Recording – City Report Launch | Civil Society Monitoring of Harm Reduction in Europe

The video is the recording of the report launch webinar that took place on Tuesday, 9th April 2024.

The City Reports are the final segment of Correlation – European Harm Reduction Network (C-EHRN)’s Civil Society-led Monitoring of Harm Reduction 2023 Data Report. These concise harm reduction ‘case studies’ highlight either innovative practices or urgent issues demanding immediate attention in five different European cities. The reports will serve as advocacy tools to engage decision makers at all levels, either by showcasing best practices or as an urgent call to action.

Panellists:

 

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C Care, Essential Harm Reduction Services, New Drug Trends, Mental Health of Harm Reduction Staff, TEDI Reports and City Reports (Warsaw, Bălţi, Esch-sur-Alzette, London, Amsterdam). The Executive Summary can be accessed here.

City Report – London. The disproportionate harms of drug prohibition on oppressed peoples

In London, punitive drug policies are a driver of discriminatory policing and incarceration, evidenced by the number of drug possession offences that are unduly focused on Black, Asian and minority ethnic communities. Despite decreased overall police stop and search rates, racial disproportionality has increased, with Black individuals facing drug-related stop-and-searches at nine times the rate of white people. Additionally, Black individuals comprise a quarter of cannabis possession convictions, despite representing less than four percent of the population. The criminalisation of drug use in the UK also limits access to housing for people who require social accommodation, causing fear of eviction among people who use drugs. ‘Public Space Protection Orders’ further exacerbate this issue by penalising activities like rough sleeping and drug consumption, pushing marginalised individuals into deeper isolation and further marginalisation. These punitive measures fail to address underlying issues, amplifying the risks and harms faced by affected communities. This underscores the crucial necessity for harm reduction as a response to both drug-related risks and the harm caused by prohibition.

 

Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C Care, Essential Harm Reduction Services, New Drug Trends, Mental Health of Harm Reduction Staff, TEDI Reports and City Reports (Warsaw, Bălţi, Esch-sur-Alzette, London, Amsterdam). The Executive Summary can be accessed here.

Recording – Roundup Webinar | Civil Society Monitoring of Harm Reduction in Europe

 

The video is the recording of the webinar organised to celebrate the core publications for the C-EHRN Civil Society-led Monitoring of Harm Reduction in Europe that took place on the 7th of March.

The event brought together four volumes of the 2023 Data Report:


Moderator: Rafaela Rigoni (C-EHRN)

Speakers:
Iga Jeziorska (C-EHRN) – Essential Harm Reduction Services
Tuukka Tammi (THL) – Eliminating Hepatitis C in Europe
Daan van der Gouwe (Trimbos) – New Drug Trends
Guy Jones (TEDI) – Drug Checking Observations and European Drug Checking Trends via TEDI

 
Following a new format, Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction in Europe 2023 Data Report is launched in 6 volumes: Hepatitis C Care, Essential Harm Reduction Services, New Drug Trends, Mental Health of Harm Reduction Staff, TEDI Reports and City Reports (Warsaw, Bălţi, Esch-sur-Alzette, London, Amsterdam). The Executive Summary can be accessed here.

Zachte Landing Project: More than a return ticket and a farewell

We talked to Ewa Wielgat about the “Zachte Landing” Project and the T6 shelter, funded by the City of Amsterdam. Ewa is one of the social workers at AMOC, a drop-in centre managed by De Regenboog Groep.

T6 is a 24/7 shelter for people experiencing homelessness, some of whom are EU migrants. In the T6 shelter, clients can stay up to one year, which allows them to stabilise, recover from the stressful life on the streets and get themselves organised. Later, “Zachte Landing” completes the cycle by assisting EU migrants, without legal documents, insurance and work, with a safe and trustful passage to life in their home country if they are willing to return.

Their many clients deal with a broad range of problems (e.g. (mental) health problems, homelessness, extensive drug or alcohol use, lack of social contacts in the home country). Therefore, they need on-site support services, including medical or drug treatment, housing, mental health services and work integration.

Current Project partners are situated in Poland and Romania, as most of the clients at AMOC come from these countries. Ewa and her colleague are case managers, assisting the clients in their language. In addition, the case managers develop different steps and support services in cooperation with their partners in the respective countries.
Ewa says that they have already supported the return of several clients to their home country. They stay in contact and follow up on their development from here.

“Zachte Landing” builds on the idea that people can take responsibility for their lives. However, it also acknowledges the need for a stable and safe environment (e.g. housing, treatment) to motivate the clients in their decision-making.
The service provided by “Zachte Landing” certainly is more than buying a return ticket and sending clients to the unknown but guaranteeing them an assuring start and with care, support and empathy, boosting their confidence to try.
Although the project will end soon, Ewa is optimistic. The preliminary results of the project are promising. The integrated harm reduction approach works are empowering and show the positive impact of a stable and safe environment for the well-being of individuals and the recovery of people in vulnerable situations.

Projects such as “Zachte Landing” put the individual in the centre and treat them with respect and dignity. Something which everyone deserves. We hope to hear more about such projects and initiatives.

