Executive Summary | Civil Society-led Monitoring of Harm Reduction in Europe 2023

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 CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). 

Empowering Communities: Red Liv’s training program on Naloxone administration

Naloxone is a medication that can counteract the effects of an opioid overdose, available in pre-filled syringes or nasal spray formats. When promptly administered following an overdose, it can be life-saving, offering vital support while waiting for emergency medical assistance. Given the concerning rise in cases of overdose involving synthetic opioids like nitazenes in various European cities, there’s an urgent call for widespread distribution of Naloxone and comprehensive training for people who use drugs.

In Copenhagen, C-EHRN’s Danish Focal Point, Red Liv, Center for Vulnerable Adults and Families, has been at the forefront of developing a nationwide training program on Naloxone administration for people who use drugs since 2010. This initiative has served as a model for other countries, including Norway and Sweden. By employing a train-the-trainer approach and adhering to national and WHO standards, staff at local services offering opioid agonist treatment (OAT) have been equipped to provide take-home Naloxone (in nasal spray form) and educate local communities on its usage and the identification of opioid overdoses. What began in Vesterbro, Copenhagen, has expanded into a nationwide network encompassing rural and urban municipalities.

This experience has proven the feasibility of establishing a supportive network of trainers for Naloxone administration and provision. However, sustaining such a network requires ongoing support, which local organisations find challenging due to insufficient political prioritisation and uncertain funding. Despite these obstacles, organisations like Red Liv continue to advocate for the importance of these initiatives amidst the many responsibilities faced by staff at harm reduction services.

Building on their extensive experience, Red Liv has compiled a series of reports and recommendations on Naloxone administration and how to support and upscale the existing network, available in multiple volumes in Danish and a summarised version in English. Their work is an excellent example that can support other European organisations wishing to implement similar interventions.

Read the English summary and recommendations here.

 

You can find more information on the development from pilot project to national standard [in Danish] here:
-Save Life 4 (read here and here)
Save Life 3
Save Life 2
Save Life 1 (pilot)

Roundup Webinar | Civil Society-led Monitoring of Harm Reduction in Europe

To celebrate the core publications for the C-EHRN Civil Society-led Monitoring of Harm Reduction in Europe, we invite you to join the roundup webinar on the 7th of March, 1:00 PM (CET)!

 
The event will bring together four recently published volumes of the 2023 Data Report:
 
During the interactive webinar, the primary authors of each publication will join  Rafaela Rigoni, C-EHRN’s Head of Research, to debate positive developments and the main advocacy asks arising from the reports’ conclusions. We’ll invite participants to interact via a Q&A session.
 
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

To join the webinar, register by the 6th of March on this link!

 

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 CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

New Drug Trends: Insights from Focus Group Discussions

We are launching our publication New Drug Trends: Insights from Focus Group Discussions, part of Correlation – European Harm Reduction Network’s Civil Society-led Monitoring of Harm Reduction In Europe 2023 Data Report.

The study relies on 18 focal group discussions conducted among civil society organisations designated as focal points within the Network and explores the latest insights concerning the emergence of new illicit substances in cities where focal points are located, as well as other developments in drug use patterns, including polydrug use, routes of administration, and changes in local drug markets.

We bring an interview with Daan Van der Gouwe, primary author, researcher at Trimbos Institute and coordinator of the Dutch Harm Reduction Network. Read the interview and download the publication below!

Which main developments would you highlight when it comes to new or unknown substances compared to last year’s report?

We have witnessed a number of developments this year. When we look at the community of people who are engaged in high-risk drug use, we see the appearance of various synthetic opioids in heroin or benzodiazepines, for instance, nitazenes, but fentanyls are also gaining ground in some areas in Europe. With nitazenes, it seems to be geographically limited still in the northwestern part of Europe, mainly in Ireland and the UK. Whereas when it comes to fentanyls that are found in heroin,  we see it in other areas of Europe. This is the main finding that we didn’t see so much last year.

