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Suggestions about treatment, care and rehabilitation of people with drug use disorder in the context of the COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease is characterized by a respiratory infection with symptoms ranging from mild common cold/flu-like to more serious health problems.
The symptoms usually include fever, coughing, sore throat and shortness of breath. Muscle pain and tiredness have also been described. On 11 March 2020, the World Health Organization (WHO) announced that the current outbreak of COVID-19 is a pandemic1.
Although COVID-19 is usually mild and most people recover quickly, it can be very serious for certain groups of people, including the elderly and people with stressed immune systems or underlying conditions.
Pandemics and health emergencies like the current COVID-19 outbreak can cost many lives and pose additional risks to the global economy and overall security and stability.
Ensuring continued access to health care during a pandemic, including services for people who use drugs and treatment of drug use disorders, is key not only to protect the health of populations, but also key to security and stability.  Drug use disorders are frequently accompanied by somatic conditions such as HIV/AIDS, hepatitis B and/or C, tuberculosis, lung or cardiovascular disease, stroke, cancer and injuries and traumas among others.
Moreover, people with drug use disorders, especially those who inject drugs, may have a compromised immune system. Finally, stigma and discrimination linked to drug use and drug use disorders often result in limited access to basic resources such as housing, employment, health care and social support.
For all these reasons, it may be more difficult for people who use drugs and with drug use disorders to protect themselves and they may be particularly at risk of developing COVID-19.
Therefore, it is important to ensure the continuity of adequate access to health and social services for people who use drugs and with drug use disorders and to provide the continuum of care required as described in the International Standards for the Treatment of Drug Use Disorders (UNODC/WHO, 2020) to the best extent possible also in times of crisis.
This includes low-threshold services as well as psychosocial treatment and pharmacological treatment in a range of settings. This is also in line with the strong mandates of the Member States of the United Nations that have, inter alia, committed to health for all leaving no one behind in the 2030 agenda and highlighted the need to protect the health, safety and well-being of individuals, families, vulnerable members of society, communities and society as a whole in the UNGASS 2016 Outcome Document on addressing the world drug problems.
In this context, it is suggested that Member States and drug treatment, care and rehabilitation systems and services develop plans to ensure continuity of care for people who use drugs and people with drug use disorders, bearing in mind the following issues.

 

Suggestions about treatment, care and rehabilitation of people with drug use disorder in the context of the COVID-19 pandemic