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Author: Nigel Brunsdon

Injecting Drug Use Among Under-18s

Harm Reduction International has compiled the first global data snapshot on injecting drug use and related HIV and other harms among children and young people under the age of 18.

Young people who inject drugs have specific developmental, social and environmental vulnerabilities. They are less likely to use harm reduction and treatment services and are less informed about risks and their rights. Early onset of injecting, and being a new injector, have been associated with increased risks of HIV and hepatitis C transmission, while specific groups of young people, especially those that are street involved, are at considerably higher risk.

TB Advocacy Guide for People Who Use Drugs

This handbook has been designed to be a practical tool for activists to support them to assess their local circumstances, identify priorities for advocacy and to design, deliver and review their own TB advocacy campaigns. Each setting and context will throw up different issues and challenges for TB advocacy.

TB is a growing threat to people who use drugs, particularly when set against the backdrop of high vulnerability to, and prevalence of, HIV. As such it is important for drug user advocates from drug user organisations and PLHIV groups to help develop a coordinated advocacy response.

Naloxone In The Family

Greg Scott talking about family engagement around naloxone, and the power this has. Including why it’s important for all of us to have easy access to naloxone for all family members even if we don’t expect to have a use for it.

Get Tested

Hadiyah Charles the Hepatitis C Advocacy Manager from the Harm Reduction Coalition talks about the need for greater HepC testing.

Harm Reduction Cafes

This presentation was delivered to the National Needle Exchange Forum meeting in Bournemouth. I was talking about the Harm Reduction Cafe community project that I’ve developed as part of my job with HIT.

Update: The Harm Reduction Cafe website is now closed, it may be back but that depends on how much spare time I can find.

Overdose Toolkit

Sharon Stancliff MD talking about the development around the latest Opioid Overdose Prevention Toolkit from SAMHSA, and the way it promotes naloxone distribution.

As of 2018 the toolkit has now been revised and updated.

Naloxone Challenges

Sharon Stancliff talks about the issues delaying wider distribution of naloxone around the USA, including issues like legality and costs.

USA’s Influence

Sharon Stancliff talks about the problems caused by the way the USA influences the rest of the world. Especially in terms of it’s impact on harm reduction and international drug policies.

A Response to Media Reports of Drug Litter

The following ‘harm reduction response’ has been inspired by UnitingCare ReGen’s proactive response to negative media reports of needles/syringes in community settings. This ‘letter’ provides a template for similar action by relevant bodies based in the UK (harm reduction agencies, drug and alcohol workers, drug users).

In March 2013, Laurence Avis of UnitingCare ReGen, (the lead alcohol and other drug treatment and education agency of UnitingCare Victoria & Tasmania), wrote an open letter to members of a local community following an account of needlestick injury (involving a young child) that had been reported in a local newspaper (The Sunbury Leader, 26th March 2013). The letter was written in order to avoid hysterical, ‘kneejerk’ and stigmatising responses by local authorities and officials in matters relating to street-based injecting.

The following ‘harm reduction response’ has been inspired by UnitingCare ReGen’s proactive response to negative media reports of needles/syringes in community settings. This ‘letter’ provides a template for similar action by relevant bodies based in the UK (harm reduction agencies, drug and alcohol workers, drug users).

Dear (Journalist / Editor / Newspaper)

I am writing to you in connection with the recent story in your newspaper regarding the incidence of (drug related litter / needlestick injury) in (name of town/area).

Although it is entirely natural for people to fear the consequences of needlestick injury (particularly in public spaces in community settings), the actual risk of serious harm to public/individual health from these types of injuries is relatively low. It is also important to emphasise that the epidemiological risk of contracting hepatitis C or HIV from these injuries is also very low (and no known incidence of serious blood borne infection from this form of injury exists in the research literature). Although I am not stating that there is completely ‘no risk’ of viral infection, you (as a broadcaster of information for public consumption) should be aware that research from the UK (Parkin and Coomber 2011) defined this ‘low risk’ as:

the odds of sero-conversion following community acquired needlestick injury ‘where the source is unknown but assumed to be an IDU [injecting drug user], is 12-31% for HBV, 1.62% for HCV and 0.003 – 0.05% for HIV’ (Blenkharn 2008, 727). As such, there is perhaps only limited rationality in fear associated with virally contaminated needle/syringes in community settings

(Parkin and Coomber 2011, 1219)

All injuries involving sharp objects should be taken seriously (including blades, glass, razors and needles) and receive appropriate medical treatment. Injuries caused by needles however should not be a cause for panic or as a reason to mobilise discriminatory responses against people who inject drugs. The research shows that the chances of contracting a blood-borne virus like HIV or Hepatitis B or C from a used needle discarded inappropriately in community settings are minimal, as these viruses can only survive for a short time outside of the body. (That is why they are termed ‘blood borne viruses’; because they need ‘blood contact’ to stay alive). As with any puncture wound there would also be a low level risk of tetanus, but this can be remedied by arranging a booster shot at a local Emergency Room or community GP.

Needles and syringes are distributed each year to members of the public through the UK’s network of Needle and Syringe Programs (NSP), including the program run by (name of centralised agency) in (name of town/city/region/local authority) in your news story. NSP are regarded as an important part of public health policy in the UK and have been influential in reducing drug (and sex) related harms since their introduction to the UK in the mid 1980’s. These programs are a key part of assisting people with drug problems and assisting them towards recovery from drug dependency.

People who discard any form of litter are acting irresponsibly, especially when there is a social expectation that people will manage their ‘rubbish’ in a responsible manner. This is especially so when littering involves cigarette butts, chewing gum, glass, sharp items, dog faeces and needles attached to syringes. While the story contained within your newspaper involved sharp items discarded by (one/two) individual(s), the specific actions of (this/these) individual(s) should not be regarded as sufficient evidence to support the moral outrage aimed at injecting drug users (inferred/noted) in your news story.

The stigmatisation and discrimination of people who inject drugs in our community is not a helpful response to difficult and challenging problems surrounding their drug dependency. Newspaper articles such as yours (date/title) may only influence negative responses towards people who may be vulnerable and in need of assistance. Accounts such as that in your paper may only push these people further away from seeking help with drug dependency and exacerbate their related health and social problems.

If you do have to report on such issues, a better approach may be to write an article that emphasises the need for parents/teachers/children to provide some form of awareness and training on the harms attached to handling sharp items, dog faeces, broken glass, barbed wire etc. For communities to respond positively to community issues, there is perhaps an equal moral responsibility for broadcasters such as yourself to provide the appropriate awareness needed for more positive action (and not promote fear and loathing that is directed towards already vulnerable people).

I look forward to your response,

Blenkharn, J.I., 2008. Clinical wastes in the community: local authority management of discarded drug litter. Public Health 122, 725–728.
Parkin S, and Coomber R. (2011) Injecting drug user views (and experiences) of drug-related litter bins in public places: A comparative study of qualitative research findings obtained from UK settings. Health & Place, 17, 1218–1227.

Where the letter has (brackets), individuals/correspondents using the template should insert the details relevant to their particular geographical location.

I recommend using this letter as a template (adapt it as required) to respond to press reports that seek to diminish and devalue the role of harm reduction in community settings and/or seek to over-sensationalise accounts of discarded paraphernalia in community spaces.