Employing People Who Use Drugs

And why it is a good idea!

Introducing a Good practice guide for employing people who use drugs .

A truly indispensable toolkit.
PWUD (People Who Use Drugs) have insights and expertise that can help inform the planning, delivery, monitoring and review of harm reduction and many other drug related services. When we involve PWUD in the design and delivery of services for our community, the overall work becomes more relevant, targeted and accessible. Working in partnership with PWUD helps services to reach and connect with other PWUD more effectively, and importantly, to understand and meet their needs.

A really powerful way of involving PWUD is to employ them as staff.

EmployingPWUDs_guide1

Employing PWUD sends out a clear message that they are valued partners and are welcome at all levels of service delivery. It also has a very practical set of benefits, helping services to better understand the needs and lived experience of PWUD. PWUD have the right to be employed. Policies that routinely exclude PWUD from the workplace are discriminatory.
This guide has been carefully and thoughtfully written and involved the community of people who use drugs in its design and execution.  It provides really excellent information in the form of a practical toolkit that services themselves can and should use when it comes to considering the employment of PWUD’s in services.

It is true, there are unique issues that PWUDs may bring to the workplace if / when employed. However, the really interesting insights,  ideas, and approaches a service will experience from engaging PWUDs is sure to make the extra effort of learning how to structure the work environment, all the more worthwhile.

This guide also has really well thought out and evidenced based information for ensuring that PWUDs who are engaged as volunteers or mentors in any service, are able to deliver their very best, and are properly supported and compensated by the service they work hard for.

It is essential that people who are still actively using drugs, and those who are relatively stable in treatment  -are recognised as able to make a valuable contribution to the development of our communities drug and alcohol services! It is a field that should not be exclusively for people ‘in recovery’, and as this guide will show, there are many valid reasons why the entire community of people who use drugs all have valuable roles to play in giving us better quality drug and alcohol services.

Here are just some of the topics discussed in this excellent guide. Make sure every drug service is aware of its existence.

2.2. When drug use is a problem (and when it is not)
2.4. Employing ex-drug users and people in recovery
2.4.1. Employing people who are engaged in OST and drug treatment
2.4.2. Employing people who are active drug users
2.4.3. Employing people who are active stimulant users
2.5. The value of staff who use drugs

4.2. Problem drug use and work
4.3. Imposing personal models and philosophies of drug use
4.5. Moving from being a peer to working in a harm reduction organisation
4.6. Inappropriate relationships with clients
4.7. Supplying, or soliciting the supply of, illicit drugs
4.8. When peer support groups become unhealthy
4.9. Managing staff with health conditions that impact on performance
4.10. Managing a death in the workforce or among the client group

Appendix 3: Risk assessment circle
Appendix 5: Examples of job advertisements for staff who use drugs and peer outreach workers
Appendix 6: Model questions for peer interviewers
Appendix 7: Conducting a review meeting
Appendix 8: Developing a self-control programme
Appendix 9: Checklist for managing staff with problem drug use at work
Appendix 10: Training exercises from the Bangkok workshop
Appendix 11: Normal and complex grief reactions

Save yourself a copy and spread it around the staff in the drug services you know -you never know -you might get a job there one day!

NOTE: This guide came out at the end of 2016 and I have written about it before however it was hidden on our website so I thought it should be pulled out again and given a front page showing. I hope you will agree it will be a useful guide for some years to come.

International Remembrance Day, 21st July -For those who have died from the War on Drugs – which is a war on people!


This is a speech spoken at a Remembrance Day event in London yesterday. It gives a personal point of view looking at how the War on Drugs -which is a war on people in every part of the world that has been happening for almost 100 years! Here is just one persons story of being inside this insane maelstrom.

My Name is Anna

My name is Anna and I call myself a drug user activist.

I have been a drug injector for over 30 years and a drug user activist for more than half of that.

In that time – like many of us here today – I have seen a lot of things….

And, like many of us here – I have also had some extraordinary relationships, encounters and random chances with many, many people who used drugs.

People who, for the most part – were not dodgy or crazy – well maybe just a little –

Who were not dirty,  lying or cheating horrible people –

But mostly passionate, caring, sensitive and generous people. People who – yes they may have been pushed to the brink –marginalised and isolated by a society that had to criminalise before it cared – judged before it understood; people who should have received better protection from our drug policies – rather than annihilation…..

People who I have loved and cared about, like we all have –and this is why we are here on this very important day today.

As a drug user activist for many years now I have given speeches and presentations at lots of places all over the country –and while every presentation is different – but this one is special.

It is special because this is the one time I can honestly truly stand up and say – loud and proud – how grateful and how fortunate I am to have made friendships with some of the best people in the world – other drug users – fuck – other junkies! – wonderful, courageous people who have often battled huge odds to still be here – today – and many who are literally here today and in this audience.

People who have found each other, often initially through their enjoyment or pain, their that sharing of an illegal substance. You might say prohibition has brought many of us together.

But prohibition has also meant that –many of these very same people – these special, wild and crazy characters – are NOT here today.

Because they are DEAD. Those people –and we all knew someone – who died directly because our insane drug policies continue to make the same mistakes over and over again – day in and day out –while people like I have just mentioned – die!

Think about this: every minute of every day –someones brother or sister is crying out for methadone but cant get it because (like in Russia) they have an idea that it should be kept illegal to stop drug users indulging themselves.

That someones father is being bundled up in a rug in Guatemala and kidnapped by a quazy religious cult who have financially fleeced the relatives by selling a story that incarceration in a blacked out house – against a persons will is the only way to save someone from drugs.

