DDN July_Aug_2022 DDN July/August 2022 | Page 15

local drug-using community to support Drug Science in its research into the potential for an overdose prevention centre ( OPC ) in the UK . The service had been looking at the factors that could influence public injecting locally , said Simon of Cranstoun Sandwell , as well as examining reports of needle litter from the local waste management agency . ‘ But this didn ’ t give us the full story .’ While further research and outreach work was able to identify four potential sites for the most suitable OPC setting , the only way to confirm this was through the privileged knowledge of the people in the local drug-using community .
‘ So we recruited a team of individuals who were interested in making positive changes to their community and their peers ,’ he said . SCORE had taken the service ‘ to places we would never have found otherwise ’, and were also able to improve service provision outside of the research . ‘ They were able to tell us about things we were missing as a service , and we ’ ve
been able to take that feedback and improve the service for everybody .’
VALUABLE INSIGHTS The main aims of the feasibility project were to consult people about their experience of streetbased drug use , said researcher Ben Scher , as well as identify what elements of international OPCs would be useful in Sandwell and get the input of local businesses and residents . ‘ But the most valuable was the ethnographic field sessions ,’ he stated . ‘ Led by the SCORE team , we were taken to areas we would never have been able to access otherwise .’ The team also gained valuable insights into issues around not having somewhere safe to use , fear of the police and other practical considerations . ‘ They wanted to be part of the solution , not just viewed as the problem .’ The research had already been presented at the House of Commons , he added , ‘ and we hope it can have a real impact on UK drug policy reform .’
‘ We ’ ve been in very difficult
‘ It ’ s really important to see active drug user organising starting to come back into UK work . ’
situation since the pandemic ,’ Southwell told the conference . ‘ We had about 30 per cent needle and syringe coverage in the UK before that . One provider told me they ’ ve seen a reduction of 25 to 50 per cent in coverage since , and it hasn ’ t gone back up again since the lockdowns ended . So something ’ s gone really wrong .’ This had serious consequences for hep C among other issues , he warned . ‘ If you test and treat but don ’ t sort out prevention we ’ re never going to get to hep C elimination .’
One exception to the rule had
been in Bath , where he and his wife had run a local peer-to-peer scheme giving out around 1,000 needles and syringes per month . ‘ We ’ re a very , very responsive service and we ’ re now starting to network into rural areas through family members and other contacts . So we ’ re starting to look at how peer-to-peer NSP could be used to move us from 30 per cent coverage , recover that 25 per cent loss , and then try to push up to 100 per cent . We ’ re never going to reach 100 per cent coverage unless we involve drug suppliers and users in that process .’
HARM REDUCTION Magdalena Harris of the London School of Hygiene and Tropical Medicine had been running peersupported projects around crack pipes , risk practices , and stimulant harm reduction , she said . ‘ One of the reasons is that there ’ s been a real absence of focus on stimulant harm reduction ,’ with concerns about blood-borne viruses tending to dominate when it came to funding streams . People had been making their own makeshift crack pipes using plastic bottles and tin cans , she said , which increased the risk of both respiratory harm and burns . Reduced availability during COVID also meant that people had been sharing pipes , with the associated risk of transmission .
Evidence showed that crack pipe provision reduced the likelihood of injecting , she pointed out . ‘ If you ’ ve got a crack pipe you ’ re more likely to smoke .’ A proposal was eventually put together around trialling crack pipe provision , and the project