Within the group of people with high-risk drug use, we also see an increa

se in the use of cocaine and methamphetamine. This cocaine includes crack cocaine, especially.

People also spoke about the ban on opium cultivation by the Taliban in 2023, that this should have an effect on the heroin market, but we don’t see that very clearly at the moment. Heroin is still available but it may be the case that this year, in 2024, it will be a different situation.

When it comes to recreational drug use, we do not see so much difference. We see some appearance of 2C-B, ketamine, some cathinones and especially also cocaine being more present on local drug markets in Europe.

 

The findings show that the internet takes up an increasing space in the sale of drugs. Are there any recommendations or best practices on how harm reduction services can respond to this?

Yes, this is a clear finding. We have witnessed this feature for several years already, but last year it was really strong. I’d like to make a plea for harm reduction NGOs to go online and inform themselves about the changing markets, to see what’s going on online, but also to start some interventions there and to do internet-based harm reduction, for instance, online outreach work.

We have had a pioneer, his name is Fernando Caudevilla, DoctorX, who did this work already 10-15 years ago. He did that on the darknet, he answered questions of people who use drugs, and he gave very proper harm reduction advice to anyone who had questions about drug use. Maybe in some countries like the Netherlands, we have this clear-cut information everywhere online, but in many other countries, for instance, in Russia, this information is not available.

This kind of work, online harm reduction services are essential for people to take note of. This would be a very important thing to do and to start conducting.

 

Would you pick a quote from the report that you find significant and explain why you find it relevant?

I’d like to quote the focal point in Glasgow in the UK, Scotland:

“(…) There are few reports to corroborate (the use of nitazenes), but (…seem to be….) people who have reported long term use of other drugs and have purchased as heroin.” (p. 13.)

I think this quote is a good example of where we are nowadays. We have a number of reports on nitazenes and other synthetic opioids in heroin, but the evidence is lagging behind, particularly because there’s a lack of drug checking services in the European Union or globally. So people do not really know what they are buying and using. This is why it’s very important to have drug checking services so that when people purchase heroin, they could find out that this ‘heroin’ contains no heroin, or contains heroin but also nitazenes, which are much stronger and can be lethal. So it’s essential to have these services all around the globe.

 

How do you think harm reduction organizations can use the report?

The report can be used as an advocacy tool, to advocate for a better early warning system, especially since now drug markets are more polluted. Look at the heroin market, but some other markets also seem to be more polluted. Also because drug markets continue to go online.

Harm reduction services also need to find funding for better services and for better serving the needs of people who use stimulant drugs, especially crack and methamphetamine, since we have seen an increase in crack and methamphetamine on the market and services for these users are also lagging behind.

This report clearly identifies these developments which are in line with data from, for instance, the EMCDDA [European Monitoring Centre for Drugs and Drug Addiction]. It would be good that harm reduction services use the report and the recommendations to get access to additional funding to serve the people they’re working for in a better way.

 

Qualitative data is a significant complementary source to gain information, and as you mentioned, there seem to be limitations when it comes to gaining information about the quality or composition of substances, and that’s where drug checking can be very important. How do you think research methods can be combined in the best way and what do you think is necessary for this to happen?

What I think is necessary to develop further is that we look at different sources. In the scientific world, we call it triangulation of data. It means that we use data from the focus groups that we have been conducting for many years now in the framework of Correlation to compare those data with the drug checking data from several cities. But also, I think wastewater analysis could be a very interesting tool. Also, there’s a project going on which identifies and detects drugs in syringes.

I think with all those different sources together we can quickly see trends and developments in the drug markets. Also, what is even more important than just detecting or identifying is to intervene as quickly as possible.

For instance, this situation with nitazenes, it’s very worrying in a specific part of Europe now, but it could extend to the whole of Europe quickly. Then it also needs to be responded to in a very quick and precise manner. The data we get, along with all the other data, for instance from drug checking, could help to do so.

