New guidance issued for drug and alcohol support groups and treatment programmes

Introduction

The Covid-19 pandemic continues to have a major impact in Ireland and globally. Progress has been made on suppressing the virus due to the huge effort of our citizens. By working together, the Irish people have saved lives and limited the impact of the disease. We all must continue to do everything possible to avoid the virus spreading.

Covid-19 has created a time of uncertainty and anxiety. The restrictions on social interaction, the requirement for self-isolation and the restructuring of services, can be particularly difficult for people who use drugs or are dependent on alcohol.

The Department of Health is committed to the safe resumption of drug and alcohol services, including community-based services, residential programmes and recovery support groups.

The Department has developed this guidance for drug and alcohol support groups and treatment programmes in recognition of their important role in helping individuals to build recovery capital and to avoid relapse into harmful patterns of substance use.

The guidance applies at all levels of the national framework for living with Covid-19. Public health advice and restrictions at level 5 require individuals to stay at home, except for travel for work, education or other essential purposes, or to take exercise within 5km of home.

This guidance applies to the following drug and alcohol services -

support and recovery groups for people and families who live with drug and alcohol addiction (including gambling addiction), eg self-help/fellowship groups, peer support, family/parent support
community projects providing services and supports for people who use drugs, eg drug rehabilitation CE programmes, harm reduction/advocacy training
treatment programmes (non-residential) for people with drug and alcohol addiction, eg counselling, stabilisation, therapeutic communities, aftercare

General points to note

Protecting public health is a shared responsibility of convenors, leaders and participants in support groups and programmes.

Support groups and treatment programmes are high risk settings when the incidence of Covid-19 is widespread in the community.
It is recommended to hold meetings and deliver programmes online or outdoors where this is possible, without diluting the benefits for participants.

People living with drug and alcohol addiction and who experience poor physical health and weakened immune systems are at higher risk from Covid-19. They should avoid face-to-face group/programmes meetings and instead attend meetings that are conducted online.

If hosting a face-to-face group/programme meeting, organisers are advised to undertake a risk assessment to ensure the health, welfare and safety of participants. See here for sample risk assessment prompt sheet. Employees and volunteers who convene groups and programmes should follow the Return to Work Safely Protocol, and have access to training and personal protective equipment.

Public health advice

Drug and alcohol support groups and programmes should adhere to public health advice on Covid19, including the following:

Frequent handwashing - Cough and sneeze etiquette - Sanitise equipment before and after use - Social distancing of two metres - Wear a face covering in indoor environments
Reduce the number of social contacts
Restrict movements for 14 days if a close contact of someone with Covid-19 or if returning from travel to a country not on the green list
Self-isolate if experiencing symptoms of Covid-19 and contact a GP immediately

Facilities and attendance at support groups and programmes

Facilities used to host groups and programmes should not be shared with other users, where possible.

There should be separate entry and exit points, management of queues to avoid congestion and thorough cleaning of rooms and toilets before and after use.
Facilities should be airy and well ventilated.

The maximum number of participants is 15 people (including leaders). The specific number should be determined by the capacity of the venue to ensure 2 metres social distance and should be adjusted accordingly in smaller venues.

At high levels of transmission, it is recommended that the number of participants is reduced.

Face coverings should be worn indoors at all times.
Support groups and programmes should have a maximum duration of 90 minutes and should be shortened when the risk of transmission is high.
Leaders or participants should only attend one group or programme.
People in residential treatment settings should not attend external support groups at this time.

Responsibilities of convenors and leaders

Convenors and leaders should put in place a plan to communicate this guidance and public health advice to participants in support groups and programmes - Convenors and leaders should receive training in Covid-19 preparations either through their employer/service provider or through a third party.
A Covid-19 officer should be appointed for each support group and programme, who would be responsible for ensuring that Covid-19 guidance is adhered to
The Covid-19 officer should be recorded on booking forms for facilities.
The names and contact details of all participants should be recorded; ideally this should be done in advance of a group or programme event, to manage attendance
A health questionnaire should be circulated to all participants in advance; where this is not possible, a temperature check should be conducted for participants
Where the recorded temperature is over 37.5 degrees, participants should not be allowed to attend the group/programme
No refreshments should be provided at a meeting/programme;
All chairs, doors and handle should be sanitised before and after every meeting/programme - There should be no sharing of equipment or books at a meeting/programme

Responsibilities of participants

Participants should attend their nearest support group
Participants at higher risk of Covid-19 should not attend support groups or programmes
Participants should complete a health questionnaire in advance where possible
Individuals should wear a mask in communal areas and on arrival and departure
There should be no congregating before or after a meeting/programme - Participants should bring their own water

Tracing and isolation procedures

Have procedures in place for isolating a person who develops Covid-19 symptoms
Maintain a log with details of leaders and participants to facilitate contact tracing
Inform all participants if an individual subsequently reports symptoms of Covid-19
Advise participants to restrict movements if close contacts of a positive case of Covid-19 - Give participants details of HSE Live helpline 1850 24 1850 for support

Reviewing and communicating the guidance

The Department of Health developed this guidance following consultation with public health officials and providers of drug and alcohol support groups and programmes. This guidance is subject to ongoing review and updating to reflect public health advice, Government decisions on restrictive measures and emerging issues.
The Department appreciates the assistance of drug and alcohol task forces, sectoral oversight bodies and HSE addiction services in communicating and disseminating this guidance. The Department welcomes feedback on the guidance and any issues of concern.
A poster summarising the guidance is available and should be prominently displayed in venues hosting support groups and treatment programmes, along with general public health posters.
Any queries on this guidance should be directed to dpu@health.gov.ie

Additional advice for people affected by drug and alcohol during Covid-19

Advice on harm reduction is available for people who use drugs or with alcohol-related problems.

Drug and alcohol services continue to operate during Covid-19, albeit with some restrictions. Relevant information and supports can be found on Drugs.ie.

The HSE Drug and Alcohol Helpline 1800 459 459 can be contacted Monday – Friday, 9:30 am – 5:30pm; or email helpline@hse.ie.

Guidance documents and resources for addiction services are also available from the HSE, including guidance for the safe operation of Tier 4 residential drug and alcohol services