# name
The impact of the COVID-19 pandemic on harm reduction services in Spain.

# metadata.dc.description.abstract[].value
BACKGROUND:
                Containment policies and other restrictions introduced by the
                Spanish government in response to the COVID-19 pandemic present
                challenges for marginalised populations, such as people who use
                drugs. Harm reduction centres are often linked to social
                services, mental health services, and infectious disease
                testing, in addition to tools and services that help to reduce
                the harms associated with injecting drugs. This study aimed to
                explore the impact of the pandemic on these services in four
                autonomous communities in Spain. 

METHODS : This is a cross-sectional study that employed a
                seven-section structured survey administered electronically to
                20 centres in July 2020. Data from the most heavily affected
                months (March-June) in 2020 were compared to data from the same
                period in 2019. Averages were calculated with their ranges,
                rates, and absolute numbers. 

RESULTS: "All 11 responding centres reported having had
                to adapt or modify their services during the Spanish state of
                alarm (14 March-21 June 2020). One centre reported complete
                closure for 2\xC2\xA0months and four reported increases in their
                operating hours. The average number of service users across all
                centres decreased by 22% in comparison to the same period in the
                previous year and the average needle distribution decreased by
                40% in comparison to 2019. Most centres reported a decrease in
                infectious disease testing rates (hepatitis B and C viruses,
                human immunodeficiency virus, and tuberculosis) for March,
                April, and May in 2020 compared to the previous year. Reported
                deaths as a result of overdose did not increase during the state
                of alarm, but 2/11 (18%) centres reported an increase in
                overdose deaths immediately after finalisation of the state of
                alarm." 

CONCLUSIONS:
                Overall, Spanish harm reduction centres were able to continue
                operating and offering services by adjusting operating hours.
                The number of overall service users and needles distributed fell
                during the Spanish state of alarm lockdown period, suggesting
                that fewer clients accessed harm reduction services during this
                time, putting them at greater risk of reusing or sharing
                injecting equipment, overdosing, acquiring infectious diseases
                with decreased access to testing or discontinuing ongoing
                treatment such as methadone maintenance therapy, hepatitis C
                treatment, or antiretroviral therapy.

# metadata.dc.rights[].value
cc by (c) Picchio, Camila A. et al., 2020

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
The impact of the COVID-19 pandemic on harm reduction services in Spain.