As the world struggles to adjust to the “new normal” of a global pandemic, some of the most vulnerable members of society have too often been left out of the conversation: people experiencing addiction and/or homelessness. The guidelines around COVID-19 safety are difficult, if not impossible, for a demographic that already faces so many challenges in daily life. How can you maintain social distancing in a crowded shelter? How can you wash your hands after every interaction without regular access to running water? How can you focus on a pandemic when you are battling the illness of addiction or worried that you won’t have Narcan to save your friend’s life?
The team at AIDS Action’s Access: Drug User Health Program knows the many challenges facing this population well. Access distributes and exchanges syringes to people who inject drugs (PWID), distributes life-saving Narcan, and operates drop-in centers where clients can access harm reduction kits, HIV/STI testing, counseling, support groups, meals, and more in a safe and affirming environment. When COVID-19 social distancing guidelines forced the closure of the physical drop-in spaces in Cambridge and Jamaica Plain in mid-March, the Access team knew that in order to keep their clients in this critically important care, they needed to go mobile.
Beginning on March 22, Access instituted the COVID-19 Outreach pilot program. As with all Access work, it was paramount to inform the community about this program as early as possible. New signage was posted outside the Central Square drop-in center that explained that while the physical space was closed for safety reasons, Access services would still be available in the community. The signage also listed the numbers for team members’ individual outreach phones, to give clients a direct line to support. A week later, the Jamaica Plain drop in site followed the same process.
The next step was to identify the areas where clients were located and divide up those regions among Access staff. Working in pairs, team members were assigned to areas in 11 Boston area communities. With the local shelters being hit hard by COVID-19 outbreaks, many people have chosen instead to join encampments in the woods, parks and around the city, so the Access team has also been visiting these sites.
Outreach teams travel to areas of need on foot, on bike, and in the Access van to check in on clients, deliver supplies, pick up sharps, and respond to requests for help. Team members stay in contact throughout the day using Slack app messaging, mapping out logistics quickly in real time, so clients aren’t kept waiting long or feeling forgotten.
Overdose Aftercare and Outreach Specialist Brian Sink operates the Access van, which serves as the base of operations for this program. Brian keeps his fellow team members well stocked on harm reduction kits, sterile needles, Narcan, and supplies so that they can continue to operate in the field and work from home as much as possible. He coordinates the removal of full sharps containers and larger supply drop-offs from the van, allowing for safe and effective deliveries and pickups across the area.
The Access team has also been working hard to help clients obtain or refill prescriptions for addiction treatment medications like methadone, suboxone, and sublocade.
On a typical day, Access staff picks up used needles and delivers new needles, Narcan, water, food, harm reduction kits, safer sex supplies, personal hygiene items, tents, tarps, socks, blankets, and other essential items. Between March 22 and April 17, the Access team collected 4,229 used syringes and distributed 11,130 new syringes and 662 doses of Narcan to 454 people. However long this pandemic lasts, the Access Outreach program will continue to reach out and ensure that our clients have the resources they need to stay healthy and connected to care.