The latest strain of COVID-19 has raised pressures facing substance misuse services to an all-time high. Martin Blakebrough, CEO at Kaleidoscope, examines the critical role drug and alcohol services can play in the vaccine\u2019s roll-out. Looking back to the first wave, is it possible to know how many of our service users were infected? We were unable to test them. We saw very few hospitalisations, but who would call the ambulance for those completely isolated? And if they were to die with drugs in their system, would it be recorded as a COVID death? Martin Blakebrough is chief executive of Kaleidoscope Many people with addictions self-medicate, and as a consequence they are used to feeling below par. The difficulties of booking a test, engaging with a new service and arriving at a test centre on time present mental and physical barriers for our service users that many people cannot understand. Furthermore, testing positive could become another problem among a hundred other issues \u2013 why bother? The latest wave of infection rippled through our workforce with a number of our frontline workers testing positive, particularly within our residential services. It is difficult to know how our employees contracted the virus as they live and work in multiple settings, but an increased infection rate among staff puts our service users at greater risk. So how can we protect our community, those who are currently treatment na\u00efve, and anyone not accessing support from our services? How do we ensure that vulnerable people can access the vaccine and complete both doses? Through involving clinically trained peers \u2013 and most recently through a campaign involving the \u2018superheroes\u2019 Vaccine Woman and Naloxone Man \u2013 we can make the vaccine accessible where service users already attend, be that their treatment setting or hostel, a disused car park or a squat where people who use drugs have to exist. By involving keyworkers in the vaccine\u2019s rollout \u2013 workers already engaged with society\u2019s most hard to reach people \u2013 we can more easily guarantee they receive the all-important second dose. With an online system that records data in real time, we can contact those hardest to reach and follow up on appointments. We simply cannot have a vaccination rollout that ignores those more vulnerable as a result of negative mental health or substance misuse. We need imagination to ensure we support those we serve, and must think creatively about support bubbles, online technology and other interventions. It would be sensible to pair service users who live alone in a buddy system where they can support each other, via social media and face-to-face wherever government guidelines permit it is safe to do so. We know that peer support works, and it is available outside of the traditional hours many mainstream services can manage. A testing and vaccination system that meets our communities\u2019 individual needs, operating alongside a peer-led support network that protects those most at risk, will give us all a fighting chance. ----------- Get protected Staff as well as service users need to embrace the opportunity of a vaccine, says Kim Kaur. Kim Kaur is an outreach worker at Humankind I was worried and anxious about getting the vaccine at first. There seems to be a lot of fear and misconception about the safety of the vaccine on social media and being part of the BAME community I am aware of some of the concerns around the vaccine. However I felt confident in the NHS, in having the vaccine, and showing the BAME community and wider public that this is there to protect people. It\u2019s never easy to receive an injection, but when I attended the clinic, the staff were so well organised, friendly and welcoming which made the whole experience all the easier, the clinic was clean and the process comfortable and painless. This has made such a massive difference to me personally and professionally, knowing that myself and my colleagues are protected by the vaccine against symptoms that may well have otherwise hindered the vital service we provide to our service users. I would like to thank our NHS for the huge effort they have made in protecting us frontline workers and I would encourage all my colleagues to consider having the vaccine.