 

What is the added value of this type of civil society-led monitoring with focal group discussions in comparison with the other types of monitoring of drug trends that are already done by major monitoring agencies?

The added value of the work that we do within the framework of Correlation is that we can get much richer data across than just the valuable data that are being collected by other agencies. They also take some time for publications, which means the day they are published, the data is rather old. We have developed now a system in which we can publish our data in a bit quicker way, which also means that we can intervene more quickly.

The other value is that we can put more layers of information of context in the data that are provided by other services, for instance, about drug markets. As an example, besides the internet-based drug markets that are now emerging, in some focus group discussions, there was a mention of increasing violence in the drug markets. Violence between drug dealers, violence between people who use drugs, violence between people who use drugs and drug dealers, and also violence between people who use drugs, drug dealers and the largest society. It seems that in some cities this violence is becoming more apparent than before, and this is also something we need to address.

 

What do you think the most urgent steps are that need to be done at the European level?

Two things I’ve already mentioned are the expansion of drug checking services throughout Europe, and also the expansion of harm reduction online.

Since there’s an increase in the appearance and use of stimulant drugs, especially crack cocaine and methamphetamine, but also some cathinones, harm reduction services should step up in delivering services that address the people using these stimulants.

Finally, there’s a need for preparedness for the changing heroin markets.  As I said before, we see that the heroin market is increasingly polluted with fentanyls, but also in some areas with nitazines, and we believe that harm reduction services throughout Europe should prepare themselves in the best possible way to respond to the crisis that may emerge in the coming years.

 

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 CareEssential Harm Reduction ServicesNew Drug TrendsMental Health of Harm Reduction StaffTEDI Reports and City Reports (WarsawBălţiEsch-sur-AlzetteLondonAmsterdam). The Executive Summary can be accessed here.

 

Joint Report on Drug Consumption Rooms in Europe

The EMCDDA and Correlation – European Harm Reduction Network (C-EHRN) have published today the latest overview on the situation of drug consumption rooms (DCRs) in Europe. The purpose of the report is to encourage evidence-based discussions around DCRs and the implementation of varied DCR models in Europe.

DCRs are a fundamental health and social response that fosters the well-being of people who use drugs by providing hygienic and safer spaces where to use substances in the presence of trained social workers and/or healthcare professionals. DCRs are usually located in areas where there is an open drug scene and where injecting in public places is common. The primary target group for DCR services are people who engage in drug use patterns that can result in dangerous health outcomes.

According to the report, in 2022, over 100 DCRs were operating globally, with services in several countries such as Belgium, Denmark, France, Germany, Greece, Luxembourg, the Netherlands, Norway, Portugal and Spain, as well as in Switzerland, Australia, Canada, Mexico and the USA.

Primarily, DCRs aim to prevent drug-related overdose deaths, reduce the risks of disease transmission through the use of unhygienic supplies and/or their sharing, and connect people who use drugs with support, health and social services. Besides this, they can also aim to minimise public nuisance.

In the report, two main operational models of DCRs in Europe are described: integrated DCRs, operating within low-threshold facilities, where the supervision of drug use is just one of the services offered, and specialised DCRs, offering a narrower range of services directly related to supervised consumption.

As frontline, low-threshold services, DCRs can support the monitoring of new and emerging local trends. For example, it has been found that in Europe, injecting heroin is less common in recent years, while the use of synthetic opioids and stimulants has increased in some countries. Over the years, following a dynamic drug landscape, many harm reduction services, including DCRs, have adapted to the needs of local clients. For example, some DCRs have started providing services for smoking as well as injecting and allowing the consumption of a wider range of substances within the facility.

DCR evaluation presents specific challenges, but currently available evidence supports the positive impact of DCRs on the access to healthcare and harm reduction services among people who use drugs, and especially groups that are not reached enough by these services. DCRs do not increase crime in the areas where they are located and, instead, contribute to a decrease in public drug use. Evidence also shows how DCRs contribute to reducing drug-related deaths.

