Drink and Drugs News DDN 1805 - Page 8

NNEF CoNFErENCE

The National Needle Exchange Forum focused on some vital harm reduction issues , as DDN reports . Photography by Nigel Brunsdon

Straight to the point

A29-year-old kid dying of sepsis in 2018 in the UK ’ s second city .’ This was just one drug-related death of many , said National Needle Exchange Forum chair Philippe Bonnet , and reinforced why the focus on harm reduction must not waver and why the work of the NNEF was more vital than ever .

Back after a break in holding its annual event , the NNEF presented a packed conference programme that brought together speakers from health , criminal justice , drug treatment , legal services and policy .
With the first UK drug consumption rooms feeling like a distinct possibility and ever more influential voices and organisations joining the call for decriminalisation , the issues on the programme were bringing back an essential focus on harm reduction .
First speaker to the platform was West Midlands police and crime commissioner David Jamieson , who recently spoke out on the need for treatment over punishment ( DDN , April , page 6 ).
‘ We ’ ve got to move away from a polarised binary position – soft or hard on drugs ,’ he said . ‘ We need new dialogue and thinking .’ Was spending £ 1.4bn a year in the West Midlands on the ‘ war on drugs ’ a good use of resources , he asked . Jamieson had launched a strategy to divert people away from the courts and into treatment , through a series of recommendations that recognised drug dependence as a health issue over a criminal justice one .
As a former detective sergeant and undercover drugs operative , Neil Woods had developed an informed perspective of policing the illicit drug market . ‘ Locking up nasty people ’ was a ‘ constant narrative for the public and press ’, he said , but the market was so huge that this had a ‘ tiny impact ’ and ‘ the process of policing drugs makes drug dealers more violent ’. The growth of ‘ county lines ’ was involving children in gangs and causing more violence .
His experience had made him evaluate how police operations increased problems for many vulnerable people in society and conclude that the answer was harm reduction .
‘ It ’ s the time to be drastic , the time to be brave ,’ he said . ‘ Criminalisation of drugs will be looked back on with as much disgust as criminalisation of homosexuality .’
Public Health England ’ s drugs and alcohol manager , Tony Mercer , had been asked to comment on the arguments of harm reduction versus abstinence – a ‘ polarised debate ’ that worried him .
‘ Ideology can get in the way of interventions ,’ he said . ‘ We need workers who are happy to provide whatever ’ s needed at the time .’ Spending energy on a debate that couldn ’ t be solved meant taking our eye off the ball , he added . ‘ It ’ s a debate that can ’ t be resolved , so we need to reframe it .’
Referring to William White ’ s work on the need for different interventions , he said ‘ The aim of everything should be to reach and engage people .’

