Statement by Dianova International – The unexpected irruption of Covid-19 all across the world has been an eye-opener on how crucial it is to have strong and well-prepared health systems. Health is a common responsibility which is too important for any of us to turn a blind eye.
Many high-income countries’ health systems have been on the verge of collapse, as hospitals have been struggling with surging infections. However, now that most European countries are seeing a “substantial decrease” in cases and the rest of the world is getting ready to face the peak of infections, some governments are starting to draw their own conclusions, from the need to strengthen primary care and telemedicine to the necessity of ending overdependence on offshore supply chains.
People who use drugs and Covid-19
The pandemic has revealed numerous dysfunctions in our health and care systems. Sadly, these dysfunctions have primarily been affecting those most vulnerable. Among them, Covid-19-related consequences seem to take a particularly heavy toll on people in the throes of substance use disorder and addiction, as well as on those in recovery.
According to the World Drug Report 2019, some 35 million people, up from an earlier estimate of 30.5 million reported in 2016, are affected by drug use disorders and require treatment and harm reduction services. The latest available data also indicates a staggering death toll: 585,000 people died as a result of drug use in 2017.
The challenges engendered by stay-at-home orders are likely to have had negative effects on people with substance use disorders or in recovery, including increased drug or alcohol consumption, risks of overdose, and relapse.
Moreover, as emphasized in a report by the European Monitoring Centre for Drugs and Drug Addiction, people who use drugs face additional risks of infection by Covid-19 as compared to the general population, because of lifestyle factors and pre-existing health problems. Examples of these include: the high prevalence of chronic pulmonary diseases among clients in treatment, and that of HIV, viral hepatitis infections and liver cancers – leading to weakened immune systems – among people who inject drugs.
In addition, the United Nations Special Rapporteur on the right to health pointed out that, in the current Covid-19 context, people who use drugs had to face – or are still facing – specific needs, due to criminalization, stigma, discrimination, social marginalization and higher economic and social vulnerabilities, including a lack of access to adequate housing and healthcare. He then concluded by stressing the need to recognize vulnerable groups of people who use drugs as a high-risk population in order to mitigate the spread of the pandemic.
Lastly, while about one third of all people who use drugs are estimated to be women, the latter are consistently reported to be at higher risk of HIV and other infections and more at risk of experiencing intimate partner violence than women in the broader population. This phenomenon is also likely to be exacerbated in these times of crisis.
Other mental health problems are also widespread: it is estimated that one in four people in the world will be affected by mental health disorders at some point in their lives placing such disorders among the leading causes of ill health and disability worldwide. This situation seems to have been worsened by the pandemic: lockdown measures and resulting economic downturn have negatively affected many people’s mental health and created new barriers for people already suffering from mental illness and substance use disorders.
Addiction services, essential services
Substance use disorders are life-threatening conditions and addiction prevention, treatment, reintegration, and harm reduction services, are needed more than ever. In the midst of a crisis of this proportion, the Dianova network’s addiction counsellors have, as most other addiction professionals, carried on with their mission and daily tasks dutifully, multiplying preventive protection actions. Dianova’s therapeutic communities and other addiction services healthcare facilities have taken very strict precautions to keep their beneficiaries and staff safe, whether by suspending new admissions or by limiting them to thoroughly screened or quarantined patients. Everywhere, Covid-19 prevention procedures have been put into play, all staff members remaining vigilant and duly following essential health and safety protocols and physical distancing measures.
Yet, in many countries, authorities have been able to give addiction services only very little support. In some cases, health systems initially thought of as solid have been unable to provide these professionals with basic personal protection equipment or financial support to buy them.
Be that as it may, our addiction professionals have been carrying out their duties with intellect and integrity despite these difficult and often dangerous circumstances, providing vulnerable people with appropriate counselling and support. They kept on working.
In order to mark the International Day against Drug Abuse and Illicit Trafficking, on June 26, Dianova would also like to pay warm tribute to the hard work, dedication, and innovative attitudes of all addiction professionals in these times of doubt and emergency.
This anniversary provides a perfect occasion for us to step up and demand that addiction services be on par with other healthcare services and that they be given similar levels of attention and support.
Should another crisis of this nature arise, addiction services shouldn’t be the poor relation of the public health system any longer. Substance use disorders and other addictive disorders are a matter of public health and addiction services should therefore be considered as essential. Because, as our campaign’s motto states it:
When everything is on pause, some of us must go on.
The Dianova network operates addiction prevention, treatment, recovery and rehabilitation facilities and services in various countries of Europe, the Americas, Asia and Africa – countries with varying situations with regard to the pandemic. All of our members have nevertheless reported taking very strict precautions to keep their residents and staff safe, while providing the best care for people suffering from mental health and substance use disorders. Everywhere, our staff are taking their jobs very personally and seriously, and every passing day they go much beyond what is asked of them.
Just one among many lessons, this pandemic is teaching us the pressing need to reaffirm and uphold the universal Right to Health.
Leaving No one Behind, as per the Agenda 2030, is today an even more relevant imperative towards building a world in which all people have an equal opportunity to attain the highest possible standard of health and well-being. Not only people living with substance use disorders have the right to be fully taken care of, even and most of all, in times of emergency, but so do all the professionals investing their lives in serving the most vulnerable.
Substance use and other addictive disorders are a public health issue
Addiction Services are essential