More on harm reduction at
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journey in discovering the wrongs of the ‘war on drugs’, especially the further
damage that law enforcement approaches can do to the most vulnerable. His view
is that the legal approach rarely ever reduces the supply of drugs for long and drives
the market into the hands of the most vicious criminal supply networks.
I
*****
n the afternoon delegates heard from experts based in Glasgow, London
and Dublin on issues these cities have faced in terms of responding to
injecting drug use, and the serious problems faced by PWIDs in public
spaces.
Kirsten Horsburgh of the Scottish Drugs Forum stepped in at the last
minute for Dr Saket Priyadarshi, to inform us of the current situation in
Glasgow, in light of recent advice from the Scottish Lord Advocate that any DCR in
the city would require a change in the Misuse of Drugs Act (MoDA), effectively
delegating responsibility back to Westminster and dashing Scottish hopes.
Dr Magdalena Harris of the London School of Hygiene and Tropical Medicine
highlighted issues she encounters in her current research among homeless
injectors, particularly the prevalence of skin and soft tissue infections. Then Marcus
Keane, head of policy at Ana Liffey in Dublin explained the process he has been
involved in to bring a change in Irish legislation, allowing for the first supervised
injection facility in Ireland, which will open up later this year in Dublin.
The final session of the day was delivered by Dr Gillian Shorter of the University
of Ulster. Detailing the range of DCRs worldwide, she identified different models in
operation such as medically supervised or not, injection-only facilities or those
which cater for people who smoke or even snort heroin, those that cater for heroin
use only and those that permit the use of a wider range of drugs.
The evidence presented left us in no doubt that wherever a local need is
identified, there are clear and unambiguous reasons to consider providing a DCR.
The lasting impression I have is of a clear win-win-win scenario in providing DCRs –
PWUDs can access a humane, health-promoting alternative to street-based
injecting; support services gain an opportunity to engage with them by providing
what they most need; and the wider public find that the level of discarded injecting
equipment reduces and visible heroin use declines.
Charlie Mack, CEO of Extern, closed the conference with an eloquent call to
action – to join together armed with the evidence we’d just heard and work to
make a DCR happen in Belfast. There was a very strong consensus that we must do
this, and quickly, as vulnerable lives depend on us along with our courage and
determination.
A number of other cities in the UK are currently exploring the possibility of
providing a DCR of some description. I believe that sooner or later one of these
cities will find a way by local agreement with stakeholders in their city (rather than
awaiting a change to MoDA) to provide one.
M
*****
y own thinking is that the terminology we use – ‘drug
consumption room’ – may be unhelpful, conjuring notions of a
libertarian drugs free for all. A more helpful and accurate term is
overdose prevention site (OPS), which describes exactly what it is
– although it is still limited in that it doesn’t explain that it will
allow PWIDs access to wider healthcare and social interventions
such as wound care, housing and substitute opioids. Whatever the model, it will
undoubtedly prevent fatal overdoses and the spread of BBVs among the people who
use it. Terminology is a secondary consideration to the purpose of the service.
Extern want to build on the success of the conference in the coming months. We
operate a street injectors support service, an ‘old-school’ harm reduction outreach
service, which engages with this very hidden, vulnerable population. Since starting in
October 2017, staff have successfully reversed three overdoses with naloxone,
provided and removed large quantities of injecting equipment, supplied naloxone and
much more. In addition, they have assisted PWIDs to access accommodation and even
treatment. What if we were able to offer them an overdose prevention site as well?
We dream big, and will continue to do so until we have exhausted all options
available to us to prevent the need for street injecting.
Chris Rintoul is drugs and alcohol consultant at Extern
www.drinkanddrugsnews.com
‘We did it together’
Tony Duffin describes how through local team
work, a small charity helped to change the law
to allow supervised injecting facilities
Established in 1982, Ana Liffey Drug Project was Ireland’s first low-threshold
harm reduction service. As a small charity working in Dublin and the mid-west
Region of Ireland, we provide fixed site and outreach services to over 2,000
people each year and have 35 staff, supported by a similar number of volunteers.
From 20 January 2012, we were a leading advocate for supervised injecting
facilities and played a key a role in lobbying for the introduction of the Misuse
of Drugs (Supervised Injecting Facilities) Bill 2017 – which was signed into law
on 16 May 2017 by President of Ireland Michael D. Higgins.
The following four key strategies helped us to achieve our goal of legislative
change:
Know your casE
Gather the evidence and know the argument both for and against your
proposed change. While there was only a handful of detractors, it was
important to able to respond with certainty.
spEaK To your sTaKEholDErs' sElf-inTErEsT
Don’t just know who your stakeholders are, but also know what their needs
are. When we communicated with different stakeholder groups, we always
tried to speak to their self-interest and explain how our proposed change
would benefit them.
EngagE wiTh ThE mEDia
Engage widely and frequently with traditional media and social media. Early
on we were reminde d of the old journalists’ saying – ‘good news is not good
news’. However, we had newsworthy stories which people wanted to hear.
We made our own news.
asK for hElp
You can’t do it all on your own – we were attempting to do something that
had not been done before. We asked for help at a number of key stages. At
the end of the day, successfully introducing the legislation was achieved by
civil society, legal, statutory and political champions all working together.
Tony Duffin is CEO of Ana Liffey Drug Project. For more info on Ana Liffey visit
aldp.ie
Pictured: Catherine Byrne TD, minister of state for communities and the
national drugs strategy with Tony Duffin
April 2018 | drinkanddrugsnews | 9