from peer to infinity engaging peers as partners in needle exchange
TRANSCRIPT
From Peer to InfinityEngaging Peers as Partners in Needle Exchange
Mat Southwell & Tam Miller AKA: Mr White & Mr Brown
Private sector training, consultancy and research service run by and for people who use drugs. Team’s unique selling point is its dual professional and experiential expertise.
Special focus on emerging drug trends. GST plays a role described by Dr Sloboda from NIDA as bridge-building – fostering communication and learning between academic, practice and using communities.
OverviewOverview Secondary Needle Exchanges - HOT’s Hit
Squads – Mat Southwell
From underground peer needle exchange to professional partnerships – the drug user group experience – Tam Miller
From demons to angels – the role of drug suppliers in delivering peer needle exchange – advisor Nikki Coe
The East London The East London Experience - ContextExperience - Context
1989 (HOT founded in 1991)
High levels of poverty & 40% black & minority ethnic communities
High drug prevalence exacerbated through housing policies
5% HIV rates but migrant trends from Latin EU Countries, Scotland and Ireland
Very under-developed services in late 1980s – mostly medical drug dependency units and no community services
Emergence of new drug trends
The Niddrie The Niddrie Experience - ContextExperience - Context
From 1986
High levels of concentrated poverty - Edinburgh’s poorest scheme
High prevalence of injecting, particularly Temgesic (low dose buprenorphine), heroin and benzos
50% HIV rates reflecting police restrictions on injecting supplies in 1980s and pattern of group sharing
At time services very limited and based in city centre and only during office hours. Needle exchange bus didn’t arrive until 1992
The Niddrie The Niddrie Experience - Experience -
InterventionsInterventions Informal sourcing of sterile injecting equipment –
‘peer sharing’
Illegal needle exchange – home and community based – operating within Niddrie
Mutual aid formalised with launch of Chemical Reaction user group in 1993 with Issues of Substance magazine
User group chair employed as Drugs Development Worker for Castle Project between 1995 to 2002
Return to informal needle exchange after service relationship ends
The Niddrie The Niddrie Experience - LessonsExperience - Lessons
Ability of people who use drugs and their organisations to respond to community-level threats with or without drug services
Partnerships with drug services sustained while they are effective – partnership working is not a goal in and of itself but can be helpful
Privileged-access into closed drug scene
Working in a ‘deep community’ – reach and impact
Informal secondary exchange continues but reduced conversation with drug services
The North East Essex The North East Essex Cautionary Note Cautionary Note
Mid-1990s - heroin and amphetamine sulphate main drugs of choice with strong injecting profile
Given the semi-rural area in the villages and towns around Colchester and Clacton peers, mostly drug suppliers, were engaged to deliver secondary needle exchange
Peer programme championed by Community Outreach Worker hosted in Health Promotion
Post was re-integrated into drug services when key post holder left losing commitment to secondary needle exchange
Police subsequently targeted, arrested and imprisoned most of the supply network involved in scheme
Peer Needle Exchange Peer Needle Exchange - Shared Lessons- Shared Lessons
Merits of secondary needle exchange in ‘closed’ drug scenes
Ability of peer needle exchanges to reach cultural sub-groups who may be out of contact with services
Particular benefits of reaching women who injected drugs
Engaged with trends and risk behaviour at coal face supports work around harm reduction innovation
Positive focus for work of drug user groups
Sustained involvement of peers beyond formal service
Grassroots Response Grassroots Response to Anthrax Crisis to Anthrax Crisis
Contact detailsContact details Tam Miller
Gold Standard Team & Chemical Reaction
07922 860042