Substance use disorder and chronic physical conditions including smoking and respiratory issues are common in this population, increasing risk of complications and mortality in the event of SARS-CoV-2 infection. People who use illicit drugs (PWUD) are particularly vulnerable to experiencing direct and indirect harms of the COVID-19 pandemic. Pandemic-related measures may have lasting impacts among vulnerable subgroups continued monitoring is warranted. There were signals of increased exposure to high-risk environments as well as deteriorations in access to health services. This snapshot suggests mixed impacts of the COVID-19 pandemic on PWUD in Montreal in the months following declaration of a provincial health emergency. 45% tried to access supervised injection sites, of whom 71% gained entry. Among persons reporting past six-month injection drug use, 79% tried to access needle-syringe programmes during the health emergency 93% of those obtained services. Adverse changes were also noted in indicators pertaining to income, drug markets, drug use frequency, and exposure to violence however, many participants reported no changes in these areas.
Many participants perceived increased difficulty accessing non-addiction health care services. 48% of opioid agonist treatment recipients had discussed strategies to avoid treatment disruptions with providers 22% had missed at least one dose. 70% of unstably housed participants reported increased difficulty finding shelter since the start of the health emergency. 83% and 41% reported past six-month illicit drug use and injection drug use, respectively. ResultsĪ total of 227 participants were included (77% male, median age = 46, 81% Caucasian). Participants were asked to report on events and changes since the start of the health emergency (March 13, 2020). Telephone and in-person interviews were conducted in May–June and September–December 2020.
We administered a structured rapid assessment questionnaire to members of an existing cohort of PWUD and individuals reporting past-year illicit drug use recruited via community services. This study aimed to document short-term changes in behaviours and health-related indicators among PWUD in Montreal, Canada following declaration of a provincial health emergency in Quebec. People who use drugs (PWUD) are at high risk of experiencing indirect harms of measures implemented to curb the spread of COVID-19, given high reliance on services and social networks.
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