As the World Health Organization (WHO) declares the COVID-19 outbreak a pandemic, we need to consider how to look after the one immuno-compromised group that is never mentioned, People Who Inject Drugs (PWID). PWID are confronted by far more virulent diseases such as HIV and HEP C which have far higher mortality rates than this, but it is still prudent to protect the most vulnerable during these times.
How do Drugs affect the Immune System?
Cocaine: Snorting cocaine damages mucous membranes in the nose, throat, and lungs, which in turn can lead to upper respiratory infections or a susceptibility to these conditions. Smoking crack cocaine also damages the lungs and can reduce the immune system’s response to lung infections like bronchitis or pneumonia.
Marijuana: This intoxicating drug affects several kinds of cells in the body, which can ultimately harm the immune system. Smoking marijuana reduces the body’s ability to resist infections from viruses, bacteria, fungi, and protozoa. It can also increase the risk of developing cancer. One study found that marijuana directly affects a type of cell called myeloid-derived suppressor cells, which suppress the immune system’s response in certain situations. By enhancing the effect of these suppressor cells, marijuana suppresses the immune system in general, leading to a higher risk of cancer or infections in people who struggle with marijuana addiction.
Nicotine: As with marijuana and crack cocaine, smoking cigarettes can lead to upper respiratory problems and a lowered immune system response to infections in that area. Opioids: This class of drugs includes heroin, morphine, fentanyl, opium, and prescription painkillers. While all narcotics have some effect on the immune system, injecting drugs into the veins increases the risk of viral infections like HIV and hepatitis B or C (due to sharing needles) and bacterial or fungal infections. This is especially dangerous in people whose immune systems are already compromised. Crushing and snorting narcotic drugs can also increase the risk of upper respiratory infections due to damage to the mucous membranes in the nose, throat, and upper lungs. Morphine and related opioids have been found to directly impact white blood cells, which can reduce the ability of the immune system to react to diseases.
What can we do?
It goes without saying that you should follow the guidelines on preventing the spread of COVID-19 as laid down by your national health authorities. The basic principles of hand-washing, covering your face when coughing or sneezing apply.
Unfortunately, many PWID are homeless or have no access to hand washes or gels, it may be a good idea, if your service can provide these to your clients.
Don't forget that using clean injecting and smoking equipment is just as important now as it has always been.
Let's hope that this pandemic runs its course quickly. If you want to track the spread of the virus around the world, click on the link below.