Basic HTML Version
Harm reduction |
National Needle Exchange Forum
12 |
drinkanddrugsnews
| October 2013
www.drinkanddrugsnews.com
HEALTHY
The NNEF annual meeting has become
a keenly anticipated fixture for
information and ideas.
DDN
reports
on this year’s event in Bournemouth.
Photos by
Nigel Brunsdon
K
eeping harm reduction at the heart of drug strategy was a key
concern of the National Needle Exchange Forum (NNEF)’s annual
meeting. This year it was held in Bournemouth and drew
enthusiastic attendance from needle exchange workers from all over
the country.
The forum’s chair Jamie Bridge reiterated the NNEF’s aim of promoting,
supporting and protecting good quality needle exchange in England, and invited
Steve Taylor from Public Health England to give an update on how PHE related to
this agenda.
‘Harm reduction and public health interests align in a way that they didn’t
when the NTA had to be seen to be aligning with the government’s recovery
strategy,’ said Taylor, outlining work on newer psychoactive substances, men who
have sex with men (MSM), improving access to hep C treatment, adding to
recovery resources and collecting evidence on the effect of recent legislation
relating to the use of foil.
His colleague Vivian Hope, previously of the Health Protection Agency, gave an
update on injecting drug use and infections from PHE’s injecting drug use team.
Patterns of injecting were changing, he said, with an increase in psychoactive and
club drugs as well as performance drugs – primarily anabolic steroids.
Hepatitis B and C had declined markedly over time, thanks to ‘harm reduction
approaches supported by good drug treatment’. Levels of HIV infection were
stable, although four times higher in London than elsewhere in England and
Wales, and there had been spikes in transmission of HIV, probably related to crack
cocaine and increased risk behaviour. Needle and syringe sharing had declined
overall, but the changing patterns could increase risk among different populations,
so it was important to respond quickly to any changing trends, he said.
Blenheim’s chief executive, John Jolly, was asked to give an update on
commissioning and policy in England, and could not find much to be optimistic
about in the new localism agenda, with the impact likely to be that ‘the needs of
the many outweigh the needs of the few’. Despite politicians telling us ‘changes
will be positive’, the drug and alcohol sector needed to realise that ‘we are no
longer the priority’, he said. ‘The priorities for public health are at local level.’
Ring-fenced drug money had gone into ring-fenced public health money, ‘but
it gets worse,’ he said. ‘The ring-fence comes off in 2015 and we’ll have to
compete with everything else. In London it feels a bit like the Wild West – the last
man standing.’
Niamh Eastwood, chief executive of Release, underlined the need to be ready
with legal challenges in this changing climate, and offered Release’s practical help.
‘If any of your clients are being harassed by police, let us know,’ she said.
Release was challenging such ‘incredibly humiliating’ experiences as strip search
before arrest and the practice of forcing clients to reduce their methadone script,
where it was linked to an organisation’s policy decisions. They were also keen to
challenge services that attempted to discharge clients on the grounds of bad
behaviour, reminding them of their duty to provide alternative support.
*****
Next the spotlight fell on local services for a look at experiences on the front line.
TimWhite from DHUFT (the local NHS foundation trust) credited a multi-agency
approach with bringing drug deaths down.
‘We’re doing what we can to bring services to the community,’ he said, with
the help of a thriving working relationship with the
Big Issue
and great support
from Bournemouth DAT.
Simon Chilcott of the Big Issue Foundation said that about half of the 81
Big
Issue
vendors in Bournemouth had substance issues and that the needle
exchange was successful in attracting repeat visitors, including steroid users.
‘We see street users, people who are falling through services – it would be nice
to catch them before they go down that far,’ he added.
Richard James, a blood-borne virus specialist said the BBV project had become
successful through working with other agencies, using dry blood spot testing
instead of needles, and training more workers to do the testing. With the