Covid-19, the vaccine and drugs

Covid-19, the vaccine and drugs: a research summary. 

Covid-19 has resulted in an information overload for many of us, and it can be hard to understand what information to trust, especially when it comes to our health. Here at The Level, we’ve done our research to answer some of the most common questions we get asked about Covid-19, the vaccine and drugs.

1. Is the risk of catching Covid-19 greater for people who use drugs?

Drug use on your body’s immune system. In people who use drugs regularly, research shows that a person’s immune function can be significantly decreased[1] [2] [3] [4].

This means that your body has a harder time fighting off illnesses and means you are more likely to become sick if you come into contact with an infectious disease, like a virus.

International research during the Covid-19 pandemic has shown that people with substance use disorder have a significantly increased risk of contracting Covid-19[5] [6]. However, this is not a new phenomenon. In fact, there has been lots of research done over the past few decades about the overall increased risk of contracting a variety of communicable diseases, including viruses for people who use drugs[7].

 
2. Is the risk of getting very sick from Covid-19 greater for people who use drugs?

People who use drugs are not only at a higher risk of catching Covid-19, but also of having more severe symptoms. This includes being more likely to need hospital treatment and more likely to die from a Covid-19 related cause[8]. The reason for this, is the same as why people who use drugs are more likely to catch Covid-19; their immune system is weaker, and less able to fight the virus on its own. People may also have other health problems as a direct or indirect result of regular drug use, which can put them at risk of developing severe acute respiratory from Covid-19. For example, people who use methamphetamine (especially smoked) have a higher risk of developing lung conditions like COPD (a disease that affects your lungs) which also puts them at greater risk of becoming very ill or dying from Covid-19[9].

 It can also be more complex for people who use drugs regularly to be treated for Covid-19 in hospital settings, as sometimes they also need to deal with drug withdrawal at the same time (as illicit drugs cannot be used while someone is an inpatient)[10].

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published a summary on this topic last year, and is a good resource if you want to learn more about the increase risk of Covid-19 for people who use drugs, you can read it here.

 3. Is it safe to get the vaccine if you use drugs regularly?

This is a question we get a lot from people that use drugs, especially people who use every day and may still have drugs in their system when they go to get their vaccine. Firstly, there are very few (medicines, diseases or vaccines that might interact with the Covid-19 vaccine) for the Covid-19 vaccine, meaning it is very safe. Substance use disorder, or recent substance use is not a contraindication[11].

Research has shown that people who use drugs regularly may be more hesitant about getting the Covid-19 vaccine for a variety of reasons[12]; because of this there have been a range of initiatives put in place to try better support people and their decision making among overseas. Where vaccination uptake has increased from these initiatives among people who use drugs, there have been no significant increases in adverse reactions or death from the Covid-19 vaccine[13].

It is also important to remember that the development of viral vaccinations and the technology and knowledge behind their development and use has been around for years. And at the time of writing this article, 49.6%[14] of the world’s population had received at least one dose of the Covid-19 vaccine. That is a huge number!

If you are at all worried about getting the Covid-19 vaccine you can talk with the staff at the vaccination centre. If you tell them you have recently used illegal drugs, this will not get you in to trouble and they will not report you. Their job is to make sure that you are safe and comfortable and to answer any questions you may have, even if these are about alcohol or other drugs and the vaccine.

 4. What can you do to be safer from Covid-19 if you or someone you love uses drugs?

Some people may choose to stop using drugs or alcohol during the Covid-19 pandemic because of the health effects, because it is more difficult to get drugs, or because the quality is more variable. However, we know that stopping using drugs is not always an option for everyone; it can be a difficult process, and for some people, lockdown may not the right time to quit.

There are lots of other things that you can do to keep yourself safer while Covid-19 is in our community:

• Take extra care. Wear a mask in public, keep your bubble small and keep at least 2 meters distance between yourself and people not in your bubble. This includes drug dealers or people making ‘drops’.
• Get a test if you feel unwell. Catching a Covid-19 infection early can mean that it is easier to get the medical help you need before things get worse. It can be scary to think about, but getting tested is an important step in keeping yourself and the people around you safe. Remember police cannot use your Covid-19 tracer app information, or information given to contact tracers for drug prosecutions.
• Get both of your Covid-19 vaccines as soon as you can. Right now, the Covid-19 vaccine is our best defense against the virus. The Covid-19 vaccine is safe and effective and is 100% free.
  
