addressing drug use together through a health based ... · addressing drug use together through a...

Addressing Drug Use Together

Through a Health Based Approach:

A HARM REDUCTION PERSPECTIVE

Jamie Bridge, IDPC

Vienna, 4th September 2014

jbridge@idpc.net

Who are IDPC?...

• Global network of 120 NGOs

• Promote open drug policy debate

• Promote evidence-based policy responses

Harm Reduction

“Policies, programmes and practices that aim

primarily to reduce the adverse health, social and

economic consequences of the use of legal and

illegal psychoactive drugs, without necessarily

reducing drug consumption”.

(HRI, 2010)

The UN Comprehensive Package

1. Needle and syringe programmes

2. Opioid substitution therapy, and other drug treatment

3. HIV testing and counseling

4. Antiretroviral therapy

5. STI prevention and treatment

6. Condom distribution

7. Targeted information / education

8. Hepatitis vaccination, diagnosis and treatment

9. TB prevention, diagnosis and treatment

The UN Comprehensive Package

1. Needle and syringe programmes

2. Opioid substitution therapy, and other drug treatment

3. HIV testing and counseling

4. Antiretroviral therapy

5. STI prevention and treatment

6. Condom distribution

7. Targeted information / education (naloxone)

8. Hepatitis vaccination, diagnosis and treatment

9. TB prevention, diagnosis and treatment

10.Drug consumption rooms

Needle and Syringe Programmes (NSPs)

Sharing injecting equipment =

blood-borne virus risk

Distribute sterile equipment for injecting

Collect and dispose of unsterile needles

Attract and engage people (low threshold)

Provide more than just needles!

Global Coverage of NSPs

Source:

HRI (2012)

Global Coverage of NSPs

Source:

HRI (2012)

JUST 2 NEEDLES/SYRINGES

PROVIDED PER

PERSON WHO USES DRUGS

EACH MONTH

Peer Naloxone

• Emergency overdose treatment

• Peer distribution included in UN package

• WHO Essential Medicine

• Promoted by CND Resolution 55/7 on overdose

• Global coverage of peer distribution unknown

• USA: 188 local programmes - 10,000 overdose reversals

Drug consumption rooms (DCRs)

• Supervised, professional services

• Tailored to high-risk populations

• Heavily evaluated and researched

• Improve health, reduce deaths

• Reduce public drug use

• Do not promote or increase drug use

DCR Coverage

More than 50 cities:

- Australia

- Canada

- Denmark

- Germany

- Luxembourg

- Netherlands

- Norway

- Spain

- Switzerland

THANK YOU!

jbridge@idpc.net

www.idpc.net

www.cndblog.net

Additional NSP Slide

WHO review of evidence (48 studies, 2004)

Impacts on:

- HIV infection

- Risk behaviours

- Injecting frequency

- Returns of used needles

- Uptake of drug treatment

Conclusions:

- NSPs are cost effective

- NSPs can reduce HIV infections

- “No convincing evidence” of unintended consequences

Additional DCR Slide EMCDDA Review (2010)

• DCRs reach target populations

• No reported overdose fatalities

• DCRs do not increase drug use or dealing

• Increased uptake of drug treatment

• Provide “immediate improvements through

better hygiene and safety conditions”

• Consistent evidence of reductions in

syringe sharing and public drug use

• Insufficient – but encouraging – evidence on impact on HIV

and HCV