LEAPH 2023

On 19-20 May 2023, we attended The European Conference on Law Enforcement & Public Health organised by the Global Law Enforcement and Public Health Association in cooperation with Umeå University’s Police Education Unit in Umeå, Sweden. The conference addressed multiple intersections between law enforcement and public health areas, such as drugs and drug use, harm reduction, socio-economic vulnerabilities, sexual and gender-based harassment, trauma, or mental health. The highlight of the conference was the sizable representation of police officers and researchers from Scotland, who shared the positive experiences and successes of their public health approach to policing being implemented to address the skyrocketing opioid overdose deaths in the country.

Before the conference, Correlation’s Iga Jeziorska participated in the workshop Law Enforcement, Harm Reduction and Drug Policy. On Friday, she was engaged as an expert in the Panel discussion on decriminalisation chaired by Neil Woods from The Law Enforcement Action Partnership, What does drug policy reform mean – to police and to the community? along with Julia Ryland (LEAP) and Tuukka Tammi (THL). On Saturday morning, Iga gave a presentation that challenged the idea of the role of evidence in (drug) policy making, which stirred a lively debate among police officers from England, Scotland, Norway, The Netherlands, Ukraine, Moldova, and others, on the law enforcement performance indicators.

 

 

Integrated and Person-Centered Care Models – New Publications

Two new publications on Integrated and Person-Centered Care Models are now available: ‘From “Patients” to “Co-Creators” of Interventions’ and the accompanying Policy Recommendations.

Integrated and person centred-care means putting people and communities, not diseases, at the centre of health systems and empowering people to take charge of their own health, rather than being passive recipients of services. Person-centered frameworks acknowledge the diversity of PWUD and provide a wide range of support services, addressing the negative impact of stigma and discrimination on access to health and social care, the dignity of PWUD and their right to participate in society fully.

A number of critical factors (ideological, political, structural, organizational and individual challenges) continue to hinder implementation of these models. The two publications investigate these challenges and provide policy and practice recommendations for person-centered models.

 

      Read the full publication here

       Read the policy recommendations here

Vacatures Correlation

We have three new positions available in the Correlation team; Communications Officer, Research Support Officer & Project Support Officer.

 

C-EHRN is the international department of Stichting De Regenboog Groep. We aim for an inclusive Europe in which marginalised communities, such as people who use drugs, sex workers, migrants or people experiencing homelessness, have access to social and healthcare services without being discriminated against and stigmatised.

 

We are excited to expand our small team by introducing these new roles. All roles are based in Amsterdam.

 

We are an inclusive organisation, and we welcome all applications. We want our workforce to be truly representative of the communities we serve.

 

Read the full descriptions, with information on  how to apply, below;

Communications Officer

Research Support Officer

Project Support Officer

 

Please send your application, including your motivation letter and your cv to De Regenboog Groep, for the attention of Leo de Kam, PO box 10887, 1001 EW Amsterdam or sollicitatie@deregenboog.org.

You can contact Katrin Schiffer in case you would like to have more information: 06 21 29 59 47 or kschiffer@correlation-net.org.

Vacancy Communication Officer

 

We are looking for a Communication Officer for 36 hours a week (as of April 2023), who wants to go the extra mile to make social, health and harm reduction services available for marginalised and underserved communities.

 

We are a small and international team working from our office in Amsterdam, which is part of De Regenboog Groep. C-EHRN aims for an inclusive Europe in which marginalised communities, such as People Who Use Drugs, sex workers, migrants or people experiencing homelessness, have access to social and healthcare services without being discriminated against and stigmatised. Please check our website for more information.

As our Communication Officer, you will be responsible for planning and writing engaging and informative content to promote our network activities and results, mobilise supporters, reach institutions, policy-makers and funders or gain the support of new audiences and organizations. You are ambitious, fluent in English and have excellent communication and time management skills.

 

Read the full vacancy here.

Hommage to Béatrice Stambul

“Treat people as they are, without judgment or stigmatisation, recognise the central role and expertise of users, promote pragmatic actions.”

 


Last Wednesday, 8th of February 2023, Beatrice Stambul left us after a long illness in her home city Marseille. All her family and colleagues surrounded her.

Beatrice was a strong activist in harm reduction, a friend to many of us, and an exceptional professional. Psychiatrist and social activist at the same time, her profession was what she called a ‘doctor of the soul’. For many decades, she dedicated her life to making the world a more just and fairer world for the people she felt were left behind: the communities at the margins of society or forgotten in complex global conflicts.

