ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Study: 'Safe supply' of drugs, alcohol lead to COVID compliance at isolation shelters

Canadian researchers recently reported how a Halifax pandemic response to a shelter outbreak provided "safe supply" of substances to persons experiencing homelessness. The effort saw few adverse events, high rates of adherence during 14-day seclusion in hotels.

pexels-moussa-idrissi-3645478.jpg
A Halifax, Canada project to provide managed drinking and "safe supply" of prescription drugs was associated with successful pandemic isolation for persons with substance dependency and without housing.
Image courtesy of Pexels/Moussa Idrissi
We are part of The Trust Project.

ROCHESTER — Sometimes the greater good is the greater good — even if that means supplying addictive substances to persons with chemical dependency in exchange for compliance during a pandemic.

That was the thinking behind a May 2021 so-called "safe supply" project serving occupants of isolation shelters in Halifax, Nova Scotia. The work is known as “risk mitigation,” or “pandemic prescribing,” and was recently reported in the preprint journal medrxiv.org .

That paper reported how health care workers responded following a COVID-19 outbreak in the Halifax congregate shelter system last spring. A multidisciplinary team was dispatched to provide prescription medications and alcoholic beverages to occupants in need while secluded under health orders in COVID-19 hotel shelters.

The resulting retrospective review paper, by researchers from Dalhousie University and University College London, examined the safety and effectiveness of this initiative, which provided beer, wine, liquor, opioids, stimulants and benzodiazepines as needed, in exchange for isolation adherence among persons experiencing homelessness.

The 25-day project admitted 77 residents to a staffed floor of hotel rooms turned into isolation shelters. Addiction medicine specialists assessed residents upon arrival about their concerns regarding the potential for experiencing withdrawal from alcohol, medication or cigarettes. Just 15, or 19%, responded that they had no such concerns.

ADVERTISEMENT

Of the rest:

  • 17 received opioid replacement medications
  • 27 received the opioid Dilaudid
  • 31 received Ritalin or another stimulant
  • 6 received benzodiazepines
  • 42 received alcohol, primarily in the form of beer

Some participants may have received more than one substance over the course of the study.
Over 14 days, just six residents left prematurely, and four of those later returned.

No residents experienced overdoses, with workers reporting intoxication on six occasions and diversion on three occasions, according to the paper.

"We found that an emergency, provisional safe supply program providing pharmaceutical-grade medications and beverage-grade alcohol in COVID-19 isolation hotel shelters was associated with low rates of adverse events and of high rates of successful completion of the mandatory 14-day isolation stay," the authors reported. "This suggests this approach is safe and effective in this setting."

The effort also tracked the degree to which the residents increased their intake over time. "Over 14 days in isolation," the authors reported, "mean daily dosages increased" for both opioids and alcohol, the latter from 12 to 13 drinks.

The initiative stems from an ongoing call to rethink of drug and alcohol policy in such a way to reduce worsening effects of the criminal justice system, poor health, drug adulteration and poverty, an approach known as "harm reduction."

Because the findings were published on the pre-publication health sciences server medrxiv, it is research that has not yet been peer reviewed, and therefore should be read with caution.

Paul John Scott is the health correspondent for NewsMD and the Forum News Service. He is a novelist and was an award winning magazine journalist for 15 years prior to joining the FNS in 2019.
What to read next
In Minnesota, abortion is protected by the state’s constitution and is legal up to the point of viability, which is generally thought to begin at about 24 weeks, when the fetus can survive outside the womb. Those who work with Minnesotans who seek abortions say barriers, both legal and practical, forced some to travel to Colorado, Nebraska, New Mexico, Washington, D.C., and Wisconsin even prior to the Supreme Court’s decision.
"Minding Our Elders" columnist says it's important to remember that we can't "fix" aging for our parents, but we can listen with empathy and validate their feelings.
“It’s clear that monkeypox has come to Minnesota,” said state Epidemiologist Dr. Ruth Lynfield. “While our current cases are associated with travel outside Minnesota, we expect we will soon see cases among people who have no travel history or contact with someone who did, indicating that spread within social networks in Minnesota is occurring.”
Your body adjusts to hot weather slowly. So when heat waves hit, you need to know how to hydrate and stay cool to avoid heat-related illness. This is especially true for babies and older adults. In this episode of NewsMD's "Health Fusion," Viv Williams gets tips from an emergency medicine doctor about how to stay healthy in extreme heat.