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before synthetic opioids became a significant concern . ‘ We ’ re already awash with problems in the way we deal with drug-related harm in this country . We know things have got to change but what do we start with ? The metaphor I like to use is that we both widen and deepen our toolbox .’ This meant returning to the tools we already had and improving them to maximise their effectiveness – along with expanding the range of tools available . ‘ I see “ harm minimisation ” used synonymously with needle and syringe provision , but I don ’ t see the ethos of harm reduction in many of those programmes – nonjudgmental and non-coercive , and honouring the agency of people currently using drugs . That ’ s not necessarily happening .’
CO-PRODUCTION The arrival of nitazenes meant that all of this would need to be done
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‘ I see “ harm minimisation ” used synonymously with needle and syringe provision , but I don ’ t see the ethos of harm reduction in many of those programmes – nonjudgmental and non-coercive ...’
SHAYLA SCHLOSSENBERG
‘ super-quickly ’, and one example of making the toolbox deeper was services being delivered and led by people who were current drug users – ‘ genuine community involvement ’. Drug treatment often wasn ’ t attractive , with the barriers ‘ too high , and the wait times in many areas too long . People are not empowered to partake in treatment because it ’ s not co-produced with them to be about what will work for their individual lives .’
Promoting and supporting drug user unions could also help
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to deepen harm reduction work , they said . ‘ A union is not the same as a service user feedback form . It exists for and of itself , not to improve a service .’ An example of widening the toolbox , meanwhile , would be opening an overdose prevention site ( OPS ). These were already ‘ hugely evidence-based ’, with more than a hundred around the world , and many offering housing support , trauma support , health support and more . In terms of the oft-cited legal liabilities around having an OPS , many were already shared by current NSPs – ‘ and we already manage them .’
Nothing would work without real community involvement , however . ‘ You can ’ t do the grassroots mobilisation and buy-in and the changing people ’ s minds and bringing people with you if you don ’ t have real people who are impacted by these things at the centre . We might win OPSs and we might win drug checking , but we could lose it if we don ’ t do the people building along with it .’
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PEOPLE POWER ‘ We ’ ve always been about empowering our members ,’ said Radha Allen of the peer-led B3 organisation in Brent – through training , education , volunteering and more . ‘ Even all but one of our board of trustees have lived experience .’ B3 was based in both of the treatment hubs in its |
borough , and keyworkers would get in touch if clients needed support with ‘ literally anything ’, she said .
Colin McMahon had initially come into contact with B3 as it was based in the same building as his treatment provider Addaction , he said , and he ’ d become a B3 ambassador last year . ‘ My addiction took me to the gates of insanity and hell . It destroyed me . I came into recovery in 2015 and all I had was a bin liner full of clothes . My life revolved around police , prison and criminality . My life was black and white but when I came into recovery it changed into colour and I started living again . I ’ ve gone on to do so much .’
B3 emphasised training and volunteering skills and getting people back into the community , said staff member Hadil Galal . ‘ When I first started as a volunteer I had nothing , no qualifications . We want people to be able to gain qualifications that take them to wherever they want to go .’
The organisation also ran recovery champion schools , added B3 volunteer Mitsu Cavalho – ‘ a very well-structured programme delivered through a series of workshops and lessons .’ Be Safe was yet another B3 volunteer-run service , said volunteer Sue . ‘ We help each other and give each other support and confidence and growth . I ’ m no longer in survival mode – I ’ m enjoying life . And living .’ DDN
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