Beatrice was a warm and compassionate person. Her career and professional life took place in Marseille and France, where she passionately advocated for better care services and humane drug policies. Beatrice was one of the leading figures in the French harm reduction and policy movement. In 2013 she was awarded a Legion d’Honeur.

Beatrice was always near and involved in many harm reduction actions: at the beginning of all the HIV/HR services, from the low threshold mobile needle exchange and methadone programs with Medecins du Monde, to the creation of the first people who use drugs organisation, ASUD (Auto-Support des Usagers de Drogues). Also, she was a universal activist at an international level who had been involved in many initiatives. From the very first needle exchange program bus in Russia, in Saint Petersburg in the mid-1990s, to her commitment to developing access to methadone in Myanmar, Marocco and other countries.

Breatiz left too early while actively pushing forward to open the long-awaited drug consumption room in her city. This remains a project for us to complete. We all – colleagues, physicians, patients, researchers, people who use drugs -, ‘a family’ to whom she dedicated all her life lost a hero. Yet, the fight continues.

She taught us never to give up. We will miss her.

Perrine Roux & John-Peter Kools


More information:

“Marseilles Bears a Heavy Stigma of Drug Trafficking and Use” – An Interview with Beatrice Stambul in Drug Reporter.
The death of Béatrice Stambul, psychiatrist and pioneer in harm reduction in News in France.
La Fédération Addiction rend hommage à Béatrice Stambul

Drug Reporter Interview with Tony Duffin

40 Years in the Frontlines of Harm Reduction in Ireland – Drug Reporter Interview Tony Duffin.

Ana Liffey Drug Project is a leading harm reduction NGO in Ireland who recently celebrated the 40th anniversary of the organisation; to commemorate the occasion Peter Sárosi interviewed its CEO and C-EHRN Steerring Committee member, Tony Duffin, about recent developments in harm reduction and drug policy reform in the country.

In our day-to-day work, as a harm reduction service we listen to the people who use our services. We listen for drug use trends; we talk to peers and partner agencies.

Tony has worked in the Design, Delivery and Provision of ‘Low Threshold – Harm  Reduction’ Health Services for a range of socially excluded and marginalised groups of people since 1993. He has held the position of CEO of Ana Liffey Drug Project since November 2005; Ana Liffey is Irelands first drug service established on the principles of Harm Reduction. Prior to this, Duffin worked in the addiction field, including playing a key role in opening Ireland’s first emergency accommodation for young people who inject drugs; and Ireland’s first wet residential service for entrenched street drinkers. In recent years, Duffin has made a crucial contribution in advocating for the ‘Misuse of Drugs (Supervised Injecting Facilities) Act 2017, which was signed into law on 16th May 2017.

Ukraine Donation Request

Irina Morozova, from De Regenboog Groep, works with Ukrainian refugees and is also trying to support people who decided to stay in Ukraine.

At the moment she is collecting money to buy a car (see pictures) for a unit in which a close friend of hers is fighting as a combat medic. The car will be used to evacuate wounded and sick people (military and civilians) from the front line.

It costs 5,500 euro from which 780 are collected already.

If you would like to join/donate or share the link, it would be much appreciated and you can do so here  – https://tikkie.me/pay/nh6shdndoot2tste1hr4

Thank you.

Social Intervention Tool – Secure Chat Software

SIT – Secure Chat Software for Social Orgs, eHealth and Government

Around 10 years ago Correlation made several significant and important steps towards eHealth. We needed a safe way to communicate with people to support them online.
 
Privacy and information safety are essential components in conversations in this field. There were no reliable solutions for that. So the tool called SIT – Social Intervention Tool was developed, a secure chat software to provide safe communications online.
 
Multifunctional and adaptable for various needs and workflows, scalable and suitable for cooperation among different orgs. And of course the main thing is still Security. Depersonalisation, anonymisation, encoding, meeting security standards. Privacy stays untouched and is respected as it’s supposed to, all the measures are taken to provide that.
 
Eventually it became a popular tool, working the best for Anonymous conversations and Virtual Appointments, serving orgs in different countries and providing thousands of chats every single day.
 
