On March 11, 2020, the World Health Organization declared the illness caused by the novel coronavirus, COVID-19, a pandemic. It was declared British Columbia’s second public health emergency – the first being the opioid overdose crisis – this week.

People who use drugs often face social and structural challenges like housing insecurity that may make it difficult or impossible to follow current advice around social distancing and self-isolating. Ensuring the safety of people who use drugs in the midst of this crisis is a critical concern.

As the situation evolves here in British Columbia and around the world, it’s important to be responsive to the needs of people who use drugs. For instance, maintaining adequate access to essential medications (i.e. treatments for opioid use disorder), without interruption is of critical importance, to reduce the risk of harms (and even death) that can be associated with medication destabilization.

To make sure patients have continued and safe access to substance use care, health care providers should consider the following:

• Talk with all patients about COVID-19, including ways to reduce the risk of infection and transmission and any specific concerns related to that patient’s health (e.g., existing chronic health conditions, immunosuppression).
• Advise patients on how to recognize symptoms, and make suggestions around what to do if they get sick and if symptoms are too severe to manage at home (i.e. do they have a support person could check in on them and help them access essential items and food?)
• Make a contingency plan with patients in the event that they are unable to attend appointments or access the pharmacy (i.e. is telemedicine an option to regularly check in?)
• Consider other ways to get essential medications to patients that both reduce the number of patient visits (e.g., extending the duration of prescriptions) and promote social distancing (e.g., telemedicine). This may also include delivery of opioid agonist therapy (OAT) through outreach teams or a pharmacist.
• Follow hand hygiene, respiratory etiquette, and social distancing measures and advise patients to do the same. Have hand sanitizer available and consider face masks for those who present with respiratory symptoms.

The BCCSU has compiled new guidance for prescribers and pharmacists to support continuity of care for people with opioid use disorder. This guidance will be updated frequently as more information becomes available and can be found in the “Bulletins” section at www.bccsu.ca/opioid-use-disorder. Materials for patients will soon be available as well.

Here at the BCCSU, we’ll make every effort to stay up-to-date on potential disruptions in the drug supply chain or other factors that may affect medication availability. We’ll also provide updates as they become available.