Many of those who are experiencing homelessness are in desperate need of housing. However, housing does not just include physical shelters like many of us may associate with the term, rather, housing is a human right to safety, public health, and mental wellbeing . With the emergence of the Covid-19 pandemic has come some of the most drastic changes to society that have been experienced in our lifetime. This has led to many, and especially those in the homeless population, experiencing immense changes to their mental well-being.
Mental illnesses and substance abuse have previously been shown to occur at higher rates for those experiencing homelessness as compared to the general population . However, the Covid-19 pandemic has certainly put a spotlight on and augmented the close linkage between these factors. Since March 2020, the rates of emergency medical services for suspected opioid overdoses have increased by 57%, while fatal overdoses on opioids have increased up to 60% . It has been found that one of the communities that have experienced the most significant relative increases in opioid overdoses are those living in poverty and homelessness . However, mental illness is not the only factor believed to account for the drastic rise in fatal opioid overdose rates. As the pandemic led to border closures, street opioid suppliers began looking for cheaper ways to obtain their stock, leading to the availability of more unpredictable and potent variations of opioid drugs, which may have also accounted for the observed increase in fatalities .
These concerning statistics show how important it is that a focus is drawn towards mental health support, as well as opioid education. Education geared towards an understanding of the health effects of such an addictive and detrimental drug should be available to all, with a special emphasis on making such education available to people living in poverty and homelessness. Emphasis should also be placed on informing individuals about which variations of opioids are most dangerous and providing suggestions on how best to decrease dependence on opioids, which can be a very long and painful process. As such, access to rehabilitation programs may also help ease dependence on opioids. Mental health support systems have been less readily available to those living in homelessness after the pandemic caused these services to be provided solely online or through telecommunications. Since mental health is closely linked to substance abuse, it is critical that measures are promptly taken to improve the accessibility of these services to the homeless, and at a level adequate to meeting the increased need for these services.
Finally, naloxone kits and training should be provided to businesses around homeless hot-spot areas and shelters. Naloxone is an antidote to opioid overdose that can temporarily reverse the effects of opioid drugs . Increased availability and training in the use of this antidote can certainly enhance the chances of survival of those who undergo an opioid overdose, especially during these times when the healthcare system is overburdened.
By providing services for opioid education, mental health, and naloxone availability, we can help ease the rates of opioid overdose in the homeless population. Funding may be limited, but it is critical that we do not lose sight of the needs of these citizens resulting from these trying times. Some evidence has suggested that it may take up to 5 years to fully realize the effects of the pandemic on the homelessness, mental health, and substance use sectors . As such, it is paramount that efforts and investments be made towards mitigating the negative effects of the pandemic that we are currently able to recognize, before these and other undetermined effects, become too overwhelming.
Mental Health Commission of Canada. COVID-19, Mental Wellness, and the Homelessness Workforce (2021). Retrieved from https://www.mentalhealthcommission.ca/wp-content/uploads/drupal/2021-07/covid_mental_wellness_homelessness_workforce_eng.pdf
Friesen, E.L., Kurdyak, P.A., Gomes T., Kolla, G., Leece, P., Zhu, L., Toombs, E., O’Neill, B., Stall, N.M., Jüni, P., Mushquash, C.J., & Mah, L. (2021). The impact of the COVID-19 pandemic on opioid-related harm in Ontario. Science Briefs of the Ontario COVID-19 Science Advisory Table, 2(42). https://doi.org/10.47326/ocsat.2021.02.42.1.0
Opioid Overdose. Province of Manitoba (n.d.). Retrieved from: gov.mb.ca/fentanyl/opioid-overdose.html