The Changing face of Drug Use & The Changing face of Drug Use & the Role of Needle Exchange the Role of Needle Exchange

Programmes;Programmes;

Ensuring NEP’s are equipped to meet the Ensuring NEP’s are equipped to meet the hidden and emerging needs of drug users. hidden and emerging needs of drug users.

Erin O’Mara Editor Black Poppy MagazineErin O’Mara Editor Black Poppy Magazine

NEP’s - Perfectly Placed NEP’s - Perfectly Placed to Respondto Respond

Good reputation, non judgemental, generally Good reputation, non judgemental, generally trusted amongst drug users (rare commodity!)trusted amongst drug users (rare commodity!)People ‘volunteer’ to attend, not forced People ‘volunteer’ to attend, not forced By By working closely with drug usersworking closely with drug users, on the front , on the front line, vital changes in the health and welfare of line, vital changes in the health and welfare of the drugs scene will be picked upthe drugs scene will be picked upNEP’s are an excellent background for effective NEP’s are an excellent background for effective user involvement, developing work opportunities user involvement, developing work opportunities & volunteering for users, bridges for community & volunteering for users, bridges for community concerns.concerns.

Its all legal!Its all legal!

On 8th July 2003 a press release announced that the On 8th July 2003 a press release announced that the ACMD recommendations on paraphernalia supply ACMD recommendations on paraphernalia supply had been accepted, and that 'The Government will be had been accepted, and that 'The Government will be laying a negative resolution statutory instrument to laying a negative resolution statutory instrument to implement changes to section 9A of the Misuse of implement changes to section 9A of the Misuse of Drugs Act 1971' with effect from 1/08/03.Drugs Act 1971' with effect from 1/08/03.This will make legal the supply to drug users of '5 This will make legal the supply to drug users of '5 types of items':types of items':ampoules of water for injection; ampoules of water for injection; swabs; swabs; utensils for the preparation of a controlled drug utensils for the preparation of a controlled drug (spoons, bowls, cups, dishes); (spoons, bowls, cups, dishes); citric acid; and, citric acid; and, filters. filters.

Questions, Questions & Questions, Questions & Answers?Answers?

Should I be using a green, long/short blue Should I be using a green, long/short blue or long orange spike for my groin?or long orange spike for my groin?

What direction to I inject in when using my What direction to I inject in when using my feet?feet?

Where should i go now my arm veins are Where should i go now my arm veins are gone? gone?

How do i keep my groin hole clean, its How do i keep my groin hole clean, its always weeping?always weeping?

Essential Injecting InformationEssential Injecting Information

Better knowledge about the right syringe for the Better knowledge about the right syringe for the job....job....Better knowledge about how to deal with anxiety Better knowledge about how to deal with anxiety episodes in injecting...episodes in injecting...Good knowledge about the issues around using Good knowledge about the issues around using and sharing tourniquets –....and sharing tourniquets –....What to do when a syringe becomes filled with a What to do when a syringe becomes filled with a bloodclot –bloodclot –And, of course, a good understanding of location And, of course, a good understanding of location and functions of veins and arteries. and functions of veins and arteries.

User Involvement User Involvement

Intrinsically and historically linked for the drug Intrinsically and historically linked for the drug using community with the rich and complex using community with the rich and complex issues that are ‘our lives’. issues that are ‘our lives’. User involvement has stemmed from how we User involvement has stemmed from how we are treated - medically & emotionally are treated - medically & emotionally How we are seen – through ignorance and How we are seen – through ignorance and labelslabelsHow we are affected – by discrimination and How we are affected – by discrimination and years in drug treatmentyears in drug treatment and and How we are affected How we are affected by finally having a voiceby finally having a voice

The Power of Personal The Power of Personal ExperienceExperience

By definition, no one else – no matter how By definition, no one else – no matter how well trained or qualified – can possibly well trained or qualified – can possibly have had the same experience of drug have had the same experience of drug treatment, the same initial contact with treatment, the same initial contact with services or the same journey through the services or the same journey through the mental health, legal and drug treatment mental health, legal and drug treatment system. These experiences system. These experiences are an are an important resourceimportant resource in developing services. in developing services.

Be Mindful...Be Mindful...

It is important to remember when being It is important to remember when being courted for your views, there can be a courted for your views, there can be a propensity by services/health professionals, propensity by services/health professionals, to ask to much for too long, with too little in to ask to much for too long, with too little in return. return. The exclusive ‘inside knowledge’ that users The exclusive ‘inside knowledge’ that users have developed through lived experience, have developed through lived experience, has often been at huge emotional, familial has often been at huge emotional, familial and financial cost and people can forget or and financial cost and people can forget or ignore the price users have paid, exploiting ignore the price users have paid, exploiting this fragile ‘privilege’this fragile ‘privilege’. .

Harm Reduction Equipment Harm Reduction Equipment -1-1

Water:Water: An essential resource.An essential resource.

Steriboxes:Steriboxes: see demosee demo

Swabs: Swabs: Important but in the scheme of things but steriboxes, water, Important but in the scheme of things but steriboxes, water, tourniquets, are more important if funds are an issue. tourniquets, are more important if funds are an issue.

