The History of Drug User Activism in Australia; by an Aussie Activist Superstar

Dont Miss this!!! If you want to find out the story of drug user activism in Australia by a woman who was not only there but integral to the very essence of active drug users doin’ it for themselves, setting limits in the sky and rockin right up to parliament house itself to get the job done – then you cannot miss this production!! From WHACK; Victorias Drug User Magazine; Annie Madden, the firebrand of an Aussie cog in the Aussie activist wheel, was asked to write about he years of experience and knowledge around the evolution of the Australian drug user history movement – and it is compulsory reading my friends! The History of Drug User Activism in Australia by AIVL’s Chief Exec and Superwoman incarnate, Annie Madden – get out your reading specs, sit back with your favourite tipple, and IV the contents of this fabulous issue….

Please click this link for the easy to read online magazine, which you can print out.

http://hrvic.org.au/docs/historyofIDUactivism/index.html

A Word About Ms Annie Madden…

Annie Madden, Chief Exec, AIVL Australia; Australia's Own Superstar Activist!

Annie Madden, Chief Exec, AIVL Australia; Australia’s Own Superstar Activist!

Australian Injecting & Illicit Drug Users League (AIVL)

Annie Madden is currently the Executive Officer of the Australian Injecting & Illicit Drug Users League (AIVL) which is the national peak body representing state and territory drug user organisations and illicit drug users at the national level. Prior to her current role, Annie was the Co-ordinator of the NSW Users & AIDS Association (NUAA) for six years. She has an honours degree in Social and Political Sciences. She is on numerous national, Commonwealth Government and research committees including the recently appointed Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis C and regularly takes extremely effective roles in global United Nation and WHO reviews, committees, global guidance publications and drug related recommendations. She has been working in the areas of illicit drug use, HIV/AIDS and hepatitis for over 14 years, has been an injecting drug user for over 18 years and on methadone for many years also. Annie is one of the world’s most inspiring women user activists who has worked tirelessly day in and day out to challenge the discrimination and human rights violations occurring to people who use drugs. And not just in Australia where she works at the top of her game, going head to head with politicians and Charity heads, doctors and do-gooders, parents and always her peers – drug users, but around the world, wherever she gets the chance to fight against ignorance and discrimination, for women who use drugs, for all of us, of any colour. Annie Madden is a woman we should all be proud of, especially, as drug users, we are lucky enough to have her on our side. Coz she is a truly kind and caring person, humble, hard working, smart and emphatic. Thanks for all you’ve done Annie Madden, and all your future will bring. We send you thanks, light and love.

Your friends at BP and around the world, those who know you, love you, and those who haven’t yet had the pleasure, thank you.

A Vending Machine for Crack Pipes? Now that Rocks!

Well, I’ll be damned, harm reduction is getting down with drug users -how  fabulous when we find a glowing example of a perfectly useful, innovative and user friendly invention that actually makes it out of its’ idea stage, only to leap frog over the community hysterics into production and onto our streets; the streets of Vancouver in this case. A vending machine for crack pipes -selling the pipes that one may be constantly in need of (if one has a constant preoccupation with the white rocks, that is…) for just 25c.

OK, so as the VICE news item below says, the over-arching idea behind this was to prevent HIV or Hepatitis C transmission that people COULD be exposed too, when finding themselves sharing pipes and some bodily fluids from the associated burnt or cut thumbs and lips that can occur from heavy sessions on the pipe. But I notice at least one of the vending machines is located in a popular drop in service, which on its own provides an important moment for a user to touch base, be seen by peers and health professionals, add to an important data pool on drug usage, – and all at the same time as making a personal positive health choice and a chance to reduce harm. Nice one!

But what is really cool is that this is an evolution of the work our rather clever peers are doing in Vancouver, work started in the area by VANDU (Vancouver Area Network of Drug Users),

Mariner James of the Portland Hotel Society with the machine.

Three Cheers for our Junkie Peers!

So three cheers to the continuation of user ingenuity and peer outreach in Vancouver, they have done us all proud. I should say however, that the sheer scale of what drug users are up against in Vancouver seems to ensure our colleagues are constantly fighting hard to maintain some semblance of humanity  for our community there.

The Downtown Eastside, centered on the intersection of Main and Hasting streets in Vancouver, has one of the highest concentrations of injection drug users in the world. An overgrown ‘Skid Row’ is flush with prostitution and destitution, most of its residents live in badly maintained hotels and hostels lining Main Street.

