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people. It’ s very much about making every contact right.’
INCOMPLETE PICTURE In 2023, the Metropolitan Police had recorded almost three chemsex-context deaths a month in London alone, said Clyne Hamilton-Daniels of Queen Mary University of London. Emergency departments were the‘ endpoint’, he said – but there was invisibility.‘ Someone may attend after a chemsex session, but we’ ll often report those presentations as overdose or mental health crises or suicidal ideation. Those descriptions may be correct in some respects, but they’ re often incomplete.’
Chemsex involved risk, but could also offer a temporary escape from loneliness, stigma and stress, he said.‘ That shouldn’ t be romanticised, of course, but neither should it be edited out.’ In order to be effective, harm reduction measures needed to recognise pleasure as well as danger, he said.‘ Simply telling someone to make better choices is not a functioning public health
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system.’ Something that queer community harm reduction could teach wider services was that‘ you don’ t have to become more institutionally acceptable before your knowledge and contribution have value,’ added Seba of the Safe Only CIC.
LACK OF SUPPORT Cara Lavan of Anyone’ s Child brought home the importance of harm reduction when she told the summit about her partner Jake’ s death more than a decade ago.‘ There was no support and nowhere where we could go, largely because the drugs Jake was choosing to use were illegal’ – reinforcing the couple’ s fears that their young son could be removed if they sought help. Jake had relapsed with crack and heroin after being falsely accused of a crime, she said.‘ The steps and the abstinence programme had worked for Jake the first time, but he was struggling with them this time.’
Anyone’ s Child was a powerful campaign as it meant that families were able to support each other in the face of the
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stigma and shame that made people reluctant to speak out, she stated.‘ When somebody dies of an overdose so many people will cover it up, say it was a heart attack.’
DO THE RIGHT THING From a commissioning perspective, harm reduction should be about care and compassion for people,‘ not necessarily population health’, said Alistair Flowers of Birmingham City Council.‘ We need to bring it back down to the individual.’ It should be about system leadership, he continued.‘ It shouldn’ t be about bravery, it should just be about doing the right thing – it shouldn’ t be brave to talk about this stuff.’ Conversations could often become‘ cautious’, however, with people tending to self-censor, and the focus could be on activity rather than ideas.‘ I think it should be about both.’
Harm reduction wasn’ t recovery, he said, although commissioners could‘ sometimes get pushed into that –“ we can do harm reduction if it leads
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to this”. They’ re both valid and they’ re both valuable, but they’ re not the same thing. That distinction is fundamental.’ Commissioners created specifications, frameworks, KPIs and contracts, he said –‘ and those things give us
‘ Recovery does not mean abstinence. It’ s a journey, a way of working.’
GARETH BALMER, WITHYOU
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‘ Are we only legitim ising experience when people are in recovery? People don’ t need to have exited experience for their journey to have value. Living, lived and formalised expertise – what if we equalised all three?’ |
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SEBA, SAFE ONLY CIC |