I’ve spoken to lots of sources about how covid is affecting Glasgow’s drug-injecting street population who I’ve written about before. A tiny bit of it is included in an article coming out with @se_kip soon. But there was loads of reporting I couldn’t fit so here’s a thread: (1/)

Supply chain issues due to covid mean heroin purity in the Ggow market has decreased during the outbreak. It means heroin cut with dangerous other substances, both other hidden drugs & e.g. cement powder. Also means we can expect more overdoses when purity increases again (2/)

Needle exchanges are still operating and have gone mobile but with reduced staff and unfamiliar hours/locations etc. Methadone prescriptions are administered weekly instead of daily so people suddenly have to manage their own controlled dosage when they never have before (3/)

Drugs deaths are already a “pandemic”; when you’re used to people in your community dying regularly already the threat of covid is no more immediate than that of overdoses or drugs complications. Presents a unique challenge for frontline workers communicating covid guidance (4/)

Relatedly there’s a high level of fatalism in this population already. They’ve seen death and many aren’t scared of it because their lives are so difficult every day. If you don’t feel you have much to live for why would you carefully register difficult-to-follow advice? (5/)

On that difficult-to-follow advice: low levels of digital literacy/access to news means the messages just aren’t reaching the street. It falls to frontline workers who they’re used to regularly hearing from about HIV/overdose/clean injecting so a danger of boy who cried wolf (6/)

Obviously, living conditions make social distancing next to impossible. You can’t do it if you live on a pavement or if you rely on sofa surfing and especially not if you’re sharing injecting equipment or exchanging cash and drugs by hand (7/)

The biggest form of income for many of these people - begging - has also just disappeared virtually overnight. They can’t buy essentials like food or the drugs and alcohol they depend on, and sudden withdrawal can have serious and sometimes deadly health consequences (8/)

Street teams are stripped back but still exist bc people rely on them. They keep 2m distance but can be approached by those who are distressed or don’t know guidance. So it’s a catch 22: people are harmed if you stop visiting but risk can be increased if you keep visiting (9/)

Isolation increases risk for all domestic abuse victims but rates are high & it takes particular forms for women in this population. I heard about one whose partner stole her methadone and anti-psychotic medications. & staff can’t comfort her bc they only have phone access (10/)

Women in this population are also more likely to rely on sex work. Client numbers have plummeted so they’re more likely to engage in riskier transactions, go into men’s homes etc. Combo of existing criminalisation + authoritarian covid laws leaves them totally exposed (11/)

(Side note: Those covid laws are also *obviously* going to be used to disproportionately target marginalised populations. Anecdotally I’ve heard of multiple drug-injecting people who sleep rough being stopped under these laws and precisely none of my middle-class friends (12/))

There’s also a rise in self-stigma amongst the population: in a busy city they blend in somewhat and are mostly left to themselves. Now they’re visibly the last people on the streets so can feel like everyone is looking at and judging them for sleeping rough and injecting (13/)

Finally, heroin/methadone are associated with respiratory illness. So on Glasgow’s streets you have a high risk population who will struggle to follow guidance anyway and whose main info sources (pharmacies, needle exchanges etc) have all suddenly changed hours and format (14/)

Some orgs still doing amazing work in these near impossible circumstances: @WaverleyCare @SDFnews @SimonCommScot and lots of others not on Twitter (and others still that I’ve missed! I’m sorry!)

Here’s something I wrote on them before all this (15/) https://www.vice.com/en_uk/article/a3xb94/glasgow-drug-deaths-europe-capital

This isn’t an exhaustive list of how covid is affecting this population who are facing public health emergency on top of several other public health emergencies. I’m not doing much journalism atm bc of book writing but I’ll keep trying to make sure we don’t forget them. (16/16)

Should have done this at the start but if you’re just seeing the rolled up thread: obvious trigger warning for trauma, homelessness, domestic violence, sexual violence, drug use

Another important point about social distancing at in-pharmacy needle exchanges https://twitter.com/becksmetcalfe/status/1246887995065667589?s=21

Thanks for all the shares, I’m glad this resonates. Just to urge a note of caution for those saying “insert your own city” - Glasgow’s street population are unique in some ways re trauma levels, type of drug use etc. Many issues will be the same but you should still think locally