Farhoudian A, Baldacchino A, Clark N, Gerra G, Ekhtiari H, Dom G, et al et al . COVID-19 and Substance Use Disorders: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine (ISAM) Practice and Policy Interest Group Position Paper. BCN 2020; 11 (2) :133-146
URL:
http://bcn.iums.ac.ir/article-1-1743-en.html
Ali Farhoudian1 ,
Alexander Baldacchino2 ,
Nicolas Clark3 ,
Gilberto Gerra4 ,
Hamed Ekhtiari5 ,
Geert Dom6 ,
Azarakhsh Mokri7 ,
Mandana Sadeghi8 ,
Pardis Nematollahi9 ,
Maryanne Demasi10 ,
Christian G. Schütz11 ,
Seyed Mohammadreza Hashemian12 ,
Payam Tabarsi13 ,
Susanna Galea-singer14 ,
Giuseppe Carrà15 ,
Thomas Clausen16 ,
Christos Kouimtsidis17 ,
Serenella Tolomeo18 ,
Seyed Ramin Radfar * 19,
Emran Mohammad Razaghi7
1- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.; Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Division of Population and Behavioral Sciences, St Andrews University Medical School, University of St Andrews, UK.
3- North Richmond Community Health, Victoria, Melbourne, Australia.; Royal Melbourne Hospital, Victoria, Melbourne, Australia.
4- Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria.
5- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA.
6- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.
7- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.
8- Aftab Mehrvarzi Substance Abuse Treatment Center, Tehran, Iran.
9- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
10- North Richmond Community Health, Victoria, Melbourne, Australia.
11- Department of Psychiatry, University of British Columbia, Vancouver BC, Canada.
12- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
13- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
14- Institute for Innovation and Improvement, IWaitematā DHB, Centre for Addictions Research, University of Auckland, Auckland, New Zealand.
15- Department of Medicine and Surgery, Section of Psychiatry, University of Milan Bicocca, Milan, Italy.
16- Norwegian Centre for Addiction Research (SERAF); University of Oslo, Oslo, Norway.
17- General Secretariat of Prime Minister, Ministry of Health, Athens, Greece.
18- Department of Psychology, National University of Singapore (NUS), Singapore.
19- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.; Integrated Substance Abuse Programs, University of California, Los Angeles, California, USA.
Abstract:
Coronavirus disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations. People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD).
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● Health care providers in treatment and harm reduction settings must always have PPE.
● Screening of PWUD with COVID-19 is a priority with respects to human rights.
● Creative, evidence based and realistic approaches are needed for the current situation.
● Virtual context and mobile base platforms could facilitate mainstream interventions.
● Different clinical manifestations and drug interactions are major issues in PWUD with COVID19.
Plain Language Summary
The new coronavirus created a complex situation for all sections of the communities around the world. Health care providers are in the frontline of intervening to stop the spread of COVID-19. Meantime people who use drugs (PWUD) are at increased risk during this pandemic since they are a stigmatized and marginalized populations. Health service providers who are providing different needs for PWUD in treatment and/or harm reduction settings should always keep themselves safe with using standard PPE based on the WHO recommendations. Additionally PWUDs live in crowded locations and so screening and early identification of COVID-19 patients are important to break the cycle of transmission. It is recommended that protocols for opioid substitution therapy modify with complete adherence to patients' safety regarding both opioid drug risks and COVID-19 infections. It is important to have in mind that different stages of OST needs different approaches. PWUDs are more vulnerable to stress and other mental health problems. This makes psychological interventions such as cognitive-behavioral therapy and other modalities very important to have for PWUDs during these difficult and challenging times to assist and sustain treatment. Medical conditions such as respiratory illness, renal insufficiency, chronic pain and cardiovascular disorders are also important medical conditions that should be addressed appropriately among PWUDs with COVID-19. Health service providers in both fields of addiction treatment and COVID-19 treatment and prevention systems should be aware regarding special situations arising in the overlap of drug use and COVID-19 illness.
Type of Study:
Review |
Subject:
Clinical Neuroscience Received: 2020/04/7 | Accepted: 2020/04/9 | Published: 2020/07/1