Out of 12,000 residents in the area, some 5,000 are estimated to be drug users and any chat with a peer from these streets or indeed a look at any of the  documentaries on You Tube about the area, shows our peers are struggling;  crack and methamphetamine use remains steady or is increasing and even injecting heroin use continues to rise as much of the scene is now buoyed by pharmaceutical opiates which appears to be collecting young, newer users whereas in other places, like the UK and Western Europe, we are seeing injecting heroin use dropping among the young and plateauing among older users..

Since 2008 it seems over half of Vancouver’s opiate users are on methadone or similar OST’s although the figures aren’t as encouraging for its aboriginal population. For up to date information on the drug situation in Vancouver, Click here.

With such numbers of heavy drug users living in such a deprived area, an outsider could believe any inroads made by progressive harm reduction policies and initiatives are slowly unpicked again by repeated incarceration, illness and infection, discrimination and homelessness. Yet this is the battle that harm reductionists and drug user activists are fighting; it is indeed one step forward and two steps back and lives are literally won and lost on the back of populist election promises, just like in so many parts of the world…

Humanity on Skid Row

Although the battle to save lives and promote humane drug policies in Vancouver however is ongoing, there are certainly signs that the current interventions are working. Yet the aim must be to examine the strategies that are showing results  Statistics show the number of new HIV infections (incidence) may be decreasing among people who inject drugs, females and Aboriginal people and where targeted, innovative health and harm reduction responses are delivered, results generally follow.

According to 2011 national HIV estimates, an estimated  14% of new infections were attributed to injection drug use compared to an estimated 17% of new infection in 2008.*

In Vancouver itself, initiatives across the board have given us all a welcome insight into just what targeted, user friendly and progressive health interventions can do. The project STOP (The Seek and Treat for Optimal Prevention of HIV/AIDS Project) was a three-year pilot funded by the Ministry of Health and ending in March 2013. This fascinating endeavour would  ultimately transform the HIV system of care in the city through a variety of initiatives and activities we now know as imperative for change, such as community engagement with people living with HIV, evidence review, consultations with both service and healthcare providers, the development of population-specific reports, constant assessment of the current state of the HIV system of care, policy change, and the funding, monitoring and evaluation of over 40 pilot activities. Phew! A terrific document was recently published which I urge anyone interested in progressive health interventions for this community, to read this (Click Here).

Toronto user activists, still innovating and agitating for their community.

Across the other side of Canada in Toronto, we have the same level of innovative peer initiatives and activism behind many of the most progressive  community approaches to the drug issue. Raffi Balian, a founder member of Toronto’s  exceptional harm reduction service CounterFIT,  told me “The best and most innovative harm reduction initiatives are taking place in cities where people who use drugs are represented by strong unions; such as VANDU in Vancouver, and Brugerforeningen in Copenhagen.  In Toronto” he continued “we have been blessed because we were the first city to distribute crack stems.  A lot of the push came through the work of the Illegal Drug Users Union of Toronto in 2000, followed by the Safer Crack Use Coalition of Toronto (SCUC, 2001-2011).  In Toronto, service users can get as many as 200-300 stems without questions asked.” Upon being asked about the popularity of Vancouver’s crack pipe vending machine, Raffi was quick to enthuse  that the distribution of crack stems through vending machines, “is a brilliant idea and something that we will surely import here [Toronto].  It will take some time and effort, but I’m sure we will learn from VANDU’s efforts and will make it a reality in Toronto – just as we are doing with supervised injection sites. ”

Recent moves to copy Vancouver’s famous safer drug consumption room INSITE – (sometimes known as a supervised injection centre or clinic) has been underway, and a feasibility study on injection rooms was actually requested by the City of Toronto in 2008 (and later expanded to include Ottawa). The study was then undertaken by researchers at the University of Toronto and staff at St. Michael’s Hospital,  after watching the developments at INSITE.

The results of the study were released in April 2012 and it advised Ottawa to introduce two “safe consumption” sites and Toronto to open three sites. While they didn’t recommend specific locations, they did suggest more than one centralized location, which is what Vancouver has with its Insite program. Around the same time a Public Health initiated study emerged recommending Montreal also open up to four safe drug consumption rooms, openly referring to the benefits such sites have repeatedly shown in reducing the number of overdose deaths, assisting people to make positive changes in their lives and reducing the drug paraphernalia found on the streets and in the parks.