Effective engagement was a central theme for all of the speakers , with the

prospect of the first UK drug consumption rooms . They would be a unique part of engaging people , though not a panacea , according to the Scottish Drugs Forum ’ s Kirsten Horsburgh . ‘ We need a whole range of different things ,’ she said . Looking at the situation in her Glasgow neighbourhood demonstrated very clearly the difference they would make .
‘ You don ’ t have to go very far from the main shopping areas to find needle litter and discarded injecting equipment ,’ she said . ‘ We ’ re already providing sterile injecting equipment but not the rooms to use in .’ People needed to inject in public places – back alleys , toilets , or on the streets . In many cases they would be thrown out of hostels if they were caught injecting on the premises .
The constraints on where people could inject made them do it hurriedly – and the need for speed left them vulnerable to violence , stigma , and dangerous injecting practice , said Dr Magdalena Harris , associate professor at the London School of Hygiene and Tropical Medicine .
Urgent injecting led to venous damage and could easily transition to the groin as this was ‘ quicker and easier in a low light ’. She shared the experiences of two people involved in her research : Emma had told her about her transition to skin popping ( injecting under the skin ), which intensified the harms by causing infection . Gary had described injecting while blood was pouring out of his groin – and had seen this as the only viable option to being misunderstood and mistreated at hospital .
Safe injecting spaces would be ‘ a place for opportunistic care ’, said Harris – a place for food , healthcare , and a shared space for other support services such as benefits and housing . The facilities also made sound financial sense , as people were being hospitalised for preventable conditions such as sepsis and gangrene and not seeking treatment early enough .
‘ Soft tissue infections exacerbate social exclusion ,’ she added . ‘ They give problems with mobility and have a massive impact on people ’ s lives .’
PHILIPPE BONNET DAVID JAMIESON KIRSTEN HORSBURGH NEIL WOODS TONY MERCER MAGDALENA HARRIS
8 | drinkanddrugsnews | May 2018 www . drinkanddrugsnews . com
NNEF CoNFErENCE The National Needle Exchange Forum focused on some vital harm reduction issues, as DDN reports. Photography by Nigel Brunsdon Straight to the point ‘A E 29-year-old kid dying of sepsis in 2018 in the UK’s second city.’ This was just one drug-related death of many, said National Needle Exchange Forum chair Philippe Bonnet, and reinforced why the focus on harm reduction must not waver and why the work of the NNEF was more vital than ever. Back after a break in holding its annual event, the NNEF presented a packed conference programme that brought together speakers from health, criminal justice, drug treatment, legal services and policy. With the first UK drug consumption rooms feeling like a distinct possibility and ever more influential voices and organisations joining the call for decriminalisation, the issues on the programme were bringing back an essential focus on harm reduction. First speaker to the platform was West Midlands police and crime commissioner David Jamieson, who recently spoke out on the need for treatment over punishment (DDN, April, page 6). ‘We’ve got to move away from a polarised binary position – soft or hard on drugs,’ he said. ‘We need new dialogue and thinking.’ Was spending £1.4bn a year in the West Midlands on the ‘war on drugs’ a good use of resources, he asked. Jamieson had launched a strategy to divert people away from the courts and into treatment, through a series of recommendations that recognised drug dependence as a health issue over a criminal justice one. As a former detective sergeant and undercover drugs operative, Neil Woods had developed an informed perspective of policing the illicit drug market. ‘Locking up nasty people’ was a ‘constant narrative for the public and press’, he said, but the market was so huge that this had a ‘tiny impact’ and ‘the process of policing drugs makes drug dealers more violent’. The growth of ‘county lines’ was involving children in gangs and causing more violence. His experience had made him evaluate how police operations increased problems for many vulnerable people in society and conclude that the answer was harm reduction. ‘It’s the time to be drastic, the time to be brave,’ h R6B( 7&֖Ɨ6F`G'Vw2v&RVB&6vF2V6F6wW7B27&֖Ɨ6F`6WVƗG( V&Ɩ2VFVvN( 2G'Vw2B6vW"FW&6W"B&VV6V@F6VBFR&wVVG2b&&VGV7FfW'7W2'7FV6R( 2( &6V@FV&F^( FBv'&VBĕR$U@G&FG'Vw6Ww2#DdBԔU4ऴ%5DT%4%U$t( FVw6vWBFRvbFW'fVF2( R6B( vRVVBv&W'2v&PF&fFRvFWfW.( 2VVFVBBFRFR( 7VFrVW&wFV&FRF@6VF( B&R6fVBVBFrW"WRfbFR&RFFVB( N( 2FV&FRF@6( B&R&W6fVB6vRVVBF&Vg&RB( &VfW'&rFvƖvF^( 2v&FRVVBf"FffW&VBFW'fVF2R6@( FRbWfW'Fr6VB&RF&V6BVvvRVR( ffV7FfRVvvVVBv26VG&FVRf"bFR7VW'2vFFP&7V7BbFRf'7BTG'Vr67VF&2FWvVB&RVVP'BbVvvrVRFVvB6V66&FrFFR66GF6G'Vw2f'V( 2'7FV'6'W&v( vRVVBvR&vRbFffW&V@Fw2( 6R6BrBFR6GVFW"v6vrVv&W&@FV7G&FVBfW'6V&ǒFRFffW&V6RFWvVBR( RF( BfRFvfW'f"g&FR6r&V2FfBVVFRƗGFW BF66&FVBV7FrWVVB( 6R6B( v^( &R&VG&fFr7FW&PV7FrWVVB'WBBFR&2FW6R( VRVVFVBFV7BV&Ɩ06W2( 2&6W2FWG2"FR7G&VWG266W2FWvVB&RF&vWBb7FV2bFWvW&R6VvBV7FrFR&V֗6W2FR67G&G2vW&RVR6VBV7BFRFVFBW'&VFǒ( 2@FRVVBf"7VVBVgBFVgVW&&RFfV6R7FvBFvW&W0V7Fr&7F6R6BG"vFV'&2766FR&fW76"BFRF66bvVRBG&6VF6RW&vVBV7FrVBFfVW2FvRB6VBV6ǒG&6FFFRw&0F2v2( V6W"BV6W"rƖvN( 6R6&VBFRWW&V6W2bGvVPffVBW"&W6V&6VBFBW"&WBW"G&6FF6pV7FrVFW"FR6v6FV6fVBFR&2'6W6rfV7Fv'@FW67&&VBV7FrvR&Bv2W&rWBb2w&( 2BB6VVF20FRǒf&RFF&Vr֗7VFW'7FBB֗7G&VFVBB7F6fRV7Fr76W2vVB&R( 6Rf"'GV7F26&^( 6B'&2( 26Rf"fBVF6&RB6&VB76Rf"FW"7W'B6W'f6W27V60&VVfG2BW6rFRf6ƗFW26FR6VBf66V6R2VRvW&P&Vr7FƗ6VBf"&WfVF&R6FF27V626W62Bvw&VRB@6VVrG&VFVBV&ǒVVv( 6gBF77VRfV7F2W6W&&FR66W6W6( 6RFFVB( FWvfP&&V2vF&ƗGBfR76fR7BV^( 2ƗfW2( TtE0DU$4U tDT%$0wwrG&FG'Vw6Ww26