Cairn Centre IEP
Perth – Drumhar Health Centre IEP
Angus – Angus Integrated Drug and Alcohol Recovery Service (AIDARS)

What if I need to self-isolate?

If you are told to self-isolate, you should ask someone to collect injecting equipment for you and take it to your house. Ask them to collect enough equipment to last you for up to 14 days (enough for clean equipment for every injection).

What about cleaning and re-use of equipment?
Cleaning needles and syringes should be a last resort but you might need to do this if you cannot get to a needle exchange (if you are self-isolating, sick or if the Government restrict public movement).

The method below can be used for sterilising needles and syringes, which will reduce the risks of Blood Borne Virus (BBV) transmission but you need to follow the process very carefully to properly disinfect injecting equipment. You will need 3 sterile containers, 2 containing water and 1 containing bleach.

Container 1 Water The syringe should be filled to the top by drawing up the water to fill the full barrel. This water should be squirted out (away from other paraphernalia) ideally down a sink or toilet.
Container 2 Thin Bleach Then, the syringe should be filled to the top with thin bleach, by drawing and squirting out (away from other paraphernalia) ideally down a sink or toilet.
Container 3 Water Then, the syringe should be filled to the top by drawing up clean water to fill the full syringe. This water should be squirted out (away from other paraphernalia) ideally down a sink or toilet.

There is still a risk of BBV transmission from other injecting paraphernalia (spoons, water, filters) so you should have a BBV test once normal services start again.

Interruption to supply
Travel and work restrictions may cause an interruption to the supply of drugs. This means that the drugs you are buying could be more likely to be cut with something unexpected or may not contain only or any of the drug you expect.

Withdrawal
If you don’t have access to the drugs you usually take you could experience symptoms of withdrawal. Withdrawal symptoms can include seizures, sickness and diarrhoea, headaches, pains and hallucinations. The severity of the symptoms will vary depending on the type and amount of drug used but most symptoms will ease after a few weeks. Ask your pharmacy if you can take medicines to help such as loperamide to help with diarrhoea and ibuprofen or paracetamol to help with the headache.

Taking benzos, GHB/GBL or drinking alcohol?
If you take these drugs on a regular basis it is important to avoid sudden withdrawal. If you think you will be short in supply try to taper (reducing the amount you take each day) slowly and seek help and advice from your local drug service. If symptoms become too much seek medical help and in an emergency call 999.

Taking downers?
Drugs like heroin and Valium slow down your central nervous system, reducing your heart rate and breathing. If you are taking these drugs during times of respiratory infection be aware that these drugs could reduce your breathing to a dangerous level. If you require medical assistance be honest about the drugs you are taking.

Accessing services
NHS Tayside will try to maintain needle exchange services as normal but some services may reduce the hours that they are open or some services may close. Keep an eye on their social media accounts and look for any local or national announcements.

Where to get information
It can be stressful to read about COVID-19 in the media. Sometimes the information from some news sources can create feelings of panic. Think about the sources of information that you are reading. A good way to keep up to date with the facts about COVID-19 would be to stick to trusted sources like the ones listed below: