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

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.