Debate
Contemplating a landscape of change and fear, HIT Hot Topics speakers called for solidarity. DDN reports, pics by Nigel Brunsdon
Across the greAt
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When we meet someone, we ask what music they listen to – it gives us a mirror we can understand. We start to apply labels‘ us and them’ as soon as we start to talk that language.’ Talking at the recent Hit Hot Topics conference, epidemiologist Keith Sabin suggested that we being to categorise and stigmatise without even realising it.
Even the researchers were part of the problem.‘ We put people in a box and say“ these people are higher risk”. It’ s a dichotomy that doesn’ t need to exist. We have to overcome this language, because language becomes a perception.’
With Donald Trump’ s election victory newly sinking in, the threat of division and alienation felt raw to many of the speakers and delegates.
‘ The war on drugs is an efficient and effective umbrella for genocide,’ said US activist Deborah Peterson Small.‘ The goal is to eliminate people, and what’ s happening in the Philippines is the logical extension. It’ s not just the actions of a mad man – it’ s happening all over the world … if you think Duterte is an aberration, think again. Read your history – all the conditions before World War Two are in place now.’
Furthermore, she said, the media talked about‘ this stuff’ as if it was normal.‘ But Trump and his hostility to drugs and drug policy is no joke.’
So what do we do to stop this slide into the abyss? Neuroscientist Dr Carl Hart drew a positive from the shock election result.
‘ The progressives fell asleep under the Obama administration … maybe now they’ ll wake up!’ he said.‘ We claimed victories for things that weren’ t victories. You know the score with Trump. It’ s best to know the score than to hear pretty lies. Go to work!’
For many of the speakers, the challenges were very clear. Magdalena Harris, qualitative sociologist at the London School of Hygiene and Tropical Medicine, brought scrutiny to the complicated scenario of hepatitis C treatment.
For the 216,000 people living with chronic hepatitis C in the UK, the revolutionary new treatment was giving them the opportunity of a 90 to 100 per cent cure rate, without the former gruelling side effects. Being able to dispense the treatment in community drug treatment settings conjured up the vision of eliminating hepatitis C in a generation.
But restricted budgets, and a list price of around £ 35,000 per person per course( although the price to the NHS was confidential), meant that NHS England had limited treatment slots to 10,000 a year. The 22 local area networks had just 50 slots each a month, so were having to prioritise patients with the
greatest clinical need, such as those with cirrhosis. People who inject drugs came high up on the priority list – but only because they were seen as at risk of transmitting the virus, Harris explained.‘ They are being called transmitters and tracked like salmon. This language can be very alienating.’ While reducing mortality and onward transmission were clear criteria, Harris was also concerned that other life transforming benefits of treatment were not being acknowledged, such as the change to identity and the social benefits. It was easy to lose the full picture when looking at statistics and ranking greatest clinical need.
Faye McCrory, a recently retired consultant midwife, said we should cast the net wide for the full picture.
‘ What has a midwife to do with drug services?’ she said, before answering‘ Drug misuse does not sit in isolation.’ Her challenge while working at a specialist midwifery service was to get staff to treat patients‘ as women, not as drug users and prostitutes’.
Many taboos had had an impact on these women – sexual abuse, child sexual exploitation, human trafficking, sharing information, safeguarding and child protection – and there were many ethical and moral dilemmas that meant health professionals should listen without prejudice.
Researcher Aaron Goodman also had an interesting
DR SUZI GAGE |
DR CARL HART |
AARON GOODMAN |
FAYE MCCRORY |
DEBORAH SMALL |
MICHAEL S |
6 | drinkanddrugsnews | February 2017 www. drinkanddrugsnews. com