“It’s fucking horrible right now,” Andy said. “Since this corona thing, the quality of the heroin on the streets is just shite. The stuff I bought today was this plastic-y, chemically smelling mess. I could barely smoke it. Imagine someone putting that into their veins—that’s actually fucking terrifying.”
Andy is a long-term heroin user who sleeps on the streets of Falkirk, Scotland. COVID-19 and the lockdown have obviously hit many different groups in different ways, but few as severely as street-homeless people who use drugs. There are the obvious health impacts that make them more vulnerable to any disease, the impossibility of self-isolating when you don’t have a home, and the constant need to source the drugs you rely on—or face the nightmare of going into withdrawal in the midst of a pandemic. But in fact, the problems are even more complex.
“I make my money by begging,” explained Andy. “But now there’s almost no people on the street, I’m hardly getting anything. People are afraid to even come near you to drop a coin in your cup. I know people who get by on shoplifting—but now most of the shops are shut, what are they going to do? If it goes on like this, they’re going to turn to robbing people or breaking into places. If this goes on a lot longer, crime is going to go through the roof.”
On March 27 much-publicized guidance came down from the UK government that local councils should house all rough sleepers. But implementation seems to have been patchy at best.
“There was an initial wave of people getting into hotels that really showed what can be done with a centralized approach,” said Melissa Kerschen of the UK homelessness charity Glass Door. “The worry now is that councils might be slipping back into their old habits of trying to shift homeless people on, amidst a lack of clarity from central government. There are particular worries around homeless migrants with no recourse to public funds, and about a new wave of homelessness, as people are unable to pay rent because of the lockdown and lose their places”.
For homeless people who use drugs, the problems are particularly severe. “People being moved into hotels is good,” observed Niamh Eastwood of the drugs and legal representation charity Release, “but we need to make sure there are the wrap-around services that people need. In particular we need to ensure access to harm reduction services and opioid substitution therapies. It’s been a massive task for the drug treatment sector—and there’s been some genuinely heroic efforts there.”
“I’ve been trying to get a prescription—of course I have—but they just won’t take me on.”
Just how massive a challenge the UK treatment sector has faced is made clear by Bec Davison of the service provider Change, Grow, Live. “We moved about 30,000 users from one-day [opioid substitution therapy] scripts to two-week scripts in four days,” she said. “It was extremely difficult, but necessary so that people weren’t forced to break social distancing at the pharmacy every day. But the real challenge is that we’re now seeing a surge of demand as people who were managing their own drug use are unable to beg or shoplift—so they are now coming into treatment for the first time.”
This is perhaps the main struggle that Andy has faced on the streets of Falkirk. “I’ve been trying to get a prescription—of course I have—but they just won’t take me on,” he said.
This experience is backed up by Peter Krykant, a Scottish drug-user activist. “There’s work being done with people already in treatment, but two thirds of problematic drug users in Scotland aren’t in treatment—and the bar is too high for them to even get assessed,” he said. “Most people can’t even getting assessed unless they’re deemed high risk, like they’re injecting in their neck or groin. So, many people are going back to injecting from smoking heroin, because they’re not getting help, the deals are so small, and the drugs are so badly cut.”
This increase in risky behaviors is an alarming aspect of the coronavirus-drug use nexus. “I’m trying to buy methadone from people with prescriptions,” explained Andy, “but if I can’t get it, then I’ll go back on the street Valium. There’s been more of that about now because it’s easier to get through. I try and stay off it usually, but if I need to now, I’ll have to take that. There’s also been more fentanyl around now to make the shit heroin deals stronger.”
“Street Valium,” usually referring to etizolam, is a benzodiazepine which has been involved in deaths of Scotland’s drug users for decades. In the case of fentanyl, Europe has thus far been largely spared the nightmarish situation of North America, where tens of thousands have been killed annually by the adulteration of heroin and other drug supplies. But the terrifying aspect of the coronavirus disruption of illicit drug markets here is that once these products arrive, they will not simply disappear again when the lockdown ends.
“In three months coronavirus has done what 50-odd years of drug policing failed to do—marginally interrupt the supply.”
Neil Woods of Law Enforcement Action Partnership (LEAP*) UK, who spent 14 years as an undercover cop, posing as a homeless drug user, is all too aware of this. “In three months coronavirus has done what 50-odd years of drug policing failed to do—marginally interrupt the supply of certain commodities,” he said. “However, just as with drug policy more generally, users just move on to even more dangerous drugs.”
There are some causes for hope. “This is a massive challenge, but also a massive opportunity to do some joined-up thinking,” said Hannah Slater of the homelessness charity Crisis. “If we’re suddenly thinking in a new way about prescriptions, maybe we can think about other ‘impossible’ things like drug consumption rooms, heroin prescribing, etc. It’s now harder for things to go back to so-called normal.”
Yet those future prospects are cold comfort to Andy, who is still sleeping on the streets. “People on the street are scared and angry,” he said. “We’re scared of getting sick, and we’re scared of not being able to make any money to score. If this continues for [another] six weeks, it’ll be like hell—it’ll be a nightmare. We need help. We’re human beings. Don’t judge us—help us. That’s all we’re asking.”
*LEAP is the fiscal sponsor of The Influence Foundation, which operates Filter.