In addition, an expert panel recently concluded that DCRs foster safer injecting practices and therefore can contribute to reducing the transmission rate of communicable diseases among people who inject drugs.

Among other measures to reduce cases of fatal and non-fatal overdose, the EU Drugs Action Plan 2021–2025 calls for DCRs to be introduced, maintained or enhanced ‘where appropriate and in accordance with national legislation’.
The report concludes that, despite the challenges encountered in conducting research in this setting, more studies are needed to support the work of DCRs by showing their contributions to reducing both individual and community harms.

Read the joint EMCDDA and C-EHRN Report on DCRs in Europe here.
Read the EMCDDA Report Release here.

 

Overdose Awareness Day – Some of the latest updates in the fight to end overdose

The 31st of August marks the International Overdose Awareness Day, a day to amplify the voices fighting to end overdose and to remember those who have passed away due to overdose. In support of initiatives making efforts on this path, we bring some of the latest updates.

Highlights include:

  • the European Network of Drug Consumption Rooms,
  • research on the effectiveness of the Scottish “How to Save a Life” mass media campaign addressing the rising number of drug-related deaths,
  • the efforts made in Athens in overdose prevention,

along with some additional resources that came our way in August.

 

New members can now join the European Network of Drug Consumption Rooms

C-EHRN hosts the International Network of Drug Consumption Rooms since 2007. In the past years, it became obvious that more cooperation is needed at the European level to support the development of high-quality DCRs. As an answer to this need, the European Network of Drug Consumption Rooms (ENDCR) began to take shape. At the beginning of 2023, we developed the Terms of Reference for the ENDCR, a network aiming to support capacity-building and advocacy activities and to create a platform for mutual support. 

We invite organisations in the WHO Europe Region operating or planning to implement a DCR to apply for membership by reading the Terms of Reference and sending an email to administration@correlation-net.org, indicating their interest in joining the network. Once contacted, we can provide a membership confirmation survey link.

 

Scottish Naloxone Distribution and Mass Media Campaigns: A Blueprint for Overdose Prevention

Recent Scottish research offers insights into addressing drug overdoses through effective strategies. Two studies delve into the roles of naloxone distribution and mass media campaigns in preventing overdose-related deaths. Scotland’s “How to Save a Life” (HTSAL) campaign, addressing increasing drug-related deaths, aimed to raise awareness and expand naloxone distribution.

The first study reveals that the campaign significantly boosted community naloxone availability. However, sustainability post-campaign requires consideration. The second study shows the campaign’s success in enhancing public understanding of drug-related deaths and naloxone while highlighting that responses to overdose need comprehensive coverage. Scotland’s proactive HTSAL campaign sets an example for similar regions, highlighting the importance of ongoing investment to sustain overdose prevention efforts beyond campaign periods.

 

Athens Recognized at International Summit for Naloxone Accessibility

In March 2023, Athens was amongst the 5 cities recognized for public health achievements at the Partnership for Healthy Cities Summit convened in London by Bloomberg Philanthropies, World Health Organization, Vital Strategies, and Mayor Sadiq Khan of London. The recognition was gained for the steps taken to enhance the availability of naloxone within community-based initiatives and among medical practitioners. Additionally, the city has initiated research into the factors leading to mortality among people who inject drugs to gain deeper insights into the effects of the overdose crisis.

Marios Atzemis, Harm Reduction Officer at Positive Voice, C-EHRN’s focal point in Athens, underlined the importance of recognising those who played a crucial role in the progress, including Professors Angelos Hatzakis and Vana Sypsa, the Hellenic Scientific Society for the Study of AIDS, STDs and Emerging Diseases and George Kalamitsis, chair of the Hellenic Liver Patient Association “Prometheus”. He also added: “We are tired of losing friends and peers from deaths that could be prevented and we strongly support the participation of the directly affected communities in the design, implementation and delivery of programs, services and policies that are addressed to them. We also strongly support and encourage the collaboration of all the stakeholders and the key populations in the drug field as it happened to the naloxone case.”