INSITE – North America’s first drug consumption room in Vancouver

Although conservatives in Toronto raced to  dampen spirits with their usual confused concerns about the recommendations, the brilliant partnership working recently undertaken by drug user activists like those at VANDU, who worked long and hard with various  groups, advocates, researchers, health professionals, lawyers and others to fight for the special exemption to Canada’s Federal Drug Laws which enabled INSITE to remain open for good, (an exemption which now finally stands) today means that cities and provinces like Toronto, Ottawa and Montreal, can also fight for a similar exemption -and should.

Yet before we say goodnight to our peers in Vancouver (and across Canada) may we just wish our friends luck as they embark on their latest Crack Pipe Vending Machine initiative and hope that other countries may soon follow their courageous lead. Well done in using another tool in the fight to prevent HIV and Hep C, in fostering rights and responsibilities for people who use drugs, and forwarding the adage that judgements and moralising will never help the drugs debate, only humanity, intelligent policies and community partnerships involving the drug using community -will provide us all with the solutions we require now and for the future. G ‘Night friends.

Toronto Public Health

Pic: Another recent initiative that drug using peers have been trained up in, in Toronto -using the anti overdose drug Naloxone, to be administered to an opiate user at the time of an overdose to essentially restart breathing again.

*2011 Estimates of HIV prevalence and incidence in Canada, published by the Public Health Agency of Canada (PHAC)

The Crack Pipe Vending Machine -A Vice Article.

“Crack pipes: 25 Cents,” reads the sign on a shiny vending machine, painted in bright polka dots. Decades ago, this device sold sandwiches. Now, when you put in your quarter and punch in a number, there is a click, a pause, and a little whirr. Then the spiral rotates until a crack pipe—packaged in a cardboard tube to avoid shattering—drops into a tray. Then you reach through the flap and retrieve your new stem.

According to the BC Centre for Disease Control, Hepatitis C and HIV can be spread through sharing crack pipes. The intense heat and repeated usage that comes with crack addiction can quickly wear pipes down to jagged nubs. Users are always in need of fresh supplies. Like distributing clean needles, making crack pipes available is just good public health policy, as users don’t have to resort to risky activities to come up with the cash to buy one on the street.

The crack pipe vending machine was the dream of Mark Townsend and Mariner Janes, of the Portland Hotel Society (PHS), a non-profit that provides services to persons with mental health and addiction issues. There are currently two machines and they’ve been in place for six months.  Each holds 200 pipes and needs refilling a couple times each week.

One of the machines is located at PHS’s bustling Drug Users Resource Centre. As I arrive there with Mariner, people greet each other as a writing workshop wraps up, while others queue up for lunch. I ask if anyone wants to talk to me about the vending machine that stood in the corner.

Joe looks at me like I’m an idiot, then smiles, and adds: “It’s a vending machine, what else do you need to know?” He says he uses it all the time and that “a quarter is way better than what’d you have to pay on the street.” A bit of a debate kicks off about how to improve the machines e.g. including other crack related supplies: lighters, push sticks, etc.

A woman named DJ chimes in. She uses the machine and tells her friends about it. She says she’d like to see more pipe vending machines around the Downtown Eastside. “But bolt them down… People go: ‘Hey, pipes!’ And shake it to get them to drop out for free.” Mariner nods his head, all too aware of the shaken machine dilemma.

Mariner hopes that distributing pipes will one day be as accepted a practice as handing out needles to IV drug users has become. He says, “the stigma around crack use is much higher than, say, heroin or any other drug. There’s a particular quality of panic.” And he worries about the possible sensationalism that the vending machines might attract from more conservative commentators.

But community support for handing out safe crack smoking supplies is growing. Three years ago, the Vancouver Coastal Health Authority began a pipe distribution pilot program. The Vancouver Area Network of Drug Users started even before that. Vancouver Police have come round, giving the nod to some harm reduction initiatives, even directing users to the safe injection site and other programs.

“Aiyanas Ormond of the Vancouver Area Network of Drug Users told me the vending machines are “a good intervention. Access to a pipe can make the difference for people having a safe practice.” Citing research from the Safer Crack Use, Outreach, Research and Education (SCORE) project, he noted that significant harm reduction comes from distributing pipes to users in the sex trade. They won’t have to work potentially unsafe dates just to pay for the pipe itself.”

Mariner spends his days behind the wheel of PHS’s needle exchange van, doing outreach and distributing clean needles and pipes around Vancouver. There is a neighbourly, comradely feeling between him and the people who use the vending machines, or sidle up to the his van whose purpose is announced in giant letters on the side panel of the vehicle.