Filters & tourniquetsFilters & tourniquets: : see demosee demo

The sterifilt: The sterifilt: see demosee demo

Citric Sachets:Citric Sachets:Pill filters – research this valuable Pill filters – research this valuable equipment.equipment.

All legal – all available – all absolutely necessary - All legal – all available – all absolutely necessary -

Harm Reduction Equipment Harm Reduction Equipment -2-2

Syringe I.D –Syringe I.D – New from Exchange supplies:New from Exchange supplies: Prevents accidental Prevents accidental

sharingsharing

Crack Pipes: Crack Pipes: Utilise the research from USA & your User Utilise the research from USA & your User

Groups and clientele to research equipmentGroups and clientele to research equipment

Mouth pieces: Mouth pieces: Utilise the research from USA & your User Utilise the research from USA & your User

Groups and clientele to research equipmentGroups and clientele to research equipment

Plastic packs of Vaseline:Plastic packs of Vaseline: Easy to put together, Easy to put together,

cheap and very useful for dry and burnt lipscheap and very useful for dry and burnt lips

Naloxone tabletsNaloxone tablets: : Now allowed to be dispensed under PGD Now allowed to be dispensed under PGD

(Patient Group Direction) and legal for anyone to administer! (Patient Group Direction) and legal for anyone to administer!

TRIAL EVERYTHING – NEVER ASSUME – ALWAYS ASK YOUR CLIENTS 4 REVIEWTRIAL EVERYTHING – NEVER ASSUME – ALWAYS ASK YOUR CLIENTS 4 REVIEW

Essential Health & the NEPEssential Health & the NEP

Hep B vaccinations…Hep B vaccinations…

Clear Hep C information…Clear Hep C information…

Safer using/injecting Safer using/injecting consultationsconsultations......

Food…Food…

Wound management…Wound management…

ContraceptionContraception……

Condoms AND lube…Condoms AND lube…

Opening TimesOpening Times::

Be innovative.Be innovative. The fact is drug users don’t live The fact is drug users don’t live within a 9-5 existence, sex workers, homeless within a 9-5 existence, sex workers, homeless users, and many IV and drug users would make users, and many IV and drug users would make use of a service that is open for a few hours at use of a service that is open for a few hours at night, even if it is only for HR equipment. night, even if it is only for HR equipment. Relinquish a couple of hours in the day in order Relinquish a couple of hours in the day in order to respond to needs and be open for a couple of to respond to needs and be open for a couple of hours at night – 8-10pm for example. Or work hours at night – 8-10pm for example. Or work hard to get a vending machine on site – hard to get a vending machine on site – (there is (there is someone here today with info on them)someone here today with info on them)

Workshops, chats, groupsWorkshops, chats, groups

Hep C treatments…Hep C treatments…

Coinfection issues…Coinfection issues…

Wound managementWound management … …

User involvement…User involvement…

Injecting practicesInjecting practices……

ContraceptionContraception: :

Overdose preventionOverdose prevention: :

Workshops, chats, groupsWorkshops, chats, groups

Safer using…Safer using…

Vein careVein care……

Mixing drugs and medicationsMixing drugs and medications……

Information collation and production...Information collation and production...

Bacterial issues...Bacterial issues...

Training, Volunteering and Work Training, Volunteering and Work ProgrammesProgrammes

NEPs are perfectly placed to take the NEPs are perfectly placed to take the forefront in UI. Because real UI will involve forefront in UI. Because real UI will involve mechanisms to support and encourage mechanisms to support and encourage users to get into the drugs field for work or users to get into the drugs field for work or volunteering. Our ‘specialist knowledge’ is volunteering. Our ‘specialist knowledge’ is extremely rareextremely rare and almost always and almost always culturally and regionally specific - you wont culturally and regionally specific - you wont get a service that responds to injectors get a service that responds to injectors needs, without needs, without fully considering & fully considering & involving the injector. involving the injector.

OUTREACHOUTREACH

Slowly dying, must be resurrected!Slowly dying, must be resurrected!

Will be essential in how effective services Will be essential in how effective services are in responding to current & future are in responding to current & future changes in the drugs scenechanges in the drugs scene

Especcially effective when address the Especcially effective when address the most isolated and vulnerable users – most isolated and vulnerable users –

A lifeline for those with mental health A lifeline for those with mental health issues or suffering from violence.issues or suffering from violence.

InformationInformation

Work with your client base to find out what’s Work with your client base to find out what’s going on in your area and respond to itgoing on in your area and respond to it

Engage your closest user group to define and Engage your closest user group to define and create the information you needcreate the information you need

Be creative in your information – ‘Up the bum’ Be creative in your information – ‘Up the bum’ campaignscampaigns

Subscribe to magazines and look out for the Subscribe to magazines and look out for the best leaflets – ask your clienst for advice as to best leaflets – ask your clienst for advice as to what they find helpful or usefulwhat they find helpful or useful

The End! Thank YouThe End! Thank You

Notes availableNotes available