 

Read about SAVE LIFE, an inspiring initiative from Denmark

SAVE LIFE is a crucial component of HealthTeam for the Homeless (SundhedsTeam) in Copenhagen, who are also C-EHRN’s focal point. It focuses on outreach health efforts for marginalized people and people who experience homelessness. Since 2010, SAVE LIFE has developed training in lifesaving in combination with the opioid antidote naloxone. Originally in Vesterbro, Copenhagen, the project expanded across rural and urban areas in three phases. Training includes nasal spray naloxone use, overdose recognition, and life-saving assistance. The first cross-municipal project began in 2013, with some municipalities engaged for a decade. Since 2020, SAVE LIFE has coordinated nationwide training in municipalities with a substitution treatment.

Project materials and resources are available on their website, and reports and scientific articles can be accessed here. For inquiries, contact Henrik Thiesen at gg63@kk.dk or alkodoktor@dadlnet.dk.

 

Additional Resources

Manual | Safer Consumption Spaces

Access the DCR manual with guidance and resources for the implementation, operation and improvement of drug consumption rooms.

Article | Tales from New York. ‘We should learn from the drug treatment approach here’

Read Tony Duffin’s inspiring article about the work of OnPoint, Overdose Prevention Centres and what we can learn from the drug treatment approach in NYC.

Webinar | Report Launch: Aid for War on Drugs

Date: 12 September
Organised by: Harm Reduction International
Registration here.

Minister of State Niall Collins commends Ana Liffey’s Mid West Team

 

Limerick County TD, Minister of State Niall Collins commends Ana Liffey’s Mid West Team in their tenth year of operations.

At the celebratory event, marking ten years of Ana Liffey Drug Project operating in the Mid West Region; Limerick County TD, Niall Collins the Minister of State for Skills and Further Education thanked the members of Ana Liffey’s Mid West Team for all their work over the past ten years; and particularly thanked Team Leader, Rachel O’Donoghue, and her team for the work they did throughout the COVID-19 pandemic. Acknowledging that they were the only drugs outreach team working on the streets of Limerick City throughout the restrictions, the Minister of State said,
“When fear and uncertain was permeating society across Ireland; and no one knew what was going to happen…this small team adapted quickly, stayed out there, and continued to meet the needs of those they serve. Maintaining contact with people; busting myths about COVID-19; and providing people with equipment and advice to keep them as safe and healthy as could be. The net result of this work was not only the maintaining of engagement with the people the team already knew; but, also the creation of meaningful relationships with literally hundreds of other people. Well done to all involved!”
At the event the Minister of State:
• Welcomed the findings of the new research carried out by the University of Limerick: ‘Doing More – The Health and Social Impacts of Crack Cocaine use in Limerick City’. The research findings were presented for the first time by Dr Dervla Kelly at the event.
• Welcomed the allocation of funding from the State under the ‘Community Services Enhancement Fund’ to support Ana Liffey to employ two addiction outreach workers in the Mid West Region, one worker specialising in reaching, and case managing, members of the LGBTQI+ community; and the other worker with a similar function focussing on the Traveller Community.
• Launched Ana Liffey’s new mobile health unit purchased with a grant from the JP McManus Benevolent Fund. Referred to affectionately as the Mid West ‘VanaLiffey’ – this is a significant service development which helps to deliver harm reduction services to people in a flexible and accessible manner; and to reduce the risk of overdose, and other drug related harms, in Limerick City and across the Mid West.
 
At the event Tony Duffin CEO of Ana Liffey Drug Project said,
“Our Mid West team work in Limerick City and also travel significant distances across the region to support people with complex and multiple needs. We are very grateful to the JP McManus Benevolent Fund for their support to purchase and fit out a new mobile health unit! Fondly referred to as the Mid West ‘VanaLiffey’ the vehicle is designed to help us meet people where they are at. Whether in an urban setting or a rural setting, we now have a fit for purpose private space that can roll in and out of an area. My sincere thanks
to Minister of State Niall Collins for taking the time today to launch the vehicle for us.”