And that – in the filipines a childs mother and father have been shot dead in the street by a vigilante public who cheer the bandits on and tie big signs round their dead necks calling them pushers.

While here in London someones best buddy overdoses alone in a half way hostel because they are using benzos on top of the shitty blackmarket heroin that available in an effort to drown out the misery of life criminalized after yet another prison sentence.

Prohibition is killing our community – over and over, to quickly to count the numbers –only through days like this do we have an opportunity to really reflect on who these policies are really affecting –in real time.

The anger is real – no doubt about that – it is why I became a drug user activist. But I just want to quickly tell you –being an angry activist didn’t happen overnight. It was an accumulation of several lightbulb moments that happened to me – that made me realise – OMG – I do not deserve shit treatment from people and services just because I use drugs and supposedly broke a few rules.

I used to think – well, what could I expect if I did the wrong thing. Jeezus, surely I couldn’t expect to be treated well? I was in the wrong, after all. I didn’t see then that societys label of junkie –and all its connotations – ran so deeply in people – that I was being judged and sentenced by their ignorance.

Ignorance that could literally put my life at risk.

Ill just tell you very quickly about 2 of those litebulb moments:

The first one happened after I had just been diagnosed HIV positive –it was in 1995 and things were different back then –but stigma is stigma and it is still rife today as we know –no matter what its shade or location.

So, 1995, and it was 6 weeks after I had been diagnosed –my first dr appoint. And I went with to this dr appoint –in fact I went with my mum –and I was met by a female dr who proceeded to  hammer me, in the most humiliating way, with a series of 100 questions about my drug use, whether I was sharing needles, did I have anal sex –all delivered with the most accusatory tone I was stunned into virtual silence! My mum –after she picked herself and me – metaphorically -off the floor –said ‘excuse me – I don’t appreciate you speaking to my daughter in that way’; and later, after we left and went for coffee, I realized –what she in fact was brimming with –was a judgement: I was guilty, I was a junky, I had brought this on myself. I was the non deserving.

And I realized in a flash: OMG – I had gone to this dr as an open book – as vulnerable as one can be – we both were – I felt like my life was in her hands –and that she didn’t want it. I wasn’t like everyone else – I really was ‘the other’ and this could literally affect my life now.

It was a lightbulb moment.

Later when a friend and I were bemoaning the fact that there were no drug users speaking on world aids day, considering how we had seen its impact on the injecting community; my friend Andrea, had just been telling me about her husband who had just died of aids. How incredibly courageous he was (in fact John mordant was one of several drug user activists in the world who formed the first front line of user activism back in early 1990s.- also started Mainliners) And that it really felt like there was nowhere for people like him to be welcomed, understood, appreciated –like there was for gay men at the time.

She said to me pointedly “ Because we have heroes too”.

And tears started to well up in my eyes because all of a sudden I thought about all the wonderful people I knew, some of whom were now dead –who never got the appreciation, the respect, the support even the funeral they should have got – just because they used an illegal substance.

But as I said – drug user activism helps me to channel my anger, and has helped me to fight back in constructive ways rather than remaining in a self destructive spiral of guilt, confusion, thwarted ambition, rage.

And days like today are an inspiration – to see all the wonderful people I deeply respect here today –and to celebrate the lives of those who –tragically – and for which there really are no words – are not here today –

Thank you all for coming today to remember those who lived life on the edge –in ways we all sometimes dream about doing but don’t dare –

We will keep remembering them all.

Dedicated to Raffi Ballian – a Canadian masterclass of an activist who died of an overdose this year.

Trafficking in Drug Users

Hi friends,

I just came across this old article/ presentation I wrote some years back about my own treatment journey (nightmare might be a better word!) and how so much idiocy, money, misguided support and policies, ignorance, do-gooders, moralising shits, and the whole web of the incredibly resourced, career inflating, gravy train that is the current drug and alcohol treatment /criminal justice interwoven system, is stitched up so tight across the globe, that it is going to take a hell of a lot of strategising for us to get out from under the intensity and chains of the current goal of ‘managing and controlling’ people who use drugs, in any way possible -and how carreers and reputations ride on this these days – the research, the papers, the positions in clinics and academy’s, the psychology and the ‘experts’ draining cash from everyone hand over fist with the misguided or embossed descriptions that they will ‘fix’ and cure your loved one, yourself, your child before it has even smoked a cigarette!  We are taught year by year, harder, longer and stronger – that we are weak, we have no control over our desires anymore, that we cannot do it ourselves – we HAVE to have professional help….Yet what of the professional help? The basic, colourless, inflexible, unchangeable, plain and homogenous, evidenceless help….my God, what a load of crock so much of it all is – and still – they never seem to ask us what we need. What would help. We just get encouraged to join into more peer pressure and trot out the same old slogans that we believe are right coz our old peers say so (12 steps etc). 

When is it EVER the right way to provide one solution for everyone no matter what where how when why they use drugs? in 2016, we are still one leg firmly in the dark friends….Sad alright. But it just shows – the only way is to get active – get politicised, get smart.

Hope you like it (bit dated now!)

Here – One of the BEST sites for resources on progressive ideas about drug use / treatment -based in UK – The SMMGP (includes forum, resources, GP chatter and much more).

RCGP Special Interest Masterclass Presentation

Originally entitled ‘Don’t Give Them What They Want’.

EO;  Editor Black Poppy Magazine, Written /presented July 2003

I left my home of Australia 10 years ago trying to find a way to get off heroin. I thought the beautiful scenery in Europe might inspire me, I thought London might show me a new way of looking at life. I thought I might find something that would interest me more than heroin. But I should have known that doing what many of my peers call a ‘geographical’ is very rarely the answer.

