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COVID-19 has led to new risks and vulnerabilities for people who inject drugs. Indeed, injecting can expose people to greater health risks due to the sharing of dirty needles, sharing of drugs also increases their transmission risks from both drug-related diseases and in the event of overdose (Corbett et al. 2020). Similarly, social isolation has been found to have the potential to increase stress and elevate suicide risk by isolating individuals from accomplishing concrete plans in a way that is different to the everyday routine (Ashworth et al. 2020).Finally, just as the Covid-19 pandemic has led to a global economic crisis, there is also potential for the socioeconomic marginalisation, banishment, and even incarceration of the most marginalised people who are most highly impacted by this unique crisis.

Over the past several weeks, community and health services have begun to offer some harm reduction services in a number of Australian states. However, the existing models of harm reduction service provision have not yet had to navigate the simultaneous introduction of multiple government restrictions implemented in response to the pandemic. At the same time, the “post-pandemic” period will also see a decrease in cases and suspension of some of the restrictions, which may further result in increased numbers of people who inject drugs who have not yet been reached by harm reduction services.

To continue to support people who inject drugs during this critical time, we present a summary of the changes implemented to the two community-led harm reduction services in Sydney and Melbourne

Harm reduction services within emergency departments have successfully been trialled in the United Kingdom (Harm Reduction Coalition 2018), and Australia (McCarthy et al. 2018; Work Foundation 2019). It is recommended that emergency departments function as a standard emergency care location for people who inject drugs, and that the provision of harm reduction services should be coordinated with medical staff and clinical stakeholders (McCarthy et al. 2018). The provision of emergency legal referral services, and medically-supported supervised consumption services in UK emergency departments (HRC 2018) has also been shown to be safe and effective. d2c66b5586