Sometimes, a client will ask for a more subtle approach, so as not to announce to the entire neighbourhood what’s going on. Mariner will pull into an alley, or even use a less obvious vehicle. And if a more anonymous interaction is what the user wants, all they need is a quarter. That’s his philosophy—meet people on their own terms, and provide services as a peer, not an authority.

It’s not by chance the vending machine has a happy—rather than official—design; as its meant to contrast the typically cold, heavily secured, and clinical facilities for addicts. The vending machine has an aesthetic that exudes care for the people who will use it. Mariner says “part of the design that we chose is to provide a sense of respect and dignity to the user, who is pretty much stigmatized and reviled everywhere else in the city.”

The look and feel says: I am a machine that dispenses a basic health care supply to the community, not a judgement or moral lecture.

This article was authored by: Garth Mullins ; for VICE and has been copied fully from the VICE.com website.

Feb 7 2014

Avoiding Hepatitis C / HIV – Tips from your peers

An article based on a research paper

by Sam Friedman et al.

Looking at How Some IV Users Manage to

Become ‘Double Negatives’.

In some climates where disturbingly high rates of infection exist, what key things are people doing in their daily using lives that conspire to keep them free from infection when so many of our  peers become positive. Sam Friedman et al looked into this subject and found some consistent factors

A brief BP comment before we introduce Sams article; We are always focusing on just HOW we end up getting blood borne viruses, and many of us have ended up getting, if not HIV then much more commonly, Hepatitis C (or B) -in some countries or prisons Hep C rates can be as high as 70-90% of all injectors. Yet we all know people who have managed to inject drugs for decades yet have avoided becoming infected with anything. Sam Friedman et al has turned the usual research approach  on its head here and put our own drug using culture under the microscope – searching for the little gems -those habits or behaviours that WE have utilised to keep us safe from such  infections, regardless of how long one has been injecting.

This is not about focusing on what ‘they did right and you did wrong’. No, this is about pulling

Negative (Negative album)

Sam Friedman’s research into the ‘Double Negatives’

together the cultural threads and day to day choices one can make that helps to create the environment you need to protect your health. It is interesting to see how adopting a few strategies around your using lifestyle, can work to protect you from what can be extremely common infections. Of course in a world of prohibition, opportunities to choose a safer path can change dramatically overnight, such as a stay in prison. Sometimes, with all the knowledge and support in the world, you can just be damn unlucky, or have no control over transmission events.

However, it is worth looking at Friedmans research to see, against just such a prohibitionist backdrop,  with perils around almost every corner, how our negative peers manage to stay negative -leaving us with the thought; “Can I incorporate some of these tactics/strategies/principles/street codes into my using life? Well yes you can -and all of these ‘tips’ are just as relevant for a positive person as well – after all, who wants to get re-infected? So, enough of the prologue, take it away Sam! PS -BP has added the odd hopefully useful comment in italics.

Staying Safe: How you and others might

avoid becoming infected with hepatitis C or

HIV?

Most people who inject drugs get infected with hepatitis C within a few years (often their first few years of IV using). Some also get infected with HIV. This happens in spite of all the syringe exchange, pharmacy syringe distribution programs, drug treatment, and other harm reduction efforts they engage in—and all the ways they help each other to have safer and happier lives.

“Some people who inject drugs do NOT seem to

get infected with either virus.

What are their resources or strategies?

How might you, your friends or your children

learn from how they did it?”

To read the full article and pick up a few tips, click here.

One of those videos you just gotta have a listen too…

This is another terrific Exchange Supplies production -a straight up talk from a wonderful woman called Magdalena Harris. Mags, a Kiwi now living in London talks straight to camera about her life as a committed career drug user and her journey telling how she managed to pull all her experiences together and marry up her knowledge of drugs with academia. A really empowering story, Mags eloquently and succinctly takes us through her life as a street drug user – New Zealand style -with all its pharmacological nuances, to treatment and methadone which left her even more despairing as she battled the punitive ‘clinic system’. Make no mistake, this is no self pity story. This is upfront and in your face -but more than that it is extremely perceptive and Mags is able to tell us just how valuable those years of using were to the work she does today.Many will empathise with her battle with hepatitis C and her dilemma over ‘to treat or not to treat’  – and at each turn of the story you will find something you can take from it to empower, inspire, laugh or get angry. For just 15 minutes, its well worth a look readers. Nice one Mags, thanks for being so honest but more than that even, thanks for the inspiration. And thanks to Exchange Supplies for bringing us another goodie! we love you guys!

