LETTERS AND COMMENT
homemade smoking equipment and pipe sharing.‘ There is no equivalent to OST – not really anything for this population,’ she said.
Harris described how improvised equipment, including adapted inhalers, metal pipes, cans and bottles, could contribute to burns, cuts and respiratory harm. There was a direct link between equipment and respiratory risk, including metal fragments in the lungs. Pipe sharing also created opportunities for the transmission of infections. So could equipment provision help? The SIPP study evaluated the impact of providing safer inhalation kits through drug services, outreach projects and peer networks. More than 5,000 kits were distributed during the project, with monitoring data indicating that many recipients were people who had never previously engaged with a drug service.‘ I’ m delighted we actually did what we said we’ d do,’ she said.‘ This is a very physically vulnerable population.’
Findings showed that participants receiving safer inhalation equipment were less likely to share pipes, less likely to use homemade equipment and less likely to inject drugs. The intervention was also associated with increased engagement with services, with providers reporting contact with individuals who had previously been difficult to reach.‘ For some people it was the first time in their life they’ d been near drug treatment,’ said Harris. She argued that the findings demonstrated the value of safer inhalation provision as both a harm reduction intervention and a route into wider support. However, she noted that legal barriers remained – it was‘ not in the public interest’ to provide the equipment – meaning services currently required police support and local agreements to do it.
‘ The more you push people to come off drugs, the more they die.’
ALEX BOYT
Both presentations highlighted the importance of early intervention, effective partnership working and practical harm reduction measures. It was vital to stay a step ahead, adapting services to emerging drug trends and ensuring that people at risk could access support before harm escalated.
‘ We still have far too many services pushing people to come off drugs,’ commented Alex Boyt, who worked with drug services in Camden for many years.‘ The more you push people to come off drugs, the more they die. There’ s never been a KPI to keep people alive. DDN
‘ There’ s a certain irony in spending vast amounts of money and effort to stop people dying from illicit drug use only for them to be killed by cigarettes later on.’
BURNING ISSUE David MacKintosh’ s letter( DDN, June, page 13) was a timely reminder of a hugely important but all-too-rarely discussed issue in drug services – the sheer number of people who smoke. As others have pointed out in the past, there’ s a certain irony in spending vast amounts of money and effort to stop people dying from illicit drug use only for them to be killed by cigarettes later on. It really is the elephant in the room.
If the NDTMS stats are correct, then nearly half of people in drug or alcohol treatment are smokers – that’ s compared to just 12 per cent of men and less than 10 per cent of women in the general population. Indeed, anyone accessing drug treatment for the first time and unsure where to go would only need to look out for which building had a crowd of people – both service users and staff – puffing determinedly away outside it.
It may be that the issue has come to be seen as just too big and intractable to really do anything about – firmly in the category of‘ just one of those things’. On top of this, he’ s right to say that‘ overburdened and underfunded’ services have quite enough to deal with. But he’ s also correct to point out not only that many people accessing drug treatment actively want to stop
smoking, but that the health dividends of helping people quit could be genuinely huge – and all for a relatively tiny outlay. Surely it’ s worth a try? Joe Benfield, by email
MORAL DUTY Thank you for the‘ Arm in arm’ feature in the current issue( June, page 18). It ' s commendable that DDN regularly runs articles on veterans, their difficulties in readjusting to civilian life, and the drug and alcohol use – and all too often homelessness – that can go with that.
It can be extremely hard for people who’ ve experienced hugely traumatic and life-changing things to relate to people who haven’ t. And it’ s scandalous that people who’ ve served frequently feel discarded and surplus to requirements afterwards.
If we expect people to put themselves at risk of horrific injury and death on our behalf, then we have a moral duty to make sure they’ re treated with decency and compassion when they leave the forces. I’ m glad there are some drug and alcohol treatment services that are setting up dedicated teams to help do that. I just wish there were more of them. Joanne Keenan, by email
POSITIVE ATTITUDE I’ d like to offer insight into the recovery work at my prison – Phoenix Futures runs recovery here for those struggling with drink and drug problems. A wide range of tools are used to help prisoners, beginning with in-cell packs designed to understand the roots of our addictions. The service also provides monthly SMART Recovery group sessions, an opportunity for us to share our recovery journey together, whilst Phoenix Futures also brings in Alcoholics Anonymous bi-weekly to work through the programme. One-to-one sessions are available too, though the most enjoyable activity is the weekly recovery gym session.
Drink and drugs have damaged our bodies and this no pressure, relaxed activity allows us a safe space to work on recovery – it could be five-a-side football one week, volleyball or pickleball the next – either way, it does wonders for our recovery, both physically and mentally. Name supplied, HMP Bure
DDN welcomes all your comments. Please email the editor, claire @ cjwellings. com, join conversations on our Facebook page and LinkedIn, or send letters to DDN, CJ Wellings Ltd, Romney House, School Road, Ashford, Kent TN27 0LT. Longer comments and letters may be edited for space or clarity.
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