Harm reduction and abstinence-based models for treatment of substance use disorders during the COVID-19 pandemic: a global perspective

Venkata Lakshmi Narasimha; J L Butner; Enjeline Hanafi; Mehdi Farokhnia; Roshan Bhad; Fatemeh Chalabianloo; Christos Kouimtsidis; Alexander Baldacchino; Shalini Arunogiri

doi:10.1192/bji.2022.1

Harm reduction and abstinence-based models for treatment of substance use disorders during the COVID-19 pandemic: a global perspective

BJPsych Int. 2022 Aug;19(3):66-69. doi: 10.1192/bji.2022.1.

Authors

Venkata Lakshmi Narasimha¹, J L Butner², Enjeline Hanafi³, Mehdi Farokhnia⁴, Roshan Bhad⁵, Fatemeh Chalabianloo⁶, Christos Kouimtsidis⁷, Alexander Baldacchino⁸, Shalini Arunogiri⁹

Affiliations

¹ Assistant Professor, Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India.
² Addiction Medicine Specialist, Yale University School of Medicine, New Haven, Connecticut, USA.
³ Department of Psychiatry, Addiction Psychiatry Division, Faculty of Medicine, Universitas Indonesia, Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
⁴ Staff Scientist, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
⁵ Associate Professor, National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
⁶ Senior Consultant in Addiction Medicine and PhD Fellow, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
⁷ Honorary Senior Lecturer in Addictions, Department of Medicine, Division of Brain Sciences, Imperial College London, United Kingdom.
⁸ Medicine, Psychiatry and Addictions Professor, Division of Population and Behavior Sciences, Medical School, University of St Andrews, UK.
⁹ Monash Addiction Research Centre and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia. Email: shalini.arunogiri@gmail.com.

Abstract

The COVID-19 pandemic has significantly affected treatment services for people with substance use disorders (SUDs). Based on the perspectives of service providers from eight countries, we discuss the impact of the pandemic on SUD treatment services. Although many countries quickly adapted in provision of harm reduction services by changes in policy and service delivery, some went into a forced abstinence-based strategy. Similarly, disruption of abstinence-based approaches such as therapeutic communities has been reported. Global awareness is crucial for responsible management of SUDs during the pandemic, and the development of international health policy guidelines is an urgent need in this area.

Keywords: Abstinence; COVID-19; addiction; harm reduction; substance use; treatment.

Publication types

Review