Remote risk reduction: an adapted and effective program to deal with the Covid-19 pandemic

Harm reduction policies (HR) for people who use drogues (PWUD) have a positive and significant impact on their health, in particular, by limiting the spread of a number of infections. These HR policies have led to the opening of HR centres, mainly located in big cities and highly urbanised zones. HR services in France have been complemented by the development of a remote HR programme (e.g., HaRePo Harm Reduction by Post) a free and confidential programme designed for people who have difficulties accessing HR tools and counselling. PWUD can access the programme by phone and/or email. An HR professional delivers HR counselling and HR tools and connects PWUD to other HR services, medical, and social workers. The Covid-19 pandemic and the lockdown have made access to HR equipment difficult for some users. Users’ fear of contamination has also limited their movements. In addition, the specialised HR reception facilities have had to adapt their operating methods, and some have had to reduce or even temporarily stop their activities (reception, marauding, etc.). Due to its characteristics and in particular, the fact that the physical presence of the PWUD is not necessary, HaRePo has maintained its activities. In this article, we analyse how the Covid-19 pandemic and associated health measures affected the activity of the remote HR programme via two indicators: the number of new PWUD entering the programme, and the number of packages containing HR materials sent. We observed a significantly higher increase in the number of new PWUD over the lockdown period compared to previous years. This increase continued even after reopening. Similarly, the number of parcels containing HR material increased very strongly. Nevertheless, we have noted that the increase in the activity of HaRePo was not the same across regions. We explain the increase in activity over the period by: i) the transfer of users who usually frequent the traditional HR centres who did not have access to these centres during the lockdown, and ii) by a tendency to store equipment to avoid a possible shortage.