INHSU 2022 Day 1 – Key Reflections

 

We are excited to be attending the INHSU 2022 conference in Glasgow, and want to share some key reflections and images from day 1 (October 18th) as shared by Graham Shaw and Roberto Perez.

At the opening, the Scottish Government’s Minister for Public Health, Women’s Health and Sport, Maree Todd, stated that Scotland was close to halving viral hepatitis C (HCV) prevalence and by as much as 60-70% in some parts of the country. However, she also noted that HCV incidence remains high.

Jason Wallace of the Scottish Drugs Forum (SDF), speaking on behalf of the community of people with lived and living experience, outlined the main points from the statement developed by the community forum the previous day. Of particular note was that research must be controlled by the community, including the early involvement of the community in developing all aspects of a research proposal, as well as ownership of research data. He also stressed that poly drug use is the norm, not the exception. The community also demands a defined role of volunteers as well as to be paid equally for being employed in research work, as well as a clear pathway for peer workers to progress in drug-related programmes, together with proper supervision and support within such organisations.

In Andrew McAuley’s presentation, he spoke of the increasing global trend in drug-related deaths (DRD) which have roughly doubled over the past 30 years and exponentially increased since 2014 and that this trend has further climbed since the COVID-19 pandemic, with the USA and Scotland the stand-out leaders in the rate of DRD. Medically Assisted Therapy (MAT), also known as Opioid Agonist Therapy (OAT), Take-Home Naloxone (THN) were notable responses to opioid-related prevention of deaths and Direct Acting Antivirals (DAA) for the treatment of HCV. Drug Consumption Rooms (DCRs) and Drug Checking Services (DCS) are also key to the prevention of DRD but that there are gaps in evidence.

Niamh Eastwood of Release UK outlined the various aspects of how the war on drugs has failed and how non-white people were clearly being targeted by law enforcement agencies who use the war on drugs as an excuse to stop-and-search non-white people around nine times more often than they do with white individuals. However, advocacy continues to push for the decriminalisation of drug use and possession for personal use, including the cost savings arising from decriminalisation. A picture from the presentation is included below.

Impact of the Russian invasion on ART and OAT access by PWID in Ukraine

Jack Stone of the University of Bristol outlined the impact of disruptions to services for people who inject drugs due to the Russian invasion of Ukraine. Modelling shows that short-term closures of interventions could have a substantial impact on the increase in HIV infections even though OAT and ART access continued to increase outside of conflict areas but reduced in the areas invaded by Russia, partly a result of a drop-off of NGO service provision in such Russian-controlled areas of Ukraine. Images from the presentation are included below.

‘What the fresh hell is this?’

Presented by Garth Mullins, the producer of the Crackdown podcast based in the USA. The session discussed the ever developing emergence of new substances promoted through the consequences of prohibitionist policies, as seen originally in the early 20th century in the USA with alcohol. Particular focus was given to ‘benzo-dope’ and how naloxone responses to overdose only impact the ‘dope’ component and not the benzo’s, leaving people with severe memory loss from a few hours to several days. Contributors provided their own ‘benzo-dope’ overdose experiences, including Jason Wallace of the Scottish Drugs Forum who said that Benzos were implicated in an ever increasing number of drug-related deaths. Angela McBride of the South African Network of People who Use Drugs outlined the impact of alcohol and cigarette prohibition in South Africa during COVID-19 lockdowns but that such experience has been easily forgotten. Sione Crawford of Harm Reduction Victoria, Australia as well as Mat from the Canadian Association of People who Use Drugs (CAPUD) all noted the need for a safe supply to reduce overdose events and continued failure to provide a safe supply of substances will allow the black market to prevail and the resultant high levels of drug-related deaths.

