COVID-19大流行對藥物濫用者身心的衝擊與影響

Physical and Psychological Impacts and Challenges for Drug Abusers during the COVID-19 Pandemic

2019年12月底爆發新型冠狀病毒疾病（COVID-19）疫情以來，2020年2月1日在菲律賓出現第一起，在中國境外感染COVID-19死亡案例；3月疫情已蔓延至歐美大陸，歐盟及亞洲多國宣布封境，全境居家隔離，但毒病如入無人之地，多地淪陷成為重災區。世界衛生組織終於宣布進入「全球大流行」。對藥物濫用者而言，原本多屬弱勢群體，或是常無家可歸，經常面臨不穩定的衛生和健康狀況的困擾。因COVID-19的大流行，戒毒服務的量能大幅減少，加劇了復發的可能。除了讓患者取得藥品的方便性措施及提供心理支持之外，藥物濫用者比以往任何時候都更需要住房和社會服務。由於這些藥物濫用者中許多人就業不穩定，他們的工作中斷也可能導致不良後果，例如失去住房、三餐不繼，並最終導致惡性循環，增加復發風險。最後，COVID-19流行期間，採更靈活的服務提供模式，許多國家已經引進或擴大了遠端醫療服務，對藥物濫用者來說，這意味著衛生保健工作者現在可以通過電話提供諮詢或初步評估，並使用電子系統開具受管制物質處方。期望國外的替代方案能提供本土戒毒的參考，並提供國內對於藥物濫用者於疫情期間處遇的參考。

Since the outbreak of the coronavirus disease (COVID-19)at the end of December 2019, the first case outside of China wasdiscovered in the Philippines on February 1, 2020. In March, itspread across Europe and the United States, and the EuropeanUnion and Asia announced a lockdown, with the World HealthOrganization declaring it a global pandemic. Prior to thepandemic, drug addicts were mostly disadvantaged or homeless,troubled with precarious hygiene and health conditions. As theCOVID-19 pandemic has drastically reduced the availability ofdrug rehabilitation services, the risk of them falling into relapsehas been exacerbated.In addition, several risks of the current pandemic to persons with substance use disorder are indirect. They arise from suchfactors as housing instability and incarceration, as well asreduced access to health care and recovery support services. Ahigh percentage of individuals with substance use disordersexperience homelessness, and vice versa. Among countless otherdifficulties and risks faced by those with housing instability,increased risk for disease transmission in homeless shelters iscurrently particularly relevant.COVID-19 has triggered innovation and adaptation in drugprevention and treatment services through more flexible modelsof service delivery. Several countries have introduced orexpanded telemedicine services due to the pandemic, enablinghealthcare workers to offer counselling or initial assessmentsover the telephone and electronic systems to prescribe controlledsubstances. Based on experiences of western countries, programscan be initiated to facilitate these communities in Taiwan duringthe pandemic.