I had already been to a variety of treatment clinics and surgeries in Australia. I had hadpoppies_final_black5.jpg habits on heroin, cocaine, benzo’s, and a few other pharmaceuticals, but my treatment options, no matter where I went, were methadone, methadone and more methadone. I felt screwed by the time I came to England. I felt numb and I wasn’t well either. By the time I arrived, I was hanging out, sick, extremely tired and depressed and went to a hospital looking for some relief. I was offered a two week blind detox on methadone. Suffice to say, I remained sick. I felt like I was trapped and my head just kept wanting to be well. I was in a new city and hoping to find a bit of peace of mind, I had to begin to learn the ropes of the British prescribing system. Suffice to say, it has taken me another 10 years to finally land on my feet, with a script that suits me, Erin O’Mara, an individual with individual needs. After almost 20 years I can now look to a future – that’s what a tailored prescription has really meant.

To get to this point, I have attended around 10 different methadone programmes, 2 heroin prescribing programmes, seen numerous GP’s (both private and NHS), and sat with plenty of psych nurses, key workers, social workers, psychiatrists and counselors. I’ve been to rehabs in the country and detoxs in the city, made plenty of attempts at stabilizing and fought to come off completely with concoctions of pills gathered from anyone who would give them too me or suing acupuncture, massages and herbal teas. It wasn’t that I didn’t try. I really did. Everything was riding on it. My life, my health, my liberty. But I just kept coming back to the same old blanket prescribing of methadone linctus – a drug that, while I know it helps many people, it isn’t for all of us. Drug users are not born from the same mold, we all use for different reasons, we all take different drugs, we take differing amounts of different drugs and offering us variations on the same methadone theme, while helping many, is still going to leave thousands of us out in the cold. And how long can we afford to stay frozen out?

For many drug users, getting on the treatment rollercoaster means you are certainly in for a ride and a half. I have learnt that the right prescription is only half of the equation – the other half is the treatment and understanding you receive from your prescriber. It can be so hard to explain to some prescribers that it is the creation of the types of prescribing systems -that can cause so much difficulty in adhering to it. The clinics that offer only a 2 week break or holiday a year (no opportunities to mend familial bridges there then), the confusion or distrust around your intentions, the reducing of your script every time you take something else or have a need to top up your dose, having to turn up for dosing at inflexible times -whether you have to pick up your kids or go to work or uni or like being closely watched as you sit for 3 hours on a toilet to give a urine sample before you’re allowed to get your dose. I’ve been to a clinic where a girl burnt off her tracks with a cigarette because she was afraid the doctor would cut down their methadone if they found out she was still using on top. And, at that particular clinic, sadly she would have been right. Getting the treatment dose right is essential, finding the drug that suits that individual is critical, allowing room for maneuver or looking for other drug treatment alternatives is the most important of all.

chrispolice

Your nicked!

Since leaving Australia where we were all prescribed methadone – no options, no alternatives to coming to the UK where there was some room for maneuver with prescribing has been an interesting experience. Heroin has always been my drug of choice and for me, methadone linctus just didn’t work. It didn’t work for me in Australia and it wasn’t working for me here. I looked everywhere for a more suitable script. I’ve tried morphine, slow release tablets and ampoules – which, while being a welcome relief from methadone, I found it incredibly constipating and uncomfortable and found myself again, unhappy, not wanting to take it and looking for something else. I will never forget that particular doctor who was then the first one to actually sit down with me and talk to me about what it was I felt I needed. But while we both knew it was probably a diamorphine script, he was powerless to offer me it. Thus he offered me what we thought was the next best thing. Morphine. It wasn’t that I didn’t want it to work, I did, more than anything else in the world, but it just wasn’t suitable for me.

It is so important to be able to offer alternatives to drug users when they come in looking for treatment. Generalisations about drugs and drug users are made without considering how cultural differences mediate and transform both the reality and meaning of a persons drug use. Younger users, older users, women, men, mothers, those on parole or probation, those with HIV and or Hep C, injectors, smokers, pill takers and snorters – how can we expect to support an individual with a chemical dependence if we are only prepared to offer them methadone?

It has taken years for methadone to be accepted by doctors, and still it is only by a minority. Without question it clearly works for some people and it certainly has a place in prescribing options. But there are other alternatives. At Black poppy we are receiving many letters about how helpful Subutex has been (mainly for detoxing) but many more letters from people wanting to know how they can encourage their doctor to prescribe it. We all know its out there but where? How can one be prescribed it or is it too a lottery depending on your area or GP?

Morphine also holds an important place but is usually prescribed by private doctors and is prohibitively expensive. I have a good friend who has tried methadone unsuccessfully many times and finally went to a private doctor to try and get MST’s or slow release morphine sulphate tablets. Because he can’t stomach methadone linctus and doesn’t want to inject methadone ampoules, his morphine script has meant every fortnight he has to resort to spending literally his entire benefit cheque on paying his chemist and his doctor and is still fifteen pounds short. His clothes are old, his cupboards are empty and he is fighting off a depression that threatens to jeopardize his whole stability. This is because he cannot find a single NHS doctor in his area to prescribe him morphine tablets – despite his private doctor offering support. The last time I saw him he was eating the only thing he had in his cupboard – tomato paste. Why?