HCV care models

Several different examples of HCV care models were presented from South Africa, Iran and Scotland. In all three countries, services were based within the community through building relationships and keeping each step as simple as possible; such an approach helps to reduce the level of stigma and discrimination experienced by people who inject drugs. In Dundee, Scotland, building such relationships helped move from confrontation to cooperation, such as in interactions with a local pharmacy, as well as the inclusion of other health interventions, such as wound care. In Rafsanjan, Iran, a local entrepreneur helped to fund a local response to provide HCV testing and treatment, with the local community identifying an unused bus that was repurposed and used as a mobile HCV unit. The local service was linked with the University of Medical Sciences and this model of micro-elimination of HCV is now being considered for implementation throughout the country. In South Africa, it was noted that advocacy can result in positive change in service provision and SANPUD capacitates fellow networks and organisations to pressure decision-makers for change to allow improved access to HCV testing and treatment services.

Individual choice

The choice of which opioid maintenance approach is appropriate for the individual was discussed within the context of Switzerland and Australia. A relatively wide range of options are available in Switzerland. The process of supporting an individual includes the person’s preferences as to which opioid agonist should be tried, with examples given for various substances available in Zurich and Arud. The future directions beyond medical treatment were also outlined within the context of the changing legislative environment. Key elements of effective OAT were presented together with approaches to the continued use of other substances by an individual.

In Australia, choice is often associated with not being chained to a pharmacy as well as the endemic stigmatisation of people who use drugs. In addition, there are social aspects to using substances and the medicalisation of treatment often negates this component and options also include the continued use of drugs. Also stressed during the discussion was the apparent fear held by prescribes of being held liable if an individual overdoses and the belittling view of people who use drugs held by legislators that results in unreasonable and excessively tight controls being in place for opioid maintenance.

The social sciences perspective of individual choice was reviewed and the key factors that influence individual preferences were outlined. Considerations that ‘professionals’ can make to facilitate choice by the individual were also provided.

Differentiated choice of the best suitable agonist were discussed. The first priority has to be the preference of the person in treatment; subjective experience and side effects are often overlooked and not addressed.

Long acting full agonsists include;

Long acting partial agonist;

Key elements of effective OAT;

On Top Use of other Substances;

“How can professionals enable choice in OPT decision making?”

To the extent possible;

Key factors influencing patient preferences;

Office for National Statistics publish new figures on drug-related deaths in England and Wales for 2021

The Office for National Statistics have published new figures on drug-related deaths in England and Wales for 2021, revealing another increase in drug-related deaths.

 

According to the report, 4,859 people died from drug poisoning in 2021. Drug related deaths have risen by 85th since 2012; this marks the ninth consecutive year of drug related deaths rising.

Around half the deaths involved opiates (2,219), with cocaine related deaths rising by over 8%.

“Measures which have reversed drug related deaths in other parts of the world need to be considered as a way to stop people dying and promote harm reduction. Overdose Prevention Centres, of which there are over 200 in many countries across the world including Switzerland, Germany and the USA are an undoubtedly proven way of doing just this.”

Overdose Prevention Centres are named as being a critical way of reducing thousands of avoidable drug-related deaths. Unified public services, community-based interventions, outreach programs and drug support services were also named as methods which require more funding.

Read the full article here.

Updates from the AIDS 2022 Conference

The AIDS2022 conference is taking place in Montreal, with experts in the field of HIV/AIDS sharing knowledge and experience related to the virus.

Advocation for people who use drugs was present during the conference, with the stigma and judgement faced by people who inject drugs being addressed as barriers to seeking care; it was reinforced that everyone should be able to access affordable, quality care irrespective of their drug use status. Virginia Macdonald of the World Health Organisation strongly recommended the implementation of needle & syringe exchange programs and overdose prevention care.

As well as this, activists demanded stronger action to be taken from the world health organization against Monkeypox, through urgent scaled up and equitable vaccine access. The activists emphasized lifting intellectual property barriers, and the need for a plan for prevention, treatment and care.

Click here for more information on the conference.