The COVID-19 emergency brings new challenges for substance misuse

Every Thursday evening, we step outside and rightfully applaud our brilliant NHS workers. It is a show of genuine respect for people who are going above and beyond in these unprecedented times, and often putting themselves at risk in order to help others. They are among the very best of us.

But as the UK enters another week of lockdown, we should also think of the thousands of frontline staff who work in the substance misuse, criminal justice, homelessness and mental health sectors. They are also ensuring that some of the most vulnerable people in our society are cared for during this pandemic – and they are, as ever, offering life-saving support and ensuring the people they serve are safe. Their efforts are helping to protect the NHS by keeping people out of hospitals and allowing them to focus on those living with COVID-19.

As anyone who works with vulnerable people will tell you, ‘continuity of care’ for these groups is vital. A sudden change in someone’s personal circumstances can, for example, have a big impact on their recovery from a drug or alcohol problem. And so we should also think of how frontline workers have had to respond in recent weeks. Where premises have had to be closed, where social-distancing rules have been applied, and where working practices have been turned on their head in a national effort to slow the spread of Covid-19.

Inevitably, such big changes have brought (and will continue to bring) new challenges and it’s important that we recognise them, and find a way to mitigate their worst effects. That’s why Collective Voice have been in constant communication with partners across the social care sector, to identify issues, to raise concerns with central government, and to help find solutions wherever we can.

In this blog, we will explore three of these key issues.

• Drug and alcohol treatment services are dealing with a critical shortage in personal protective equipment (PPE)
  
  This issue is clearly not unique to our sector, and we understand that acute NHS settings are rightly prioritised. But people with substance misuse problems are disproportionately affected by poor health, including (often under-diagnosed) illnesses that would categorise them as ‘extremely clinically vulnerable’, as well as a range of other disadvantages – including homelessness – that may put them at increased risk of contracting and being adversely affected by COVID-19.
  
  And while treatment and recovery services – through tremendous effort – are moving lots of their work online, some aspects of it must be delivered face-to-face. Support in residential and detox settings continues to support some of the most vulnerable people with substance use and allied needs in our country and right now some of those workers don’t have the equipment they need to stay safe. 
  
  
• Government action to protect people experiencing rough sleeping.
  
  The government has acted proactively, in response to the Covid-19 pandemic, by calling on local authorities to ensure that anyone experiencing rough sleeping is housed. A number of hotels across the country are currently being used to provide accommodation. This is to be commended and will have reduced the public health risks experienced by that group.
  
  Some fantastic collaboration in the field has created an emergency support system to meet the drug and alcohol needs of a group of people likely to be experiencing a whole host of life challenges. Read more about London’s: Homeless Hotels Drug and Alcohol Support Service (HDAS).
  
  Whilst we should be heartened by this response at a time of crisis serious challenges exist across the county in how we meet the needs of this group. Collective Voice will be doing what it can to share the learning from the creation of HDAS.

• The Ministry of Justice has announced that ‘Selected low-risk offenders, within weeks of their release dates, will be electronically tagged and temporarily released on licence in stages’.
  
  Reports of COVID-19 cases in prisons are deeply concerning for the high number of extremely vulnerable people currently imprisoned, as well as for the public servants working in custodial settings. A serious outbreak in the prison estate could be devastating, so we welcome the government’s focus on this issue.
  
  However, given the high prevalence of drug use in prisons, and the major challenges facing the community treatment network (including pharmacy provision) there are serious and legitimate concerns as to how those released (estimates suggest the number could be as high as 4,000) will be supported. Even before the current crisis there were serious issues following years of disinvestment which impeded continuity of care from prisons to community treatment.
  
  As a field we’d like to see prisoners released in tranches and not en masse, not released on Fridays, and with a clear plan for continuity of care and stable accommodation. NHS England has produced some useful guidance on this issue. As with the above issue of hotel accommodation the field is ready to adapt, and to do what must be done to ensure the released prisoners get the help they need.

Some next steps, and how you can help the sector

The Covid-19 pandemic will continue pose serious challenge to our field, and at Collective Voice we will be doing everything we can to support frontline services through the uncertain period ahead.

We want to hear about your experiences of what’s happening on the frontline, we will bring experts from the field together, in order to troubleshoot problems, and we will identify and share good practice across our networks. It’s important to do this, as we believe our greatest strength is our ability to rapidly respond to the latest developments, linking our expertise, finding solutions and raising issues with policy makers where we need to. But we can only do this with your support to feed in your knowledge and experience.

This is why starting this week we are launching a series of new communication resources to support you. The first will be a weekly COVID-19 bulletin, bringing together the latest news and guidance relevant to drug and alcohol treatment and recovery. Please sign up for the email bulletin here.

We will next week be promoting an open Slack channel for the sector to share information, inspiration and resource and provide peer support to negotiate the challenges ahead. This may be particularly useful for smaller organisations. (Slack is an online instant messaging platform where you can organise conversations by different topics. We will publish a plain-English guide to using this channel, which we hope will be a safe space to raise problems, identify solutions and collaborate).

Lastly, we’re looking into how we can host webinars to highlight the insights and analysis of experts from the field.

And as ever, we want to hear from you. Whatever your concerns or suggestions, please keep in touch with us throughout this crisis. You can do this by emailing Peter or tweeting us.