There are many people who have either dropped out of the prescribing system altogether or regularly have to top up with additional drugs because the system just isn’t geared for those with poly drug dependencies. While years ago many people just seemed to stick to using one or two drugs at a time, these days poly drug use has become the norm. How are doctors going to help support people if they can’t or won’t take on anyone who was multiple drug problems. This is 2003 and this is the way drugs are now taken. Both patients and doctors must be prepared to be open and have the courage to admit when something isn’t working and be flexible when considering alternatives. It isn’t easy. I know drug users can be difficult patients. When that doctor sitting opposite you seems to have the power to change your life – things do and can get emotional. For treatments to work we all have to be open and honest. The system has to let you be open and not punish you for what it sees as ‘not conforming to the treatment’. Relapsing is part of stabilizing as well as part of ‘the cure’.

For me, after years of searching for some stability – I was finally offered the chance to try diamorphine – or heroin on a script. It is extremely rare to get this chance and I believe the deciding factor was because I had recently contracted HIV.

Heroin is provided on prescription in what was known as 'The British System'

Now I’ve had the opportunity to participate in 2 very different approaches to heroin prescribing – and it has taught me a great deal about how the differing structures, regulations and nuances behind the way heroin is administered to users, is critical to the success of the programme. For example: The first heroin script I received was back in 98, through a pilot project in London, whose aim it was to study the effectiveness of prescribing either pharmaceutical heroin, or methadone in injectable form to drug users.

The first error and one eventually admitted, was to limit the amount of diamorphine prescribed, to an unmanageably low 200mg. (The Swiss, The Dutch and others, myself included, have found 400 – 1000mg much more suitable). Pharmaceutical heroin does not have a long half life and to seriously underestimate the dosages required was to become a momentous error and one that would seriously jeopardise a person’s ability to adhere to their prescription. With a median age range of 38 and an average injecting career of 19 years, many clients at this project had other drug problems, such as crack, benzodiazepines, alcohol or cocaine which I don’t fully believe were taken on board at the time. The severely punitive clinic regulations or ‘protocols’, would bear this out. i.e. anyone caught using any other drugs or ‘topping up’ their rather limited dose, would immediately be ‘sanctioned’ by way of a 30mg reduction in ones daily prescription, reducing even further ones ability to adhere to the programme. Once ones prescription began to lower, it was practically impossible not to ‘top up’ with something else, and so clients, myself included, were locked in a constant spiral of script alterations.

A stifling clinic environment would be the clinics 2nd fundamental error, where people would be unable to talk about their other drug issues for fear of a variety of repercussions. This would lead to an even more alarming situation where clients hid serious medical issues for fear of their prescription being stopped or being transferred back to methadone linctus.

The importance of maintaining an environment where users can talk openly and honestly to their keyworkers and consultants is a crucial element in a person’s success on any drug treatment programme and this was no exception. A deeply unhappy client group had nowhere to go to complain about their treatment and having to attend to such a stressful and demoralising project promptly each morning in order to receive ones medication only exacerbated people’s and my own depression and did little if nothing to improve the spirits of those attending.

Two years later, after a desperately unsuccessful period trying an injectable methadone prescription, I had developed a dire crack problem, was drinking alcohol regularly for the first time in my life, and began having regular seizures from increased benzodiazepine use.

It was at this time that, after an enormous effort and support from my GP Chris Ford, my mum, my local MP, (and bailing up the prescribing doctor at a conference I attended), I managed to secure a place at London’s Maudsley hospital, where there was a doctor prescribing heroin to a small group of patients. I clearly remember my sense of complete and total desperation. I felt I could not go on any longer, that if they didn’t help me I would be – I didn’t know where I would be and that was the trouble. I felt that this was my last hope, that I’d tried everything. And I begged…. Most drug users know well the feeling of someone else, a doctor, having the power of your life in their hands, every single day. A script started or terminated making the difference between life and death, or misery and hope. Sometimes you end up having to beg…

I have now been on my heroin script for 2_ years. My health has improved substantially and my HIV doctor is delighted – as is my mum and I. My moods and energy levels have improved considerably and so has my ability to contribute to life and my community. I founded and continue to work on what has become a National drug users’ magazine called Black Poppy, and I am actively involved in drug user politics, journalism and harm reduction issues. It has been a difficult journey, but thanks to my mum, my mates and the open-mindedness of my doctor, who fully engages me in my treatment decisions and doesn’t wave punishments in my face, I have stabilized and am well, for the first time in 18years of using opiates.

Now, I have somewhat of a vested interest in the campaign towards prescribing heroin – both here and overseas. Last year, my mum returned to Australia to live and while I would have liked to go with her, the thought of losing my heroin script after fighting so hard to get it, felt more than I could bear. I am HIV positive. There are going to be times when I will want to be near my family. Yet archaic laws in Australia forbid me from even entering the country with my prescription. How can this be legal? Anyone, on any other medication, would be permitted to continue that medication in another country but these basic human rights do not extend to drug users. The intense and totally unfounded hysteria that surrounds the prescribing of heroin to drug users sadly endures and has made the campaign to prescribe heroin in Australia a momentous task. Yet while campaigners look to the British System for guidance, it would be a mistake not to closely examine both its failings and successes. The potential for problems in importing a system that hasn’t been culturally fine tuned for the British using community are great because to get it wrong, Britain may lose the chance to ever attempt it on a large scale again. The Swiss users have to return to their heroin prescribing clinic 3 times a day to receive their heroin, watched over as they inject by a clinic nurse. Although the Swiss programme has had incredibly positive results, would English users blossom under such a severe restriction of an individual’s freedom? Or if the dosage is not allowed to be adjusted to suit each individual, as occurred before at the London clinic, what chance is there of success?

