Effects of Covid-19 on Access to Addiction Treatment Services
The current public health crisis has cast us out into uncharted waters. For many people, this is coupled with boredom and crippling anxieties for the future. As many pick up the bottle to curb the monotony and uncertainty of their new lifestyle, we are must turn our attention to those in our communities who already face addiction and its consequences. In 2019 Ireland had over 10,000 people receiving opioid substitution treatment (OST) along with the fourth highest rate of drug related deaths in Europe. Numerous services for people struggling with addiction have been limited in recent weeks. Important issues such as addiction treatment run the risk of becoming lost in the shroud created by the frenzy of Covid-19, with Minister for Health Simon Harris noting that “addiction does not stop during a pandemic”.
Since the outbreak of Covid-19 there has been a nationwide shutdown of numerous services. Merchants Quay Ireland (MQI), Ireland’s largest voluntary addiction support service, have had to decrease their community patrols along with halting support services such as counselling, safe injecting workshops and supports for the families of those struggling with addiction. The detox and rehabilitation services run by MQI at St Francis’ Farm in Tullow and High Park in Drumcondra have ceased conducting assessments and new admissions. Detox programs at the Lantern Centre and the Keltoi rehabilitation program are no longer accepting new admissions. All Narcotics Anonymous(NA) and Alcoholics Anonymous (AA) meetings are now being conducted through online platforms. Despite the closure of many support services, numerous HSE funded clinics remain operational, prioritizing opioid substitution.
Clinics administering OST have relaxed their regulations surrounding the volume of treatment drugs that an individual is permitted to bring home. The HSE has also advised that doctors prescribing opioid substitutes to also prescribe Naloxone, a drug that counteracts the effects of opioid overdose. Gardai have reported a spike in the amount of methadone being sold on our streets. There have also been reports of vulnerable people on OST having their medication stolen from them using force. Unsurprisingly, take home alcohol sales have increased 40% compared to this time last year. Despite an overall decrease in the trade of illegal substances, many communities fear violence as drug debts may be called in under the threat of violence.
Concerns have surfaced regarding the risk of exposure for vulnerable people battling drug addiction, particularly those in homeless accommodation. Large numbers of people in this type accommodation are not facilitated to self-isolate. Smoking crack cocaine or heroin can lead to long term respiratory problems which may cause a higher risk of complications for those who contract Covid-19. Sharing needles, crackpipes or tooters can significantly increase the likelihood of exposure. MQI is still operating its needle exchange, conducting between 100-120 exchanges daily. While there are still various operations working to counteract the physical effects of withdrawal and overdose, emotional supports that were once available have either ceased or are more difficult to access.
In the words of author Johann Hari, “the opposite of addiction is not sobriety. The opposite of addiction is connection.” We must commend the healthcare workers working to ensure that those requiring OST receive their treatment. However, it is the emotional supports that play the most important role in ensuring an individual obtains long term success in their recovery from addiction. MQI has expressed their fear that there will be relapses and possibly deaths if lockdown continues. Maintaining healthy relationships, trust and connection with a support system has become increasingly difficult according to a statement made by the Saol Project. Furthermore, moving support services such as NA and AA meetings online will cut off many vulnerable people living in shelters with no or poor internet connection.
Due to the surge in relapses expected by organisations, there have been calls from groups such as the CityWide Drugs Crisis Campaign for the allocation of additional funding for government funded addiction treatment services once containment measures are lifted. The State has not commented on how they intend to aid addiction support services in the event of a spike in people seeking treatment. The lack of clarity from the State in this matter supports the suggestion that there is a possibility that this vulnerable group of people will not be adequately protected in the coming weeks and months.
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