Australia’s hidden gem: A Tradition of Exceptional Drug User Orgs

Terrific examples of Drug User Run Organisations

Here is something you will rarely hear about emanating from Australia, or mooted by its politicians. Yet it is worth shouting about -and worth emulating — and demanding more recognition for its many excellent years of work outside the drugs field! In Australia, the user run, federally funded AIVL (Australian Injecting & Illicit drug users League) is an incredible, national organisation that is at the centre of the some of the best harm reduction initiatives in OZ and in the world.  Extremely well versed in drug policy and politics, AIVL  and its team of extremely able people who use/d drugs (many at the top are women!) have been tireless in their innovation, research and developments to help empower the drug using community in ways to look after themselves, each other and their communities. The publish a National user magazine called Junkmail (like our BP blog,by coincidence -(we called it Junkmail after BP’s letters page although Junkmail has been the Aussie national mag for many years)). Many states like NSW, Queensland and Victoria also have their own excellent magazines by and for users – with NSW probably having the longest running user mag in the world in Users Voice by NUAA.

Positioned as the national drug user organsiation, AIVL members stretch across Australia, and in each state there is another State ‘user run’ organisation, which has just as much oomph, savvy, and articulateness as their ‘mothership’ AIVL. Organisations like QuIVAA (Queensland Intravenous AIDS assoc) which aims to “represent the diversity of interests of injectors and illicit drug users, through systemic advocacy aimed at addressing issues affecting users in Queensland” (Fantastic!) -along with other groups in what can sometimes really seem like a police state -Northern territory for example, or where in Western Australia they lock up more indiginous folk per head of population than anywhere in the world, targeting plenty of drug users and throwing them in the lock up in the process, over and over again…Shameful.

But you really can count on the user activists in OZ to be fighting the good fight, and if you are ever searching for good quality info on harm reduction and user rights in English – here is a good place to start. BP will be adding more reviews about user orgs as we go. (Sweden next)

AIVL gives you the list of contacts for all states in Australia – great orgs to seek out should you ever be travelling there and need advice or help with scripts, legal issues, the low down on the local scene etc.

AIVL, is Australia’s national org (click here) but here is a list of Australia’s State Organisations run by and for people who use drugs.

Canberra – CAHMA  (Canberra Alliance for Harm Minimisation and Advocay)

QueenslandQUIVAA   (Queensland Intravenous AIDS Assoc) and

NSW – NUAA (NSW Users AIDS Assoc)

Have you seen this?! Proposal for Drug Legalisation in Central America

Have you seen this?! Proposal for Drug Legalisation in Central America.

On Saturday February 11th, Guatemalan President Otto Perez Molina
declared that, following discussions with Colombian President Santos,
he will present a proposal for drug legalization in Central America at
the April 14-15 Summit of the Americas.
Guatemalan Vice-President Roxana Baldetti will begin a tour of Central
America to discuss the proposal with regional leaders and garner support
for it, starting with Panama, Costa Rica and Salvador on February 29th.
Unsurprisingly, the move was greeted by a quick rebuke from the US
government.

President Molina’s initiative is unprecedented and marks the
first time since the launching of the War on Drugs by Richard Nixon in
1971 that a foreign head of state actively challenges the US-led
policies of drug prohibition and try to build a coalition against it.

A former general of the Guatemalan army, President Molina has
impeccable credentials to launch such a move: he was elected in November
2011 on a law-and-order platform, pledging to restore security to the
country. Guatemala is on the major transit route from Colombia to the US
and drug violence has exploded there over the past few years, turning
this already impoverished and unstable country into one of the most
dangerous countries in the world.
We all need to show our support to President Molina and his potential
Latin American allies. We also need to put pressure on the Obama
administration to ensure that it doesn’t stall Molina’s proposal, and
that it allows a truthful debate to take place at the April 14-15 Summit
of the Americas and beyond.

View of Guatemala City with the

If anyone has any news or insights into this issue, INPUD would be
very keen to hear about it. Please comment in the boxes below and leave
your email.

via Have you seen this?! Proposal for Drug Legalisation in Central America.

Dec 1st Russian Embassy Protest -Be there!

The Red ribbon is a symbol for solidarity with...

WORLD AIDS DAY

On Dec 1st, 2011, World Aids day, people in 8 countries around the world will descend on Russian Embassies -To protest at the criminal treatment of people who use drugs – in the biggest catastrophe in the history of HIV in recent times. (See below for where and when).