While there is undoubtedly a role for the prescribing of heroin to heroin users, it is important to remember how crucial the role of the heroin user is in the planning, implementation and evolution of a heroin programme – or any drug treatment programme for that matter. Users must be involved every step of the way and accepted, as other users of health services are, as an integral part of a treatment programmes development, with rights, responsibilities and a mutual respect for experience.

I know I’m fortunate. As an Aussie living in London, there are times when I have to pinch myself that this is real – I have a diamorphine prescription!. That the long and often harrowing road of ‘substitute prescribing’ has finally come to an end – and now I’m free to think about my future. But in the small silences that fall between me counting my blessings, I can’t help but wonder whether it’s all just been a bit to little, a bit too late. I question why it has taken 18 long years to get here? Why did I have to wait until I’d been chewed up and spat out of over 10 different treatment programmes and Dr’s surgeries, of at least 4 rehabs and an uncountable number of detox attempts? Why did I have to wait until I’d ‘finished’ selling my young body to men, til I’d got sick and deeply depressed, til I’d used every vein in my body from my neck to my feet, til I’d contracted both HIV and Hep C? Yet doctors can prescribe heroin to people who are opiate dependent in the UK and indeed they have recently been encouraged to by our current Home secretary, David Blunkett. Are doctors prepared to start looking at other alternatives? Is the government going to stand behind them? Support each other – doctors who are prepared to look at other options – keep each other updated. As a drug user, I know what its like to be on the other side of the fence – and as a drug user, I also know there are courageous doctors out there who are trying to do their best but are often working in isolation, with little support.

bppicnunsmall1.jpgMeanwhile, 96% of all opiate based prescriptions given out to British users, remains methadone and only 449 people currently receive a heroin prescription for opiate dependence. And I am one of them.

Unfortunately, I still hear the saying, ‘Don’t give them what they want’. But it’s not about want anymore. It’s about need and it’s about our lives. I would just like to take this opportunity to thank those doctors who did go that little bit further and treated me and my needs individually. Their support has got me the prescription I needed and has allowed me to be here today.One day we might have a system that doesn’t insist on me being sick and dysfunctional from the get-go and asks the big questions like ‘Why do we have a society / laws, that push substance users to the brink of insanity and outside the margins of society just because they prefer opiates instead of whiskey, a little stimulation from khat chewing instead of 20 cups of ‘legal’ coffee.

 

Addendum: The drug conventions are based on a lot of hot air and bullshit friends, the more you look back into history and the closer you inspect the world of economics, society, and criminal justice today, the more you unravel a mish-mash of men in suits making decisions decided by money, history, fear and racism, certainly not strong evidence, humanity and common sense.

– Erin

Editor Black poppy Magazine

Ibogaine update

Well readers, I have a treat for you!

Ten years ago David Graham Scott (whom we have written about and written with on this website) screened a very personal documentary on channel

Documentary filmmaker David Graham Scott on his journey to rid himself of heroin and methadone addiction. David during the dream phase of the Ibogaine drug. Copyright david gillanders_photography 2003 Not to be reproduced, printed or published without prior consent from David Gillanders. m_ + 44 (0)7974 920 189 e_ david@davidgillanders.com

Documentary filmmaker David Graham Scott on his journey to rid himself of heroin and methadone addiction. Above: David during the dream phase of the Ibogaine drug in the film Detox or Die. Copyright 

4, about his own experience as a person struggling to finally quit using methadone -by using ibogaine. The film Detox or Die has since been viewed many, many thousands of times on the web and at film festivals and conferences. It is a really interesting, personal and thoughtful film about his attempt to embrace the spirit of Iboga, by using a guide, who stayed with him throughout the entire two day ordeal, something he filmed entirely.

Well, my treat for you in David’s follow up film made 10 years later. David not only talks about his own experience of staying drug free since then but he looks at Ibogaine in other treatment settings -one persons actual DIY treatment to cure their heroin addiction, another couple of guys who embarked on a ‘journey with ‘a guide’ whom they paid a couple of thousand pounds, someone who bailed halfway through the treatment, as well as talking to some other dependent drug users about kicking their habit and their hopes for ibogaine working for them.

Portrait of filmmaker David Graham Scott today

Portrait of filmmaker David Graham Scott today

It is a classic piece of work, expertly made by a pro, we are dead proud of him here at BP and happily I can provide you with the link to watch not just Detox or Die but the more recent Iboga Nites -which came out in 2013. David has already won numerous awards for the film and it should spark interest and debate for some time to come. Well worth a watch for anyone remotely interested in detoxing or the subject of drugs.

This comes from David’s website detailing information on the film Iboga Nites

“The psychedelic plant root hails from Africa where it has been used in religious ceremonies through countless generations. A burgeoning movement in the west has promoted iboga as a quick fix route to painless withdrawal.

Now David wants to find out how truly effective iboga is. In a Dutch suburb several addicts embark on the long night of psychedelic detox under the watchful eye of an experienced Iboga practitioner. One client collapses and ends up on life-support, the provider is jailed and David starts to question the safety of iboga treatment.

 The film culminates with a nerve-wracking iboga session in London where the director himself administers the treatment. How does the filmmaker weigh up the ethics of involving himself so deeply in this controversial detox option and what will be his final resolve on the efficacy of it?”

IBOGA NIGHTS from David Graham Scott on Vimeo.

