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Homelessness and Substance Use During the COVID-19 Pandemic: A Guide for Primary Care Providers

Moore EM, Takada S, Ijadi-Maghsoodi R, Gelberg L. Homelessness and Substance Use During the COVID-19 Pandemic: A Guide for Primary Care Providers. Opioid Response Network. Providers Clinical Support System: Opioid Response Network; 2020 May 11. 6 p.


Background Being homeless and using substances could make our patients more vulnerable to serious illness and death once infected with the novel coronavirus.1 Some substances, such as benzodiazepines, opioids, and alcohol, can cause respiratory depression. This could potentially worsen respiratory dysfunction once infected with the virus. Other substances are inhaled, which could impact the functioning of their lungs. Living in shelters and homeless encampments further puts these patients further at risk of infection due to close contacts with others. Beyond this, individuals who are homeless have higher rates of medical problems, which further puts them at increased risk of serious COVID-19 infection. One report estimated that 4.3% of the homeless population (21,295 people nationally) could require hospitalization once the infection peaks. Around 0.7% of the population, or 3,454 people, could die.1 Primary care providers caring for this vulnerable group of patients during the COVID-19 pandemic should ask about homelessness and use of substances, and advise patients of risk accordingly. They can also advise their patients on the signs/symptoms of illness, which include cough, fever, fatigue, and shortness of breath.

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