In Russia today, we are bearing witness to one of the biggest, avoidable catastrophes in the history of HIV – the lack of response to the epidemic in Russia. We must point directly to the specific responsibility that Russian medical and public health officials bear for creating and sustaining this disastrous situation. Of particular concern are Russia’s, brutalising drug policies and its recently revised Total War on Drugs, which has resulted in further pushing people who use drugs into hiding, prison, and enforced detention, and severely compromising efforts from the international community to revert the trajectory of HIV/AIDS. The world is approaching a crossroads; a strong and decisive downward trajectory in the epidemic is possible in all countries -but it will only happen if the people who are most vulnerable to infection are supported and their human rights realised. Governments have legal obligations to act. Indeed, the implementation of harm reduction measures is consistant with and required by states obligations under international human rights law. 1,2.

Injecting drugs with contaminated equipment is driving Russia’s HIV epidemic, now the fastest growing in the world and it is reflected in the numbers; as many as 80% of new infections are occurring amongst people who inject drugs (PWID), in a total HIV positive population of approx 1million. With this in mind, recent projections forecast an additional 5 million people could become infected with HIV in the near future, unless Russia transforms the way it is dealing with its HIV pandemic.6

Russian authorities have repeatedly come in for fierce international criticism over their policy towards the treatment of drug dependence, which relies almost completely on the promotion of abstinence to the exclusion of harm reduction.  Russian officials claim, incorrectly, that the effectiveness of opiate substitution therapy (such as providing methadone and buprenorphine) has not been adequately demonstrated, and as such it is prohibited by law. Yet, despite the addition in 2005 of these two drugs to WHO’s list of essential medicines, and multiple position papers by international experts calling for substitution treatment as a critical element in the response to HIV (IOM, 2006; UNODC, UNAIDS, and WHO, 2005), methadone or buprenorphine remain prohibited by law in Russia and promotion of its use – punishable by a jail sentence.
Compare this legitimate injection kit obtained...

Sterile needles and syringes are proven ways to prevent the spread of HIV

With over 30,000 people dying from drug overdoses every year, numbers that can be shown to markedly reduce with the implementation of OST, and 150 becoming infected with HIV each day (2/3rds of which are injecting drug users), also evidenced to drastically reduce with the roll out of Needle and Syringe Programmes (NSP), it is upon everyone who cares about humanity, to demand an immediate transformational shift in Russia’s approach to HIV prevention and its treatment of drug users.  Access to NSP and OST is in itself, a human right;  UN Ruman Rights Monitors have specifically stated harm reduction interventions as necessary for states to comply with the right to health. 5)

Consistent evidence from around the world shows that treatment for opiate dependence works most effectively when the exclusive goal of abstinence is widened to foster multiple outcomes – including reduction in use of illicit opiates, exposures to blood-borne infections such as HIV and hepatitis, reduction in drug overdoses, better management of existing health problems etc. Evidence has repeatedly shown the clear benefits to the individual and society as a whole when drug dependence is viewed as a public health issue, as opposed to a criminal one. Evidence also shows OST, combined with a range of harm reduction measures such NSP, leads to a drastic reduction in the spread of new HIV infections in countries across the globe; none of this more clearly demonstrated today, than in Netherlands, a world leader in harm reduction where in 2010, only ONE injecting drug user contracted HIV. In the UK, another country that has harm reduction at the centre of its HIV prevention strategy, prevalence of HIV amongst drug injectors is at 1.5%, this against a Russian HIV prevalence backdrop of 30-35%. The evidence on harm reduction has been in for years. Why does Russia continue to turn its back?
The Russian government‘s estimated annual expenditure related to drug law enforcement) equal approx 100 million US  dollars. 7. This amount does not include the money spent on detention and imprisonment. In stark comparison, only 20 million US dollars was allocated to HIV and hepatitis B and C  prevention combined, among all population groups in 2011. By 2013, amounts spent will be three times less. Considering the context and tendencies in the development of the HIV epidemic in Russia, clearly such policies are not leading to any positive results. No money at all is allocated towards HIV prevention among the injecting drug using population.6Such punitive and torturous approaches to tackling drug use are not only fuelling the HIV epidemic in the region, but also the stigma, hate and ignorance of drugs, and of people who use drugs.  The insistence by both the Russian government and medical profession to treat drug users as criminals that need imprisonment at worst, and at best – enforced detention, has meant harm-reduction programs, including needle exchange, are officially accused of propagandizing drug use and activists have been arrested, harrassed and imprisoned for promoting harm reduction measures. Demonstrators who have protested and spoken out against the Russian response to HIV/AIDS are also regularly arrested and detained, including HIV positive people calling for access to ARV’s (drugs to treat HIV) and an end to treatment interruption fuelling drug resistant strains of HIV.This World Aids Day, December 1st 2011, we will echo the urgent voices of Russian drug users who are living and dying in the grip of an HIV and TB pandemic with almost no recourse or chance to engage in or promote an effective response.  . We will gather at Russian embassies around the world to demand Russia to change it current course towards death and disease. We want to see inappropriately aggressive, state sponsored hostility to drug users replaced by enlightened, scientifically driven attitudes and more equitable societal responses” 3 We demand our own countries to apply pressure wherever and whenever they can, voicing publicly our concerns about human rights abuses in the Russian response to drug use and HIV.
Sound, evidenced based and cost effective harm reduction solutions stand at the forefront of what has been shown to effectively prevent HIV infection in the drug using community. The personal narratives of people who use drugs and their allies on the front line of human right struggles must be recognised and remain a key part of today’s growing evidence base. People who use drugs must be seen as central players in the search for solutions rather than being framed and targeted as the problem.
Nothing About Us Without Us  www.inpud.net
Dec 1st at Russian Embassies in London, Stockholm, Berlin, Bucharest, New York, Sydney/Canberra, Spain (?), and Toronto. Dec 1st
 for times and locations follow updates at http://russianembassyprotest.wordpress.com or (add your email/website)