Good Practice Guide for Employing People who Use Drugs

Good practice guide for employing people who use drugs  – An indispensable toolkit (click link)

PWUD (People Who Use Drugs) have insights and expertise that can help inform the planning, delivery and review of harm reduction and HIV services. When we involve PWUD in the design and delivery of services, our work becomes more relevant, targeted and accessible. Working in partnership with PWUD helps our services to reach and connect with other PWUD more effectively, and to understand and meet their needs. A really powerful way of involving PWUD is to employ them as staff.

Employing PWUD sends out a clear message that they are valued partners and are welcome at all levels of service delivery. It also has a very practical set of benefits, helping services to better understand the needs and lived experience of PWUD. PWUD have the right to be employed. Policies that routinely exclude PWUD from the workplace are discriminatory.

When drug use is a problem (and when it is not)

Drug use is complex, and debate on the rights and wrongs of it can become easily polarised. In this context, the medical (disease) model of drug use tends to dominate. This emphasises the problems of dependence as an inevitable consequence of using heroin and other drugs. As a result, the response to drug use is often described as a treatment or cure for a medical illness. The medical model also dominates many 12-step programmes, such as Narcotics Anonymous (NA). It also influences the way many health professionals, academics, politicians and members of the public understand drug use. They share a belief that PWUD quickly lose the ability to control their drug use, and make conscious, autonomous or rational decisions about it. However, the United Nations Office on Drugs and Crime (UNODC) acknowledged in the World drug report 2014 that only 10% of PWUD will experience problems arising from their drug use.

This implies that many people’s experience of drug use can be non-problematic and often pleasurable. Similarly, some of our staff will have experiences with drugs that are non-problematic and recreational. Although in the alcohol field the concept of controlled drinking is now widely accepted, for many years the possibility of non-dependent and controlled heroin use has been largely ignored, despite evidence that such patterns exist.

This research demonstrates that some people are able to use heroin in a non-dependent or controlled manner. Studies of people using cocaine have also shown well-established patterns and strategies for self-control. These studies highlight the importance of the social context in which drugs are used and its impact on an individual’s experience of drugs and their effects.

We learn from these studies about the importance of context when trying to understand drug use patterns, and question the value of framing drug use as an individual failing or illness. (text taken from the guide itself. To receive a copy of the guide click the link at the top of this page)

Also read:

International HIV/AIDS Alliance (2010), Good Practice Guide. HIV and drug use: community responses to injecting drug use and HIV. Available at: www.aidsalliance.org/assets/000/000/383/454-G ood-practice-guide-HIV-and-druguse_original.pdf?1405520 726

This guide has been developed by the International HIV/AIDS Alliance (the Alliance) as part of the CAHR project, supported by the Netherlands’ Ministry of Foreign Affairs. The International HIV/AIDS Alliance in Ukraine (Alliance Ukraine) led this work, supported by the programme “Building a sustainable system of comprehensive services on HIV prevention, treatment, care and support for MARPs and PLWH in Ukraine”, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

 

How to build support: influencing politicians /policymakers

Hi again, For all you activists out there, check out this really terrific piece of work from some really interesting collaborators  – and all their materials are available for others to use. Really useful stuff on how to explain the issues affecting people with multiple needs  so that politicians and policymakers can understand the issues and the people better and thus, should be more able and willing to really listen.

Thanks to Opportunity Nottingham and Voices from the Frontline:

Voices from the Frontline is an “exciting new project to bring the voices of people with multiple needs and those who support them to the heart of the policy debate.” Click here for more info. I love their thinking! Opportunity Nottingham exist to help people fighting at least three of the following: Reoffending, substance misuse, homelessness and mental ill health. “In achieving our primary goal of helping people we are also going to change the way the existing system of support works.” Bloody fantastic! I love this new way people are starting to think regarding issues of homelessness and incarceration, mental health problems and drug use etc; we have developed certain tools of empowerment -now we need to cross that divide, find out how we can make politicians really, but really understand our issues. Places where we can find the common ground, the language; As they say in the notes of what came out of their collaboration, “We need to move away from defensive practice.  Services can help people raise their voice, but they’re not really listening if they’re only defending their own position”. So true, so  true. Visit these sites my friends, for some really useful tips.

Bye for now – and thanks to the people working so hard to develop these amazing organisations and work towards changing the minds of some of the stubbonist in society – the politicians and policymakers!!

Here is the piece below…

How to build support: frontline tips for influencing politicians and policymakers

See entire article on the website by clicking here: 

Last Wednesday, a number of participants in Voices from the Frontline traveled to the Multiple Needs Summit in London. Over the last few months, all of them have been involved in a conversation about what the next government should do to improve support for people with multiple needs.

A big part of this conversation has been about how to explain the issues affecting them so that politicians and policymakers can understand and will listen. For that reason, we held a joint workshop with Opportunity Nottingham (an organisation improving services for people with complex needs in the city) to explore this.

One thing was clear: there’s a huge amount of knowledge out there about how to put the case across. Here are some of the best tips that people had.

  1. Get the right people in the room, and you’ll get the right answers. Go into a room feeling confident. Get people to listen to what you say (even if they roll their eyes.)
  2. Bring people together and get them to talk about a real case study. Then they’ll realise that languages are different, and there are other worlds they very rarely think about.
  3. Beware of ‘innovation fatigue’. For instance, someone explaining Fulfilling Lives (a major programme to help local areas improve how they work with complex needs) met with people saying “you’re just another person coming to my meetings – we’ll never see you again”.
  4. Sometimes the bad news and bad stereotypes that exist can make it really difficult. It can help to capitalise on them, though. “If I don’t address those stereotypes, we haven’t had a conversation.”
  5. The higher people are up, the less they know about what’s happening down below. Build relationships based on helping them see what’s happening. How do you bring things that don’t work to their attention?
  6. We need to move away from defensive practice.  Services can help people raise their voice, but they’re not really listening if they’re only defending their own position.
  7. Be a critical friend.  Or, as one person put it, “don’t throw a strop.”
  8. Finally, don’t assume a divide between policy people and lived experience.  There can be more overlap in their knowledge and interests than we sometimes assume.

