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Addressing Drug Use Together
Through a Health Based Approach:
A HARM REDUCTION PERSPECTIVE
Jamie Bridge, IDPC
Vienna, 4th September 2014
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
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