1) UNIDCP Flexibility of Treaty positions as regards harm redcution approaches, decision 74/10 Geneva UN 2002 ,
2) UNODC World Drug Report Vienna 2009
3) Lancet July 2010 HIV in people who use Drugs
4) The right to the highest attainable standard of health; Article 12, comment 14  International Covenent on  Economic, Cultural and Social Rights 2000
5) Barrett D et al;  Harm Reduction and Human Rights, the Global response to drug related HIV Epidemics. London, HRI, 2009
6) News Release, Oct 7th 2011, Risk of HIV Hitting Catastrophic Levels; from the Canadian HIV/AIDS Legal Network; Eurasian Harm Reduction Network; Harm Reduction International;
7) Articles 228-233 of the Russian Criminal Code

A young Russian and a message you can’t forget.

The Red ribbon is a symbol for solidarity with...

Russia’s Aleksey Kurmanaevskiy speech delivered at the UN High Level Meeting on HIV and AIDS in New York – June 9 2011 by INPUD on Thursday, 09 June 2011 at 18:33:

INPUD is a global peer-based organisation that seeks to promote the health and defend the rights of people who use drugs. We will expose and challenge stigma, discrimination and the criminalisation of people who use drugs and its impact on our community’s health and rights. We will achieve this through processes of empowerment and international advocacy. Find us at: http://www.inpud.net, Facebook/INPUD, Twitter/INPUD. Blog at: http://www.inpud.wordpress.comThe following speech was delivered by Aleksey Kurmanaevskiy at A dialogue on HIV and Human Rights at: Universal Access for Key Affected Populations. This event was hosted by the United Kingdom and the Republic of South Africa together with the International HIV/AIDS Alliance and the International Federation of the Red Cross and Red Crescent Societies. This session took place at the High Level Meeting on HIV and AIDS at the United Nations in New York City.

Aleksey is from Russia and is 30 years old. He has been dependent on drugs for 15 years, and has been living with HIV for 11 years. He is a member of the International Network of People who Use Drugs (INPUD) and will speak with you today for people who inject drugs, those who are living with HIV\AIDS, and for the members of the drug using community who are no longer with us because of HIV\AIDS, Tuberculosis, Hepatitis, and drug Overdoses.

Text of Aleksey’s speech:

Q1 – Highlight key challenge or obstacle & successful action or approach:

I would like to call to attention the laws and practices that are based on the criminalization of people who use drugs and the consequences of these measures. In our opinion, the practice of imprisoning people who use drugs in order to deny them their freedom or subjecting them to coerced treatment for the personal use of drugs should be ended. Imprisonment and coerced treatment are clear breaches of human rights that undermine the public health of people who use drugs and the wider community.

The criminalisation of people who use drugs and the widespread stigma and discrimination against our community results in people hiding and living in fear and secrecy. This can cut people off from family support and drives people further into problem drug use. As such, punitive laws can dramatically reduce the effectiveness of HIV prevention strategies with my community and undermine access to and retention in services. As a result, punitive laws are costly and ineffective.