(Should you be interested, you can read all the notes from the workshop here.)

If you want to think about how your own organisation could do more to influence decision-makers, Opportunity Nottingham have produced a brilliant handout summarising some of the things they’ve learned. Feel free to share it with others who you think might find it helpful.

Making Every Adult Matter

Making Every Adult Matter (MEAM) is a coalition of four national charities – Clinks, DrugScope, Homeless Link and Mind – formed to influence policy and services for adults facing multiple needs and exclusions. Together the charities represent over 1600 frontline organisations working in the criminal justice, drug and alcohol treatment, homelessness and mental health sectors.

For more information, click here.

And for the conference called

MultipleNeeds Summit 27th April 2015

MultipleNeeds Summit 27th April 2015

MEAM Coalition

@MEAMcoalition

Making Every Adult Matter (MEAM) – A coalition of     and  dedicated to tackling multiple needs and exclusions.

Thanks for the chance for credited reprinting everyone. BP xx

 

 

 

 

 

 

 

Does England Need a Drug User Union?

IDUD_2014Hi, I received a comment from Joe (hi Joe!) who said he was writing an aricle on why Britain needs a drug user union and could we help? Well, it happens to be good timing Joe, because it is a discussion on many peoples lips – how to unify and strength the voice of the drug user in the UK enabling it to become more effective addressing issues that routinely affect the lives of drug users. For England however, it is even more pertinent as we are currently adrift  in what might be a diverse and eclectic drug user movement, but it is one without a unified voice, or indeed a mechanism to sift and reflect back through the real concerns of the drug using community at large. So what do we do? Well, we can start by answering Joe’s question. Do we need a drug user union in the UK? (Note: this is pitched at a newcomers look into the drug user union movement so does not go in depth into some of the issues that are bubbling away for the movement).


Union2_Hi Joe,
We do need a drug user union in the UK, just like they do in many other parts of the world. Whilst a trade union’s primary role is to represent their members on employment issues, a drug user union has often emerged in a country to focus on issues affecting drug users in treatment. And just like a workers union would fight for better pay and working conditions, a drug users union focuses at least half of their energy on ensuring drug users in treatment get treated fairly, humanely, and equally – like anyone else who is a consumer of a health service.

union5Historically and no different from many other countries,  drug treatment in the UK has varied widely in its ability to reflect the needs of its client group and has often been modelled on extremely punitive, isolating and demoralising approaches to treating drug use. The most widely used approach has always been the ‘Carrot and Stick’ model, where users are rewarded with privileges for compliance. This often means permitting take home doses of methadone if users choose to ‘get with the programme’ and show it by presenting no positive urine samples. The Carrot.

The stick happens when users are punished punitively when they ‘fail’. This has varied from the inexplicable; a reduction in ones prescription (just when they are showing they perhaps need an increase) to the common; drink your methadone supervised -which can mean rather humiliatingly drinking it at the chemist in front of everybody (including your children’s friends parents). But anyone who fully understands drug dependence in all its complexity, will know that punishments make no hay when it comes to the decision, or the overwhelming need to use drugs. In fact punishments often simply isolate the person further and drive them deeper into their dependence/addiction. People become resentful, unable to confide in the people who are supposed to be supporting them, and simply lose the resources, the motivation and the knowledge about how to make the changes they wanted to when they started the programme.

Tunion3wenty years ago when ‘user involvement started in the UK, we were coming out of the dark ages in terms of drug treatment. Today, with a high degree of user involvement around the country, things have been much better for the average drug user in treatment. But success in the UK has been patchy to say the least, and todays political ideology that directs the funding wand has caused not only cut backs in drug treatment but has created a whole series of new problems, problems which are ripe for a drug user union to tackle.

The UK needs independent union/s for drug users simply because they must have an independent voice in their treatment which affects, like a work union1or a trade union, a huge part of ones daily life. Much of todays user involvement is now suffering from the left turn it took many years ago to follow the money (and sometimes the support as well, both are understandable to some degree) and get into bed with the same health authorities they needed to have clear heads about. This has not only influenced some of the decisions such groups have made, sometimes at the expense of their communities, but has now left them defenseless to big budget cuts in the health service, money which is no longer ring-fenced to protect drug treatment. Drug User Groups that have spent years working, often for no pay, sometimes doing or supporting much of the work of professionals, have, at the stroke of a pen, been vanquished. Thanks for all the work mate, but seeya later.

Perhaps if we had set up as unions, even to the extent where users who wanted to join could pay their dues with the knowledge that they were getting something for their money; positive change, we would have a strong lead and vision for the way we want drug treatment to go in this country, a direction which is centred around the needs of the client, not the government, and not the key-worker or consultant. The client who is, after all supporting a massive industry of jobs, careers and reputations.

But drug user unions have a much bigger part to play in civil society. Unions can offer educational, lifelong learning and training opportunities to their members, just like real unions.

