FACULTY OPINION: We Must Continue to Use Naloxone During COVID-19

Overdoses may be on the rise. Finding ways to safely administer life-saving interventions during the coronavirus pandemic is crucial.

By Nabila El-Bassel
June 08, 2020

People who use drugs are particularly vulnerable during the COVID-19 pandemic, as they may face the loss of necessary medical and drug treatments and programs that provide social contact and peer support. Public health restrictions that prohibit gatherings, enforce a six-foot boundary between individuals and discourage physical contact may inhibit the use of naloxone nasal spray (sold under the commercial name Narcan), an effective and widely available medication used to reverse overdoses.

This vulnerability arises at a key moment for the HEALing Communities Study (HCS) launched last year at the Columbia School of Social Work to tackle New York’s opioid crisis with the goal of reducing overdose fatalities by 40 percent in three years. As the principal investigator, I work closely with a multidisciplinary team of Columbia scientists and top researchers from several outside institutions to decrease opioid overdose deaths in 16 of the most burdened counties in New York State.

Despite the challenges of a concurrent public health crisis—COVID-19—we cannot forget those lives impacted by the overdose epidemic. In response to these simultaneous epidemics, the HCS team continues to emphasize the need for easy access to naloxone and the implementation of evidence-based treatments and harm reduction strategies. Communities involved in the study are finding new ways to distribute naloxone and disseminate information about its use. In Greene County, in east-central New York, where cancellations of support group meetings may have contributed to a spike in overdoses naloxone is being distributed in key locations such as housing units and motels. Some counties are offering free virtual training in how to administer the medication.

For the life-saving drug to be effective, friends and family of opioid users need guidance in how to dispense it safely, particularly with the COVID-19 mandated social distancing rules. Fortunately, steps can be taken to prevent both the person who administers the naloxone and the overdosing person from exposure. The New York Department of Health’s COVID-19 Opioid Overdose Prevention Program Guidance explains how the medication can be provided safely by taking precautions, such as by wearing a protective mask and gloves and routinely washing their hands.

People who use drugs with others should have naloxone on hand and agree on a plan for accidental overdose, knowing that first responders are in higher demand than usual. Loved ones should frequently check in with family members or friends who are using drugs and, in addition to carrying a mask, should always carry naloxone.

Nabila El-Bassel is University Professor at Columbia University, Director of the Social Intervention Group and Principal Investigator of the HEALing Communities Study, an $86 million grant from the National Institute on Drug Abuse to reduce opioid overdose death rates by 40 percent in 16 New York counties over three years. She originally submitted this “In Brief” op-ed to the Columbia News site. It has been cross-posted here with her permission.

Related links:

• COVID-19 Special Edition | Social Impact LIVE: The Collision of COVID-19 and Opioid Epidemics: Interview with Tim Hunt of the Social Intervention Group (4.14.2020; YouTube video)
• Statewide Opioid Overdose Prevention Study Introduced to Public (12.11.19 news article)
• Columbia’s HEALing Communities Study Holds First Community Advisory Board Meeting (10.23.19 news article + video)
• Columbia University’s School of Social Work Is Awarded $86 Million Grant from the National Institute on Drug Abuse to Reduce Opioid Deaths in New York State (4.18.19 news article)
• Social Intervention Group Joins the HEAL Initiative and Will Address Opioid Epidemic in New York State (12.21.18 news article)