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People who use illicit drugs, whether they are dependent or use them occasionally, are potentially at increased risk of harm during the coronavirus pandemic.
The coronavirus is too new to know the exact interaction with illicit drugs. There has been no peer reviewed research yet, and we don’t know how many people who have contracted the virus also use drugs.
However, we can estimate some of the possible impacts from what we know generally about drugs, their effects on the body, and how people use them, including in times of increased stress.
Regardless of your views on illicit drugs, reducing the harms from drug use during the pandemic will improve the well-being of people who use them, and those close to them. Reducing harms will also help avoid additional pressure on the health system.
Who are we talking about?
Around 2.5 million Australians (or 12.6% of people aged 14 or over) said they used an illicit drug in the previous 12 months. Cannabis was by far the most common, followed by cocaine and ecstasy.
Most use only a handful of times a year; around 10% are dependent.
In stressful times, drug use tends to increase
People are more likely to take illicit drugs (and drink alcohol) during times of stress. So it’s not surprising that, with isolation, boredom and financial worries, some people might increase their use of illicit drugs.
People who use drugs in response to stress are more likely to become dependent on them. For people who are already dependent, stress is related to relapse to drug use after treatment.
Illicit drugs have also been linked with domestic and family violence.
It’s a complex relationship between the two, but illicit drugs may interact with current stress, unemployment and spending long periods together in lockdown to further increase the risk.
Why are people who use drugs at increased risk?
Immune system
Illicit drugs, like alcohol, reduce immune function and increase susceptibility to infections. The more you use the greater the impact on your immune system.
So people who use drugs are more at risk of getting, and having complications from, COVID-19.
Lung problems
Inhaling, vaping or smoking drugs (like cannabis, heroin and methamphetamine) can directly cause lung damage.
Some drugs can also affect the lungs indirectly. For example, methamphetamine reduces blood flow to the lungs and heroin depresses breathing.
The coronavirus also weakens the lungs so people who use drugs may be more vulnerable to lung complications from COVID-19.
People who have a lung disease are also at more risk of overdose from some illicit drugs, such as heroin.
So if you contract COVID-19 and your lungs are affected, if you then use illicit drugs you potentially increase the risk of drug-related complications, such as overdose.
Chronic health problems
People with long-term drug problems are at greater risk of chronic diseases, such as heart disease.
People with additional chronic health problems are more likely to die from COVID-19.
Risks from sharing drugs
Some drugs are commonly shared. For example, a cannabis joint or bong is sometimes shared between a group of people.
As COVID-19 is spread from person to person through small droplets from the nose or mouth, sharing drugs and equipment can increase the risk of contracting the virus.
Changes in supply, production, price
There are a number of possible impacts of coronavirus-related changes to supply, including changes to drug availability and price.
A near-total shutdown of our borders may reduce the availability of both imported drugs and the chemical precursors needed to make them locally.
We might expect a reduction in supply to lead to an increase in price, which then tends to reduce demand. So, some people who use illicit drugs occasionally may decide to reduce or stop their use when it gets too expensive, or they may switch to more readily available drugs made locally.
How to reducing your risk
If you are able to, it is safest to stop using drugs during the current pandemic. If you continue to use drugs there are a number of things you can do to reduce your risk of harm.
- Stay as healthy as possible Eat well, drink plenty of water and get regular exercise. If you don’t feel well for any reason, see a doctor. The healthier you are the less likely you will get and have complications from COVID-19.
- Wash your hands, packaging and equipment Wash your hands before and after handling drugs, the packaging it came in, money or anything that has come from outside your home. Use warm water and soap, and wash for at least 20 seconds.
- Don’t share Don’t share joints, bongs, pipes or injecting equipment because you increase the risk of contracting COVID-19.
- Have someone check in on you It’s never advisable to use drugs alone. So during distancing and isolation, make sure you have someone to check in on you (remotely).
- Change route of administration If you normally inhale, smoke or vape your drugs, given the impact of coronavirus on lungs, consider an alternative way to use them if possible. Ingesting is safest.
- Withdrawal If you use illicit drugs regularly, reduced supply may mean you experience some withdrawal symptoms. Most people with mild dependence can safely withdraw at home, but if you have been using frequently (for example, daily) for several months or more, you may need supervised withdrawal. Talk to your GP or a drug treatment service who can advise whether home withdrawal is possible. If you or someone you are with begins to hallucinate, seems disoriented or loses consciousness while undergoing withdrawal, call triple zero immediately.
Nicole Lee and Jarryd Bartle, The Conversation