In the wake of two major hurricanes, harm reduction workers in Texas, Louisiana and Florida are ensuring that people suffering from addiction don’t get left behind in the chaos. According to addiction advocates, natural disasters present a major risk for relapse, overdose and needle-sharing among people suffering from substance abuse issues—and they’ve been working hard for weeks to help mitigate potential crises, the Associated Press reports.

For instance, in the days leading up to Hurricane Irma, a syringe exchange program in Miami handed out a week’s worth of clean needles and kits including the overdose-reversing drug Narcan (naloxone) in order to help local heroin users ride out the storm safely. The state of Florida, in cooperation with federal authorities, also granted methadone clinics discretion to provide up to five days’ worth of addiction treatment for patients trying to break their addiction to opioids in the midst of the storm. 

Likewise, in Texas and Louisiana, many patients were allowed to take home advance doses of methadone, while others received it in shelters or from alternative facilities during and after Hurricane Harvey. The Texas Overdose Naloxone Initiative also distributed around 500 Narcan kits to clinics along the Texas coast in the aftermath of the storm in an effort to save lives.

Advocates say they learned firsthand from Hurricane Katrina and Superstorm Sandy about just how dangerous natural disasters can be for people suffering from addiction. Researchers found that many drug users took chances during storms, like avoiding evacuation in order to stay near their dealers or sharing needles with strangers despite the risks of HIV and hepatitis C virus (HCV) infection. Harm reduction workers also found that people in addiction treatment often missed doses of their medications during storms and often started using street drugs again in order to avoid withdrawal symptoms in the aftermath of a disaster.

Advocates argue that authorities planning for natural disasters have a responsibility to take into account the needs of individuals facing addiction as well as those in recovery in their response plans. While it is still unclear how Harvey and Irma may have affected people battling opioid addiction, community responses so far in places like Florida and Texas do appear to be helping.