DDN March 2022 March 2022 | Page 12


Chemsex can be risky , but how do we get harm reduction messages to people who are young , ‘ invincible ’ and having fun ? DDN reports

‘ A

to be quite far down
of harm reduction information is coming through specialist services , and you have
the road before you pitch up at a specialist service ,’ – something that applied equally to hepatitis C , drug use or chemsex , said Leila Reid of the Hepatitis C Trust . ‘ So how do you reach people at the beginning so that they know to look for harm reduction information ?’
People who were ‘ younger and feeling invincible and having fun ’ wouldn ’ t necessarily want to hear these messages , said Patriic Gayle of the Gay Men ’ s Health Collective . Many of the victims of serial killer Stephen Port , however , who used GHB on his victims ( DDN , February 2020 , page 4 ) were so unaware when it came to drugs issues that they could ‘ be lured into a situation where they could be given fatal overdoses ’, said Bob Hodgson , independent advisor with the Metropolitan Police Service .
SERVICE INTEGRATION A key point was integration of services , said Reid , not just with drugs and sexual health but across the board , and there had been excellent work in London and elsewhere around integrating HIV and hepatitis C testing and using those chances to deliver harm reduction information . ‘ There ’ s a lot of opportunity when you ’ ve got that person there . For hep C at the moment there ’ s a bit more of a focus and energy around it , so maybe we ’ re reaching people who aren ’ t normally reachable by health systems . From a general public health perspective , there ’ s this idea of making every contact count , which is quite well established in
some parts of health and social care as well as housing – there are a lot of agencies that come into contact with people at different , difficult times .’
VITAL RESOURCES The Gay Men ’ s Health Collective had been running a pilot project of making their chemsex resources available in A & E , said Gayle . ‘ We know that in one A & E you ’ re looking at between five and ten admissions on a weekly basis for GHB overdose , and in terms of what they ’ re rather disparagingly calling “ frequent flyers ”, they ’ ll quite often have return visits .’
The material was an accessible , cost-effective tool , and the plan was to roll the programme out further , he said . ‘ What we discovered was that staff were saying they could finally give people something to take away with them .’ Healthcare workers often didn ’ t feel confident discussing certain issues with patients , said Reid – ‘ something like this can really open up a discussion in a much easier way ’.
Information detailing people ’ s rights on arrest was also important , said Hodgson , especially when someone overdoses . ‘ If someone ’ s read a “ bust booklet ” when they ’ re not already taking drugs and are able to absorb the information then that ’ s there when they ’ re thinking “ should I or shouldn ’ t I call an ambulance ?” So they know they ’ re not just subject to the whim of whatever policeman turns up at the door , they have rights and there are protocols and people they can contact . When the paramedics get there you do need to take a leap of faith – you need to tell them what they ’ ve taken so they can treat them properly – but , with good will and sensible policing and ambulance services , they ’ ll concentrate on the health needs and not bother about the drug .’
As Dame Carol Black ’ s report pointed out , sizeable gaps remained around harm reduction when it came to communities who didn ’ t really identify with the injecting population , said Reid , ‘ particularly MSM involved in chemsex , people using steroids and performance-enhancing drugs .’
‘ Harm reduction , public health , wellbeing messaging around safer drug use and chemsex would be helpful in terms of hopefully reducing the number of people who end up being admitted to hospital ,’ said Gayle . ‘ We don ’ t have that , and it worries me that in the present climate it ’ s struggling to get traction . I understand why , but if we don ’ t do something about it we have a perfect storm .’
‘ You ’ re reducing the stress on the police force , the ambulance services ,’ said Hodgson . ‘ It ’ s a small amount of money that should save a lot down the line .’
PREVENTION Prevention was always vastly more cost-effective than treatment , agreed Reid , but less easy to make the business case for , ‘ particularly if it ’ s a population that a lot of
‘ The Gay Men ’ s Health Collective have been running a pilot project of making their chemsex resources available in A & E . What we discovered was that staff were saying they could finally give people something to take away with them .’


people don ’ t have a great deal of sympathy for . But if you can engage people you can address mental health and whatever else is there – early intervention and being proactive means you can prevent hep C , HIV and overdose and work really constructively with people . That ’ s what ’ s important if we want to really change people ’ s outcomes on a big scale .’ DDN
DDN was reporting from the HRI Constellations session ‘ Chemsex harm reduction in London – another perfect storm ’. See more reports on our website , www . drinkanddrugsnews . com / hri-constellations-2021 /