Need to talk to your audience online? Please contact Alex (alex@over9.com) for more info and detailed presentation of SIT.
(There is also a nice special offer until Christmas)

Feedback Request for Initiative on Alternatives To Drug-Law Offences

Commission recommendation on the implementation of alternatives to coercive sanctions as response to drug law offences and drug-related crimes.

 

The European Commission has started an initiative regarding an alternative response to drug law offences; these alternatives will be evidence-based and their recommended implementation is designed to provide essential support to people who need assistance due to drug use or problems with addiction. The below exert details the aims of this initiative.

“According to a report from the European Monitoring Centre for Drugs and Drug Addiction, people who use drugs are eight times more likely to commit a crime than those who do not. Similarly, people in prison are substantially more likely than their peers in the community to have used drugs, to use drugs regularly or to experience drug-related problems. Indeed, some start using drugs while in this setting. There is, therefore, a vicious and costly circle of crime and drug use; nevertheless, drug-related treatment can be effective in breaking it. Furthermore, alternatives to coercive sanctions can contribute to alleviating prison overcrowding, recidivism, addiction, and problem drug use and related negative health effects. They may also have a positive economic impact since they are generally less expensive than incarceration.

 

Currently, alternatives to coercive sanctions are underused. Sometimes, they face problems and barriers linked to their design, implementation and delivery, and fail to deliver on their intended outcomes. One barrier to the implementation of alternatives to coercive sanctions is a lack of local coordination between stakeholders. For example, those deciding on the sanctions often do not learn about the outcome, and stop applying them in subsequent cases due to lack of feedback. Furthermore, availability of data on the implementation and outcomes of the various alternatives to coercive sanctions needs to be improved.

 

Experience of drug use is more frequently reported by males (50.6 million) than females (32.8 million). At the European level, 62% of women in prison and 41% of men in prison have used an illicit drug before imprisonment. The increase in drug use during imprisonment is more pronounced in women than in men. Thus, women in prison are disproportionately affected by drug use compared with the general population.

 

This initiative is necessary to fulfil the intention, under the EU Drugs Action Plan 2021-2025, to ‘scale up the availability, effective implementation, monitoring and evaluation of measures provided as alternatives to coercive sanctions’. Without action at EU level, alternatives to coercive sanctions will remain underused and the barriers they face will remain. Their design, implementation and delivery will remain fragmented. They will continue to be applied imprecisely and therefore ineffectively. The differential effect on marginalised groups will remain dependent on societal attitudes.”

 

The feedback period for the initiative is open 26 August 2022 – 23 September 2022  (midnight Brussels time), the Commission would like to hear your views to help further develop and fine-tune this initiative.

View details of the full initiative here.

View the full list of European Commission Roadmaps here.

 

Reflections on International Overdose Awareness Day

 

Today on International Overdose Awareness Day, Correlation wants to reflect on the current situation regarding overdose, overdose prevention, and non-fatal overdose in Europe.

 

C-EHRN reached out to our focal points for their insight into the current overdose situation in Europe.

 

Following the data from our 2021 Data Report, we can see that the life-saving drug Naloxone is still not widely available. Naloxone can reverse the effects of an overdose, and consequently save lives; our advocacy work pushes for the availability of naloxone worldwide. Karen Mamo from our focal point in Malta offered the below reflection on Naloxone;

“An EU wide campaign on availability and accessibility of intranasal naloxone should be spearheaded by C-EHRN… it is very unjust to have eu citizens suffer due to moralistic and structural barriers. To my knowledge, unfortunately, a private citizen is unable to order naloxone across EU borders. So for example in the case of Malta, we have naloxone in hospital, but not available for peers.”

 

Karen Mamo.

 

Tony Duffin of Ana Liffey, our Irish focal point, offered the below sentiment regarding non-fatal overdose;

The sequelae of non-fatal overdose:

On International Overdose Awareness Day 2022, we remember without stigma those who have died, and acknowledge the grief of the family and friends left behind.  It is also important to remind ourselves of the harm non-fatal overdose causes.

Sequelae: is the term used to describe an after effect of a disease, a condition, or an injury.

On a regular basis people who suffer an overdose are saved and go to hospital; however, often people are discharged, or they self-discharge, without any further follow up.  Without realising, they walk out of hospital potentially with health problems they didn’t have before the non-fatal overdose occurred.  As a consequence of their non-fatal overdose there may be negative consequences from a neurological, muscular, cardiac or pulmonary perspective.