  

5. I want to learn more about the research around Covid-19 and drug use, where do I find it?

The Ministry of Health’s Covid-19 page is a good place to start for updates about the Covid-19 pandemic in New Zealand. The Ministry works hard to simplify the latest information and make it easy to share with everyone, no matter their level of understanding of research. There is lots of information out there, and it can be hard to work out what is relevant and what is not., It is important to make sure that any information that you use to help make your  decision is trusted and from a good source. One off perspectives and social media is not always reliable. Some other places from information include: Equally well, health point/health navigator, the Immunisation Advisory Centre, Karawhiua and even internationally, places like the CDC and WHO.

You can stay up to date with the latest research on The Level as well. We continue to write about the latest trends around drugs in New Zealand.

We have linked some of the research we’ve referenced in this article so you can read them. Follow the links below to read peer-reviewed literature on the topic.

[1] Roy, S., Ninkovic, J., Banerjee, S. et al. Opioid Drug Abuse and Modulation of Immune Function: Consequences in the Susceptibility to Opportunistic Infections. J Neuroimmune Pharmacol 6, 442 (2011). https://doi.org/10.1007/s11481-011-9292-5

[2] Monica D. Prakash, Kathy Tangalakis, Juliana Antonipillai, Lily Stojanovska, Kulmira Nurgali, Vasso Apostolopoulos, Methamphetamine: Effects on the brain, gut and immune system, Pharmacological Research, Volume 120,2017,Pages 60-67.

[3] Sarkar, D., Jung, M. K., & Wang, H. J. (2015). Alcohol and the Immune System. Alcohol Research : Current Reviews, 37(2), 153–155.

[4] Friedman, H., Newton, C., & Klein, T. W. (2003). Microbial infections, immunomodulation, and drugs of abuse. Clinical microbiology reviews, 16(2), 209–219. https://doi.org/10.1128/CMR.16.2.209-219.2003

[5] Wang, Q. Q., Kaelber, D. C., Xu, R., & Volkow, N. D. (2021). COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States. Molecular psychiatry, 26(1), 30–39. https://doi.org/10.1038/s41380-020-00880-7

[6] Mahua Jana Dubey, Ritwik Ghosh, Subham Chatterjee, Payel Biswas, Subhankar Chatterjee, Souvik Dubey, COVID-19 and addiction, Diabetes & Metabolic Syndrome: Clinical Research & Reviews,Volume 14, Issue 5,2020, Pages 817-823.

[7] Global Burden Of Disease Studies: Implications For Mental And Substance Use Disorders Harvey Whiteford, Alize Ferrari, and Louisa Degenhardt, Health Affairs 2016 35:6, 1114-1120

[8] Jasmina Mallet, Caroline Dubertret, Yann Le Strat, Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review,Progress in Neuro-Psychopharmacology and Biological Psychiatry, Volume 106,2021.

[9] Halley Tsai, Justin Lee, Haley Hedlin, Roham T. Zamanian, Vinicio A. de Jesus Perez ERJ Open Research 2019 5: 00017-2019; DOI: 10.1183/23120541.00017-2019.

[10] Converging Crises: Caring for Hospitalized Adults With Substance Use Disorder in the Time of COVID-19. Englander, Honora; Salisbury-Afshar, Elizabeth; Gregg, Jessica; Martin, Marlene; Snyder, Hannah; Weinstein, Zoe; King, Caroline.  J Hosp Med ; 15(10): 628-630, 2020 10. Artigo em Inglês | MEDLINE | ID: mdl-32966196

[11] Sokolowska, M., Eiwegger, T., Ollert, M., Torres, M.J., Barber, D., Del Giacco, S., Jutel, M., Nadeau, K.C., Palomares, O., Rabin, R.L., Riggioni, C., Vieths, S., Agache, I. and Shamji, M.H. (2021), EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID-19 vaccines. Allergy, 76: 1629-1639. https://doi.org/10.1111/all.14739

[12] Arcadepani, F. B., De Macedo, M., Tardelli, V. S., Martins, S. S., & Fidalgo, T. M. (2021). COVID-19 vaccination among socially vulnerable people who use drugs. Addiction (Abingdon, England), 116(9), 2590–2591. https://doi.org/10.1111/add.15500

[13] Yasmin, F., Najeeb, H., Asghar, M. S., Ullah, I., & Islam, S. (2021). Increased COVID-19 infection risk, COVID-19 vaccine inaccessibility, and unacceptability: Worrisome trio for patients with substance abuse disorders. Journal of global health, 11, 03106. https://doi.org/10.7189/jogh.11.03106

[14] Hannah Ritchie, Edouard Mathieu, Lucas Rodés-Guirao, Cameron Appel, Charlie Giattino, Esteban Ortiz-Ospina, Joe Hasell, Bobbie Macdonald, Diana Beltekian and Max Roser (2020) - "Coronavirus Pandemic (COVID-19)". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus' [Online Resource]