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The impact of the COVID-19 pandemic on harm reduction services in Spain

BACKGROUND: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and inf...

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Autores principales: Picchio, Camila A., Valencia, Jorge, Doran, Jason, Swan, Tracy, Pastor, Marta, Martró, Elisa, Colom, Joan, Lazarus, Jeffrey V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609370/
https://www.ncbi.nlm.nih.gov/pubmed/33143699
http://dx.doi.org/10.1186/s12954-020-00432-w
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author Picchio, Camila A.
Valencia, Jorge
Doran, Jason
Swan, Tracy
Pastor, Marta
Martró, Elisa
Colom, Joan
Lazarus, Jeffrey V.
author_facet Picchio, Camila A.
Valencia, Jorge
Doran, Jason
Swan, Tracy
Pastor, Marta
Martró, Elisa
Colom, Joan
Lazarus, Jeffrey V.
author_sort Picchio, Camila A.
collection PubMed
description BACKGROUND: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain. METHODS: This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers. RESULTS: All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for 2 months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses, human immunodeficiency virus, and tuberculosis) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm. CONCLUSION: Overall, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment such as methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy.
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spelling pubmed-76093702020-11-04 The impact of the COVID-19 pandemic on harm reduction services in Spain Picchio, Camila A. Valencia, Jorge Doran, Jason Swan, Tracy Pastor, Marta Martró, Elisa Colom, Joan Lazarus, Jeffrey V. Harm Reduct J Research BACKGROUND: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain. METHODS: This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers. RESULTS: All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for 2 months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses, human immunodeficiency virus, and tuberculosis) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm. CONCLUSION: Overall, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment such as methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy. BioMed Central 2020-11-04 /pmc/articles/PMC7609370/ /pubmed/33143699 http://dx.doi.org/10.1186/s12954-020-00432-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Picchio, Camila A.
Valencia, Jorge
Doran, Jason
Swan, Tracy
Pastor, Marta
Martró, Elisa
Colom, Joan
Lazarus, Jeffrey V.
The impact of the COVID-19 pandemic on harm reduction services in Spain
title The impact of the COVID-19 pandemic on harm reduction services in Spain
title_full The impact of the COVID-19 pandemic on harm reduction services in Spain
title_fullStr The impact of the COVID-19 pandemic on harm reduction services in Spain
title_full_unstemmed The impact of the COVID-19 pandemic on harm reduction services in Spain
title_short The impact of the COVID-19 pandemic on harm reduction services in Spain
title_sort impact of the covid-19 pandemic on harm reduction services in spain
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609370/
https://www.ncbi.nlm.nih.gov/pubmed/33143699
http://dx.doi.org/10.1186/s12954-020-00432-w
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