Please feel free to contact C-EHRN with your news.
We would happily support your efforts at our best.

LAUNCHED TODAY! Harm Reduction Key Principles in Homeless Services

 

We are delightfully exhilarated to present you with this exciting must-read publication, Harm Reduction Key Principles in Homeless Services. Special thanks to all our partners, FEANTSA, De Regenboog Groep, Simon Community, Rights Reporter Foundation, Sundheds Team and Norte Vida.

The Key Principles
The Key Principles of Harm Reduction are an innovative set of tools developed through the HR4Homelessness Project. The innovation lies in their capacity to translate existing experiences and knowledge on Harm Reduction into actionable guidance through an open, iterative and evolving framework. 

The Key Principles aim to contribute to improving and transforming the services that shape access to and the quality of care that people experiencing homelessness who use drugs or alcohol receive. Further, they aim to support these services to respond to conditions that negatively influence marginalised and underserved communities’ social and health outcomes.

 

Why Harm Reduction? Why now?
Currently, a substantial number of programmes that support people experiencing homelessness in Europe require ongoing abstinence in order to receive or to access support services, including permanent housing. At the same time, a significant number of services currently articulate other conditions that, in combination with an abstinence requirement, result in high-threshold access to care and support and difficulties in generating engagement with people who use drugs or alcohol. 

High-threshold models come with the risk of implementing a “one size fits all” model that does not respond to the complex realities and diverse experiences of people experiencing homelessness who use drugs or alcohol. Instead, high-threshold services articulate structures wherein those most in need of help are least able to access it and where services end up supporting individuals who can demonstrate the capacity for change prior to the conditions and support required to achieve such change. Such an approach is often experienced as shaming or stigmatising and acts as a barrier to building trust between individuals and services. 

While evidence for the effectiveness of Harm Reduction exists, and a growing number of services in Europe, including homeless services, have started implementing Harm Reduction approaches as a guiding model in recent years, a substantial number of homeless services in Europe still lack the capacity to implement such strategies effectively. Next to this, mainstream Harm Reduction services that can implement Harm Reduction strategies and approaches generally focus too narrowly on technological or behavioural interventions centring upon personal change and not on systemic change. 

In response, the Key Principles of Harm Reduction in Homeless Services aims to support service providers to implement activities that respect the rights of people experiencing homelessness who use drugs or alcohol, which are informed by evidence. It also intends to advance social justice transformations, respect service user decisions and priorities, and contribute to eliminating stigma and discrimination of the communities they work for and with.

For more information about this resource or the HR4Homeless Project, please contact rpgayo@correlation-net.org

 

Key Principles of Harm Reduction in Homeless Settings

Check out the HR Key Principles, our key innovative output which translates the learnings of the HR4homelessness project into guidance for homeless and other services who support people in homelessness

The HR Key Principles translate the learnings from the ‘HR4homelessness’ Project, which brought together homeless and bustance use services, into guidance for homeless services to improve support provision for people who use drugs and/or alcohol.

For each of the seven principles, strategies for improving support provision are described as well as existing good practices. We provide suggestions for tools that can be helpful for staff and service users, suggestions for further reading and link you up to the respective training video(s). The seven principles are:

  1. Human Rights based service provision: HR aims at establishing quality of individual and community life and well-being – not necessarily abstinence of all drug use – as the criteria for successful actions and policies. HR calls for a non-judgmental, non-coercive access to support and care.
  2. Meaningful engagement of service users: HR engages and involves people with lived experience of homelessness and substance use in the development and evaluation of policies, services and programs that affect them. This is essential for achieving  good social and health outcomes and addressing unmet needs.
  3. Reduce risks and harm: HR focuses on reducing the harms related to substance use for the individual and the broader community. It takes into account factors that may exacerbate vulnerability such as trauma, incarceration history, racism, social disadvantage, housing status, age, sexual orientation and gender.
  4. Take on a pragmatic attitude: HR accepts that licit and illicit substance use is part of our world. HR reflects the idea that none of us will ever achieve perfect health behaviors and that ‘perfect’ health behaviors are impossible to define as they are shaped by social determinants and norms.
  5. Person Centered Services: HR services focus on responding to the needs, preferences and values of the individuals and communities they work with. This includes the recognition of the social conditioning of health outcomes, addressing power relationships between care providers and service users, and the promotion of communication and shared decision-making.
  6. Evidence-based services, strategies and policies which are relevant and effective to the communities they serve and which are regularly evaluated and, if necessary, adapted.
  7. Accountability: HR aims to minimize not only the negative health and social impacts associated with drug and alcohol use, but also the harms caused by respective policies, laws, services, and institutional practices. HR promotes processes and systems designed to hold individuals and groups in check for their decisions and actions.

COVID-19 – Addressing the impact on workers in the informal economy

In this NLO podcast episode, we discuss the impact of the COVID-19 pandemic on workers in the informal economy, including sex workers and undocumented migrants. Our guests explain the gaps and unintended consequences of government responses and how to increase equitable and inclusive access to care and social services for all.