The introduction of science-based harm reduction interventions like needle and syringe programmes, opioid substitution therapy (OST), and overdose management programmes is saving the lives of my community in many countries in the world. We have the experience, the evidence and tools to end concentrated epidemics of HIV among people who inject drugs. 30 years of evidence demonstrates that OST radically improves the health and wellbeing of people who take drugs and supports our engagement in HIV and TB treatment. Significantly OST gives people who are dependent on heroin and other opiate drugs an alternative to crime and allows us to fully participate in and contribute to society. History has shown that when people who use drugs are involved in the design, development and delivery of HIV prevention interventions, the reach is greater, the quality is higher and there is better value for money.

Q2 – 1 or 2 key recommendations to HLM on practical way forward:

I am a husband and father of two sons and very much want peace and mutual understanding within my family. I learned that it is absolutely critical to listen to my loved ones. Before agreeing on a solution, we consider all of the possible alternatives. The very welfare of our family depends upon this process of open dialogue.

I have drawn this analogy deliberately. The family can be viewed as a microcosm of society. We are all members of one global family. Though we all have unique worldviews, customs, and ways of life, there is no doubt that we have to deal with the HIV epidemic together. The foundation of such mutual understanding through dialogue is the first step in this process.

Around the world people who inject drugs are giving sterile injecting equipment to their friends, are sharing education and knowledge and supporting service access. At a global and regional level drug user organisations are supporting consultation and contributing to policy development. At a country level we can provide a community watch dog function helping donors to spend money wisely and programmers to deliver services effectively.

Our challenge to all countries is meaningfully involve people who use drugs in the design, implementation and monitoring of the HIV response. If you are serious about engaging us as true partners then this has include the resourcing of our organisations and the meaningful participation of our representatives. This is key to reversing the trajectory of the HIV epidemic and bringing under control the spiraling costs of HIV. It is time to stop framing my community always as the problem and instead to recognise that we are a key part of the solution to HIV.

Hepatitis C

A simplified diagram of the Hepatitis C virus ...

Replication cycle of the Hepatitis C virus

Once known as Hepatitis Non A Non B, Hepatitis C has been discussed a great deal in the using community over the last 20 years. Here, BP goes behind the ‘Hep C test’ where many of us once stopped, discovering why further tests are so important in getting to the bottom of your own Hep C diagnosis. There is a lot to know about when it comes to your own virus and then can be even more to consider when it comes to deciding if and when you’re going to start treatment. Especially, when, in 2015 we stand at the helm of a whole range of very effective HCV drugs and the word ‘cure’ is on every pharmaceutical companies lips.

In the last issue, BP ‘introduced’ the liver, briefly discussing what it does and how it does it. This issue, we want to look more closely at a virus that has affected the livers of an estimated 215,000 – 600,000 people in the UK alone, 170 million people worldwide with some 3 million more joining the global ranks each year. BP wanted to find some straightforward answers to some essential questions on Hepatitis C and what you may want to consider if you have been diagnosed Hep C (HCV) positive. (BP will look into treatments for HCV next issue).

Hepatitis C is?…

The actual word “hepatitis’ means inflammation or swelling of the liver. This can be caused by chemicals, drugs, drinking too much alcohol or by different kinds of viruses. Hepatitis C is just one of a number of hepatitis viruses (including A, B,D, E, G) and they are all completely different from one another. It can be hard to get your bead around just how small viruses really are. HCV is estimated to be 80 nanometers in diameter (around 30 billion would fit on this dot {,} – another reason why handwashing before and after injecting is so important; be especially vigilant if someone injects you after they’ve just had a hit – they could have microscopic particles of blood on their fingers and then may place them on your injection site. HCV is known to be remain active outside the body for some time so wash your hands and tell others to wash theirs! The hepatitis C virus is in fact a group of viruses, similar enough to be called HCV virus, yet different enough to be classified into subgroups.

Genotypes

Several families of hepatitis C have been observed around The world and these are known as genotypes, because they differ in their genetic make up. They arc usually classified as HCV genotype 1 ,or 2, or 3, etc. Some genotypes respond better to treatment than others so it is important to identify your genotype when considering treatment for Hep C..

Subtypes

Within each genotype, there are subtypes. These are classified as HCV subtype la, or Ib, Ic, etc and within a subtype, incredibly minute differences will exist among individual viruses, called quasispecies – several million quasispecies would exist within a subtype.

To read the rest of this BP article, and find out how Hep C can affect you, click here.

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