The impact of non-fatal overdose is far reaching i.e. the impact is the level of morbidity which has an impact upon the individual, their family/carers and the economic impact of the ongoing health care for the individual.

Unfortunately, through my work, I have known many people who have who experienced multiple non-fatal overdoses.  Each time a non-fatal overdose happens it is a near miss, an indicator that the person is at risk of a fatal overdose; and each time it carries the potential for sequelae related to the non-fatal overdose.

Non-fatal overdose is a significant issue, with significant consequences.  International Overdose Awareness Day 2022, is a reminder that, globally, there is more to be done to respond to the sequelae of non-fatal overdose.

 

Tony Duffin

CEO

Ana Liffey Drug Project (C-EHRN Irish Focal Point)

 

Dr Austin O’Carroll was inspired by his work with people who use drugs, and offered the below reflection on overdose;

The Hierarchy of Self Inflicted Death.

 

The taking of one’s life whether intentionally or through one’s own actions is a tragedy. All victims, young and old, deserve our sympathy. Unfortunately, as a society we do not deal this compassion out equally. Those we give most sympathy to are the men and women who intend to take their own lives due to feeling depressed and having no hope of future happiness. We give less sympathy to those who commit suicide when under the influence of alcohol whose feelings of depression and hopelessness are intensified by their drinking. We give least sympathy to those who overdose, not caring whether they live or die, as they have no hope offuture happiness.

This hierarchy unfortunately results in unevenly distributed care. Those who have attempted suicide will get a psychiatric assessment, offered a safety plan, offered future psychiatric support and on occasions be admitted to ensure their safety. Those who attempt suicide while under the influence of alcohol will have some of those interventions. Many, if not most, of those who have a non fatal overdose will have none of those interventions, even if they have had multiple non-fatal overdoses. Health professionals have unconsciously created an inequality in the level of empathy and care they offer to those who put their lives at risk due to having little or no hope of happiness.

On International Overdose Awareness Day we must commit to redressing this inequality of care.

 

Dr Austin O Carroll 

Founder of Safetynet, North Dublin City GP Training Progamme. Wonca Europe 5 Star Doctor 2020.

The full paper from Dr Austin O Carroll is available here.

 

In Greece, the mortality rates of people who use drugs continue to rise, with a large HIV outbreak among people who inject drugs (PWID) in Athens, Greece. A paper regarding these worrying rates can be accessed here.

Marios Atzemis, of Positive Voice, offered a concerning insight into the situation in Greece;

What should be highlighted from Greece is that naloxone is not available to civil society organisations, to peers and to drug users. There have been major changes to the legislative framework recently and now naloxone is available to workers of the largest public harm reduction organism -OKANA- which also holds the monopoly of the OST provision. Before that, naloxone could only be given through medical staff and its provision was characterised as a medical act. Now that has changed but it is still not available to the directly affected community. People do not usually OD in the streets in the open drug scenes and when they do they get their assistance. People die alone in deserted buildings and in their apartments. Sometimes their relatives are in the next room. If the community was trained not to use alone and if the relatives were trained how to use naloxone things could be better. All that with the prerequisite of the before-mentioned factor.
 
 
There is lack of peer to peer training to drug users for safer drug use and ways to deal with an OD while waiting for the ambulance. There is also no drug testing.
 
 
Mostly the substance free treatments never prepare you for what to do or not to do, in case you use again -relapse in their language- after such a long period of abstinence. In Italy for example ”Villa Maraini” provides naloxone to the patients who leave after ”graduating” the premises, just in case . In Greece this is not the case. Using is been demonized and considered to be the ultimate act of treason after going to treatment. People feel so ashamed and so embarrassed to say that they want to use and when they finally do it, they make sure they are alone. And they die alone. I saw so many people with my naked eyes dying while being in the ”social reintegration ” phase of the substance free treatments.
 
 
Marios Atzemis
Positive Voice

In the coming weeks, more research regarding the concerning rise in mortality rates in Greece will be shared within the network to raise awareness of the situation and to support advocacy work for this problem. Both Marios Atzemis and Christos Siou will take part in a conversation with C-EHRN regarding this issue, which will be shared within the network to further support advocacy and awareness.

 

Earlier this year, C-EHRN hosted a webinar on the state and challenges of overdose prevention, the webinar recording can be accessed here. Read our monitoring report with information on overdose here.

Visit the official International Overdose Awareness Day site here.