HIT Hot Topics delegates heard from powerful harm reduction speakers including ( top centre , then clockwise ) Lynn Jefferys , Stella Kityo , Sam Rivera , and Juan Fernández Ochoa ( bottom left )
to engage with structured treatment or who want that treatment separate from their injecting practice – have been neglected throughout the recovery policy decade . While it ’ s great news that Scotland has overcome opposition from Westminster to open a life-saving overdose prevention centre , in England it remains a political barrier . But it ’ s within our ability now to provide commissioned and much needed low threshold enhanced harm reduction hubs that can also help save lives . Tier 2 harm reduction services were successful due to being part of a mandated four-tiered commissioning model under the NTA ’ s Models of Care . So , in looking to regain some of this protected space for harm reduction interventions , is it local conversations that are needed to readdress the needs of people who inject drugs , or a redirection in national strategy ?
Tier 2 services have remained
in Northern Ireland , referred to as low threshold services commissioned by the Public Health Agency ( NI ), and separate to prescribing services provided by the five NHS trusts . As a result , expertise in harm reduction has been maintained and developed . These low threshold services are provided by the voluntary sector , and almost all have their roots in providing services for people experiencing homelessness – who face a range of lifechallenges and that services with higher thresholds struggle to engage with .
We know that some places , such as Bristol , continue to provide stand-alone harm reduction services . Through several re-commissioning cycles , Bristol Drugs Project ( BDP ) have retained a specialist team of harm reduction workers , offering a drop-in advice centre , NSP and a clinic where people can get wound care and other nursing services . Structured treatment
services are kept separate , and the benefits are clear .
ENHANCED HUBS
Release have shown leadership in the opening of their harm reduction hub and the peer led approach to NSP in Hackney by the London Joint Working Group on Substance Use and Hepatitis C are good examples of activism in action . Enhanced harm reduction hubs unattached to treatment services could offer drug checking , a safe consumption space and accessibility for marginalised groups such as women , sex workers and homeless people .
Integrated recovery services offer important structured clinical treatment , things like individual placement and support ( IPS ) and group work to a certain group of people motivated for change . But focus has been lost on the offer for the many other at-risk people needing access to the range of low threshold interventions described .
More services have now reverted to clinical vans , mobilising the offer and widening the reach of service
delivery – realising that people are not hard to reach , but that services and their configurations can be unattractive or inaccessible to marginalised individuals . Could it be that this full-circle approach back to assertive action , engaging peers , and working within communities is part of the answer ?
One thing is certain . Without swift action , changes to commissioned models , wider collaboration , and more lobbying for change , the rising deaths and increasing harms faced by those most at risk will continue . The need for spaces to attract people into enhanced harm reduction is loud and clear .
Iain ‘ Buff ’ Cameron is project manager , harm reduction services at Extern ; Jon Findlay is national harm reduction lead at Waythrough ; Peter Furlong is national harm reduction lead at Change Grow Live ; Deb Hussey is national safer lives lead at Turning Point ; Lucy O ’ Hare is training manager at HIT ; Maddie O ’ Hare is deputy director at HIT ; Chris Rintoul is innovation and harm reduction lead at Cranstoun .
WWW . DRINKANDDRUGSNEWS . COM DEC 24 – JAN 25 • DRINK AND DRUGS NEWS • 19