Join us for an exciting and insightful discussion with:

Maria-Anna Paraskeva, Senior Policy Officer, DG EMPL, F1- EFS (European Social Fund) and FEAD (Fund for European Aid to the Most Deprived) (European Commission)

Michele LeVoy, Director Platform for International Cooperation on Undocumented Migrants (PICUM)

Luca Stevenson, Coordinator, International Committee on the Rights of Sex Workers in Europe (ICRSE)

Moderated by Paul Adamson from Encompass.

Statement: Harm Reduction Must Go On!

Correlation – European Harm Reduction Network and the Eurasian Harm Reduction Association, together with the Rights Reporter Foundation, published a joint position on the continuity of harm reduction services during the COVID-19 crisis.

Download the English, Russian, German, Portuguese, Spanish, Polish, Hungarian, Czech, Montenegrin PDF version here!

People Who Use Drugs (PWUDs) can be considered as a risk group in the COVID-19 epidemic. They often live at the margins of society with low or no access to housing, employment, financial resources, social and health care, and face systematic discrimination and criminalisation in the majority of countries. Many of them have multiple health problems, which can increase the risk of a (fatal) COVID-19 infection (including long-term diseases such as COPD, HIV, TB, cancer, and other conditions which reduce the immune system). Harm reduction services are often the one and only contact point for PWUDs to access the health service. They provide health and social services as well as other basic support, and function as an essential link to other life-saving services. We call on local and national governments and international organisations introducing safety measures and to:

1. Ensure the continuity and sustainability of harm reduction and other low-threshold services for PWUDs during the COVID-19 epidemic. This includes, in particular, Opiate Substitution Treatment (OST), Heroin Assisted Treatment (HAT), Needle and Syringe Programs (NSP), naloxone provision, and continued access to Drug Consumption Rooms (DCRs). In addition, essential basic services need to be provided, including day and night shelter, showers, clothing, food, and other services. This is of particular importance to those who experience homelessness and/or live on the streets.

2. Provide adequate funding for harm reduction and other low-threshold service providers, and supply them with adequate equipment to protect staff and clients from infections (soap, hand sanitiser, disposable face-masks, tissues etc.).

3. Acknowledge the important and critical role of harm reduction and other low-threshold services in the COVID-19 pandemic and address the specific vulnerable situation of PWUDs and other related groups.

4. Develop specific guidelines and regulations for harm reduction services, with respect to the vulnerable situation of PWUDs and related target groups. These guidelines should be developed in close cooperation with involved staff and the affected communities, and build on international WHO guidelines, recommendations, and evidence and/or national COVID-19 regulations.

More specifically we call for the following:

5. OST and HAT should be maintained and take-home regulations should be established or extended for patients to have the opportunity to come for treatment rarely then ones a week. Access through pharmacies should be ensured.

6. NSP should provide PWUDs with larger amounts of needles, syringes, and other paraphernalia to minimise the number of contacts. Special bins for needles and syringes should be provided to collect used material at home.

7. Harm reduction services should provide COVID-19 prevention material and information for staff, volunteers, and service users, including soap, alcohol-based hand sanitisers that contain at least 60% alcohol, tissues, trash baskets, and disposable face-masks (if this is requested by national regulations), for people who show symptoms like fever, coughing, and sneezing.

8. Drop-in services, day shelters, and DCRs should advise and support PWUDs in preventing COVID-19 infections. Visitors should be made to sanitise their hands when entering and should stay no longer than is absolutely necessary. Kitchens can prepare take-away food to be eaten outdoors. All necessary measures should be made to increase social distancing among visitors/staff with all possible means, and rooms should be ventilated. Overcrowding in harm reductions services, shelters, and DCRs should be avoided, by establishing safety measures, e.g. minimising the duration of stay, maximum number of visitors, entering only once per day. People with permanent housing should be encouraged to stay at home and come only to pick up needles and other harm reduction paraphernalia and tools.

9. The health situation of PWUDs should be monitored closely. If someone shows symptoms, such as fever and coughing, face-masks should be provided and a medical check-up should be ensured. Cooperation agreements with public health services, related health units, and hospitals need to be established to ensure direct medical support, follow up care, and treatment.

10. Night shelters need to be made available for people experiencing homelessness, with a separation in place between those who are not infected and those who are infected and need to be quarantined but do not need specific medical care and treatment in hospitals. Night shelters have to comply with the overall safety regulations for COVID-19, and people should not be exposed to additional risks for infection through overcrowding and insufficient health care.

11. Group-related services, such as meetings and consultations, should be cancelled and postponed until further notice or organised as online services. New treatment admissions should be temporarily suspended. Coercive measures (e.g treatment referrals made by court/prosecutor/police, probation officer visits etc.) should be suspended. Mandatory urine sampling should be abolished.

12. Harm reduction services should establish a safe working environment and make sure that staff are well informed and protected against infection. Service providers should identify critical job functions and positions, and plan for alternative coverage by involving other staff members in service delivery.