The impact of the COVID-19 pandemic on harm reduction services in Spain
Abstract 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,...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-11-01
|
| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12954-020-00432-w |
| _version_ | 1811294278039633920 |
|---|---|
| author | Camila A. Picchio Jorge Valencia Jason Doran Tracy Swan Marta Pastor Elisa Martró Joan Colom Jeffrey V. Lazarus |
| author_facet | Camila A. Picchio Jorge Valencia Jason Doran Tracy Swan Marta Pastor Elisa Martró Joan Colom Jeffrey V. Lazarus |
| author_sort | Camila A. Picchio |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-13T05:15:09Z |
| format | Article |
| id | doaj.art-e208892905364336bee4a3fe6955bc72 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-13T05:15:09Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-e208892905364336bee4a3fe6955bc722022-12-22T03:00:55ZengBMCHarm Reduction Journal1477-75172020-11-0117111110.1186/s12954-020-00432-wThe impact of the COVID-19 pandemic on harm reduction services in SpainCamila A. Picchio0Jorge Valencia1Jason Doran2Tracy SwanMarta Pastor3Elisa Martró4Joan Colom5Jeffrey V. Lazarus6Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of BarcelonaUnidad Móvil de Reducción del Daño SMASDFaculty of Public Health and Policy, London School of Hygiene and Tropical MedicineComisión Ciudadana Antisida de BizkaiaMicrobiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias I Pujol, Institut D’Investigació en Ciències de La Salut Germans Trias I Pujol (IGTP)Programme for Substance Abuse and for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis, Agency of Public Health of CataloniaBarcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of BarcelonaAbstract 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.http://link.springer.com/article/10.1186/s12954-020-00432-wCOVID-19Harm reductionHealthcare utilisationHealth systemsSpain |
| spellingShingle | Camila A. Picchio Jorge Valencia Jason Doran Tracy Swan Marta Pastor Elisa Martró Joan Colom Jeffrey V. Lazarus The impact of the COVID-19 pandemic on harm reduction services in Spain Harm Reduction Journal COVID-19 Harm reduction Healthcare utilisation Health systems 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 | COVID-19 Harm reduction Healthcare utilisation Health systems Spain |
| url | http://link.springer.com/article/10.1186/s12954-020-00432-w |
| work_keys_str_mv | AT camilaapicchio theimpactofthecovid19pandemiconharmreductionservicesinspain AT jorgevalencia theimpactofthecovid19pandemiconharmreductionservicesinspain AT jasondoran theimpactofthecovid19pandemiconharmreductionservicesinspain AT tracyswan theimpactofthecovid19pandemiconharmreductionservicesinspain AT martapastor theimpactofthecovid19pandemiconharmreductionservicesinspain AT elisamartro theimpactofthecovid19pandemiconharmreductionservicesinspain AT joancolom theimpactofthecovid19pandemiconharmreductionservicesinspain AT jeffreyvlazarus theimpactofthecovid19pandemiconharmreductionservicesinspain AT camilaapicchio impactofthecovid19pandemiconharmreductionservicesinspain AT jorgevalencia impactofthecovid19pandemiconharmreductionservicesinspain AT jasondoran impactofthecovid19pandemiconharmreductionservicesinspain AT tracyswan impactofthecovid19pandemiconharmreductionservicesinspain AT martapastor impactofthecovid19pandemiconharmreductionservicesinspain AT elisamartro impactofthecovid19pandemiconharmreductionservicesinspain AT joancolom impactofthecovid19pandemiconharmreductionservicesinspain AT jeffreyvlazarus impactofthecovid19pandemiconharmreductionservicesinspain |