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new drugs, nor are they necessarily
trained in discussing drug use in the
context of gay men’s sexual
behaviour, and sometimes quite sort
of esoteric sexual behaviour.’
Gay men have reported drug
workers being uncomfortable or
embarrassed by the sexual context
of the drug use, while service users
could also be uncomfortable if they
think the worker might be
judgemental. Is training the answer?
‘We probably need a two-pronged
approach, one of which is that
generic drug services become much
better at identifying the distinctives
around the particular drug use we’re
talking about, but also that they’re
trained in terms of non-judgemental
discussion, discussion of sexual risk
and that they know whom to refer to
in terms of service support. But we
also need some new specialised
services, and that of course is where
there’s a question mark.’
Does NAT get the impression that
this is something that’s limited to
younger people? ‘I don’t think it is,’
he states. ‘If you look at the pro-
portion of service users who are HIV
positive, it’s 75 per cent at Antidote
and knowing the age profile of
people with HIV there will be some
young men but there are certainly are
men in their 30s, 40s and 50s. It’s not
just young men early on the scene –
many are very experienced on the
gay scene and have moved on to
these drugs from other club drugs.’
The letter has been sent to
London local authorities – is it largely
a London issue, or is there evidence
of similar trends elsewhere? ‘If it’s a
London issue then it is a national
issue, because so many men come
to London for clubbing and sex
parties and so on,’ he says. ‘So far
all the data seems to come from
London, but that’s partly because the
main services are in London and it’s
the services that are gathering this
information. There have been some
requests for support from Brighton
and Manchester, but there does not
as yet seem to be the same levels of
use of these drugs in the contexts
described in our letter, which of
course means we must use this
window to prevent such problematic
use spreading to other gay centres in
the UK.’
With drug treatment, HIV
prevention and sexual health services
now under the public health remit of
local authorities, there are
opportunities to join up services and
do things ‘differently and better’, NAT
urges, and the letter calls for well-
funded ‘open access, appropriate and
tailored services’ to be commissioned
as soon as possible. But with many
drug services feeling they might not
be seen as a priority in the new public
health landscape, how confident is
NAT that the money will be there?
‘We weren’t confident unless we
did something, which is why we
wrote the open letter. This is
obviously a time of immense change
– the good thing is that there’s a
pretty decent national public health
allocation, and sometimes new
people can look at need freshly. We
focused on councils taking on these
responsibilities as an opportunity for
innovation and to implement change,
and we know from talking to them
that a lot of councils are up for that,
so I don’t think we should be by
default pessimistic on this.’
Is the public health argument
also just too strong to overlook? ‘We
certainly think the public health
argument is immensely important.
We’re not claiming this is the
majority of gay men – far from it –
but if you have a group of gay men
where there is very high drug and
sexual risk taking, and very high HIV
and hep C transmission rates, this
has a ripple effect on the level of
transmission in the whole gay
community, because men in this
group will have sex with other
people as well.’
There are also, of course, the
harmful impacts of crystal meth on
mental and physical health generally.
‘Yes, we need to look at this
holistically,’ he states. ‘We need to
be worried about mortality again,
about HIV, hep C and mental health
and, in that context, equip drug
services to deal with a very fast
changing drug use scene and equip
them to deal respectfully and with
some degree of knowledge and
appropriateness with gay men.
‘One of the things raised at the
round table, given the rate that legal
highs proliferate, is that maybe there
should be some generic harm
reduction advice even if you have no
idea what it is that the person’s
taking. The letter isn’t a criticism of
drug services as such – it’s tough to
keep up with these things.’
www.nat.org.uk
MEDIA SAVVY
WHO’S BEEN SAYINGWHAT..?
In a rare outbreak of common sense, ministers are axing plans for a minimum
alcohol price. The hardest-up and responsible drinkers would have been
clobbered, with supermarket booze rising sharply. It was always a misguided
solution to alcohol abuse. It is not the job of governments to set shop prices.
Sun
editorial, 12 March
Even if the case for drink pricing were not medically overwhelming, it is
obvious that any decent person would prefer to be on the same side of an
argument as Dr Sarah Wollaston, the admirable Totnes MP, as opposed to the
wheedling teen-poisoners of the drinks industry.
Catherine Bennett,
Observer
, 17 March
Increasingly, the shame is being taken out of poor-shaming. It didn't seem so
long ago that most people would think twice about denigrating fellow
citizens who were having a hard time. These days, it appears to have been
sanctioned as a new national bloodsport, regularly slipping under the PC-
radar as little else manages to.
Barbara Ellen,
Observer
, 3 March
This is the tedious narrative. Poverty is sinful, and it must be punished… And
so the state must shrink to a nub, because the humans who need it don't
deserve it. Not that the government will say this publicly yet; it is still better,
at this stage, to lie to parliament, to the media, to us all.
Tanya Gold,
Guardian
, 25 March
Still the welfare bill keeps rising though the coalition has repeatedly pledged
to reduce it… Work must be seen to pay and a life on welfare must be made
to seem infinitely less attractive than it does now. Until that fundamental
change occurs, the bills will keep going up.
Express
editorial, 26 March
Many of today’s parents smoked weed; quite a fewwill have snorted coke, but
nervously, in a nightclub loo. For their children, however, the taboo against
drugs is weaker than at any time since Victorian ladies injected themselves
with morphine at tea parties.
Damian Thompson,
Telegraph
, 2 March
The mentality and behaviour of drug addicts and alcoholics is wholly
irrational until you understand that they are completely powerless over their
addiction and unless they have structured help they have no hope.
Russell Brand,
Guardian
, 9 March
If drug ‘addicts’ can give up their drugs by using self-control, then ‘addiction’
doesn’t exist. They can stop if they want to. Obvious, isn’t it? Not to my old
foe Russell Brand, now pontificating grandly on the subject in the
Spectator
,
the
Guardian
and the
Sun
. This alleged comedian, in his designer rags, is fast
becoming the voice of the Establishment. Perhaps the Tory Party – in its
endless quest to be fashionable – could skip another generation, and make
him its next leader.
Peter Hitchens,
Mail on Sunday
, 10 March
The brutal indifference towards the bedroom tax indelibly shames ConDem
ministers… Work and pensions secretary Iain Duncan Smith married money
and lives in wife Betsy’s ancestral home, with its swimming pool and tennis
court. He should hang his head in shame for the pain he’ll inflict on families
which are less fortunate than his own.
Kevin Maguire,
Mirror
, 6 March