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I said ‘no’ to drugs, they didn’t listen: dealing with addiction
AMSTERDAM, July 26, 2018 (BSS/AFP) – At the International AIDS Conference
in Amsterdam, a doctor is on duty to prescribe methadone, a legal heroin
substitute, to delegates who might be struggling with withdrawal.
Nelda de Grave, an addiction specialist, was not sure she would have any
takers, but considers it her duty to ensure any addicts among the conference
goers are “not sick, not in withdrawal”, and “well enough to follow” the
proceedings.
Three came for prescriptions on Tuesday alone.
One floor down, in a large advocacy space at the conference venue,
counsellors staff a “harm reduction” booth stacked with boxes upon boxes of
sterile needles for intravenous drug users who may need them.
No questions asked.
Such pragmatism about narcotics use and addiction may be par for the course
in the Netherlands, a country known for its open-minded approach to drugs,
which remain illegal.
But for many delegates it may seem too good to be true.
“We were asked (by conference organisers) to be ready especially for people
from eastern Europe and (central) Asia,” de Grave told AFP.
This is a region where experts say oppressive drug laws are fuelling an HIV
surge through the sharing of tainted needles.
Infections with the immune system-wrecking virus that causes AIDS rose 30
percent in the region since 2010, according to a UNAIDS report.
“To be on methadone… obviously is not common in these countries, so only
to attend the conference well you have to have some medication,” said de
Grave. “That is why we are here.”
– Reducing harm –
For epidemiologist and public health expert Chris Beyrer, “progressive drug
policy can really be a critical part of controlling the HIV epidemic.”
MORE/FI/ 0927 hrs
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“Part of that is making sure that people who are using, are doing so in
ways that are safer and are not associated with disease transmission,” he
said on a visit to a nearby addiction centre in Amsterdam.
The centre not only offers counselling, but also offers to test drugs,
including heroin, for purity and safety.
Walk-in customers pay 2.50 euros (about three dollars) for a test.
In the Netherlands, experts say, HIV transmission through intravenous drug
use is extremely rare.
The country has several needle exchange facilities and safe consumption
venues.
Ingrid Bakker, one of the “harm reduction” advisers stationed at the
conference, said about 20 people had made use of the service in the first
three days.
“We have a lot of stuff,” she told AFP, gesturing around the tiny booth.
“Most of it is for injecting.”
There are needles and syringes, and sterile cups for dissolving heroin.
“You can also do it in a spoon, of course that’s what most people do, but
this is sterile,” she said.
There are filters for removing impurities from the liquid heroin mix,
sterilising wipes, pads to apply pressure to the prick point, and portable,
yellow, plastic bins for discarding used needles.
“This is tinfoil for… if you want smoke heroin,” said Bakker, pointing
out another product.
– ‘Support. Don’t punish’ –
“In the Netherlands we have very good quality heroin so there’s a lot of
people who don’t inject heroin but they smoke it from foil, ‘chasing the
dragon’.”
This is a form of harm reduction, she explains, as it presents an
alternative to injecting.
There are booklets of sniffing papers too, with tips handily printed on
them.
“Crush and chop the powder as finely as possible,” the sheets advise. “Be
kind to your nasal passage and go for small lines.”
The papers help stop the spread of Hepatitis C, which can cause liver
disease, said Bakker.
“People use straws, for instance, which are quite sharp. If you share them
and if you have … just a tiny, tiny, tiny bit of blood… it (the virus)
could be transferred.”
According to Ann Fordham, who leads the International Drug Policy
Consortium, an advocacy network, there was a 30-percent increase in HIV among
people who inject drugs worldwide between 2011 and 2015.
Less than one percent of people who inject drugs live in countries where
needle exchange is available, she said.
Activists at the AIDS conference launched a campaign entitled “Just say no
to the war on drugs” — a direct challenge to the Ronald Reagan-era slogan
“Just say no” at the height of America’s “war on drugs”.
“I said no to drugs but they didn’t listen,” reads one slogan of the
alternative campaign.
“Support. Don’t punish,” states another.
A report this month by Harm Reduction International said funding for such
services in low- and middle-income countries — mainly donor money — had
flat-lined in the past decade.
In 2016, $188 million (161 million euros) was allocated — the same as in
2007, it said.
“Simply put, the lives of people who use drugs are being neglected,”
charges the report.
BSS/AFP/FI/ 0930 hrs