But drug user unions have a much bigger part to play in civil society. Unions can offer educational, lifelong learning and training opportunities to their members, just like real unions. Historically, unions have not only negotiated for and championed better workplace rights with employers but for a better deal for working people in the wider world. Having battled to extend the right to vote, it was the unions that created a political party that working people could vote for – the Labour Party. It is perfectly possible, as is reflected in perhaps one of the world’s most brilliant Drug User Unions, The Swedish User Union, for drug users to become directly influential in a country’s national politics; becoming to Go To organisation on drug related issues: Nothing About Us Without Us – the slogan for the drug user movement.

union4So yes, the collected strength and political ability of the English user movement is perhaps at a bit of a crossroads, or on a cliff edge, or even a sinking boat. It has only to look to its brethren in Scotland and Ireland (north and south) to see shining examples of cohesive and effective partnership working and union values, forging better and more humane drug policies in various sectors like health, criminal justice, treatment etc. But the space is empty for a unified user voice in England, the seat is up, the pantry littered with almosts and nearlies. Yet the values of a drug user union are urgently needed today. For those drug users still struggling with substandard or punitive treatment, poor engagement opportunities, or one size fits all care, it is just as much-needed for the society we live in, the drug policies that desperately need our thoughts, creativity and input, the solutions to community drug issues that only we as drug users can really pinpoint and tackle effectively. But that’s not all. What about unions at work?

All the unpaid hours we do to better our communities as harm reduction and recovery workers, all the glass ceilings we encounter despite our enormous skill and ability. Indeed Canada has recently ensured its harm reduction workers have been able to come together under a union banner as the Harm Reduction Workers Union, a really marvellous idea that is also primed as a template for other countries to adopt. And while history tells us that England, indeed Britain, has always been a rather tribal country, with tribal interests and cultures that still affect the way shires and counties do things, it will be basic union values that are able to touch a common core through all that diversity, and hopefully, bring us home to a unified drug user movement. A movement that is solid and secure with our UK brethren, allied in defence of ever more humane drug policies for our societies. And a vision of innovative and responsive drug treatment that is driven forward by equally by ex/current drug users and a diverse orchestra of dedicated others forever fine tuning our treatment and information response. All leading our communities down the right road ahead, across the changing landscape of drug using Britain today. Erin O’Mara

International Drug User Day, Nov 1st, 2014

International Drug User Day 2014 – Let’s hear 3 cheers for that activists

activist -Theo Van Dam, the beautiful Dutchman who came up with the

brilliant idea of a day in the calendar to celebrate the existence, the

achievements, the lives and the work of people who use drugs and their

brave and courageous direct actions that have been challenging wrongs

and fighting injustice, wherever it lies in the world.

Drug User’s must always be part of the solution and never framed only as the problem. Our  lived, perceptive and insightful lives will always provide our communities with the insight and language to tackle the issues that black markets have left us; society must work with the drug using community to end the crippling discrimination, criminalization, marginalization and isolation felt by too many – generation to generation; and for what? So some could drink beer while others could not smoke dope? So some could arrest an entire  people of colour while others could put on the guards hat and boots while swinging the keys in the lock, stops the clock….IDUD is our day friends -walk tall, believe in yourself not based on your drug or the frequency you use it, but based on the person you really are deep down. Drug users will not be defined by their substance or by societys ignorance; only by the quality of their soul at the gates. Yessirree! November 1st – celebrate it all day friends!

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.

HIV/AIDS in 1985; No Really, We Will Never Forget…

It was 1988, in Wick, a small highland town in the far north of Scotland. My wife’s ex boyfriend had been diagnosed as being HIV positive. We knew we had to get tested. My wife was from the infamous period in Edinburgh period of shooting gallery’s where it was so hard to find works (syringes) that people would stand in a line and the dealer would cook up the hits using te same syringe on everyone.

There was a prototype of a needle exchange that had been running from an area called the Grassmarket in Edinburgh but the police were routinely arresting people who visited it. The police eventually closed it down in the early 1980’s. The cops were very hard on junkies who were injectors.

It was a strange time where you could be busted for having traces of gear or even a needle packet on your person. But the drug that was the real gold dust for the using community was Diconol which were bright pink tablets (I think that were made by Roche -dipionone hydrochloride).

Opus Morphia from David Graham Scott on Vimeo.

This film was made by David around the time (1985). Incredibly, he did not go to film school.

It was a really strong opiate analgesic, a mixture of Cyclomorph and a sort of anti-emetic) and the rush was the reason people bought it. It was like a religious experience, you generally felt you were in the company of God for a few moments,  it was a truly beautiful sensation, the best I have ever had in my life.

So anyway, my girlfriend and I went to get tested. I wasn’t really bothered about it, I never even thought I’d be positive, and neither did my girlfriend.

Three weeks later the results were in and it was my girl that got the bad news. She was positive and  I wasn’t. I said I would stick behind her no matter what happened; and typical of her (remains anonymous), she took it all in her stride. God only knows how, as things would get a lot, lot worse.

I would go with her to the HIV clinic and all the positive people had to sit along a wall. There was those old-fashioned weighing scales measuring height and weight, and without any privacy whatsoever, they would announce your weight, like at school, and because everyone always went there  coz they had to for their methadone (there was almost nothing on offer then), it was like some cattle market.

Gallows humour would run loose among the patients, as is the Scottish way, topped off with small junkie self platitudes such as ‘thank fuck I ain’t as bad as him’ .  Comments bounced around the echoing hospital hallways like” Oh, he is going down….61Kilograms today laddy, that’s quite a drop to tell ya ma” or “Oh,lookee there, she has that whatsimacallit, the scabby things, she must be getting AIDS nurse, right or no? “, and on and on it went. People just wasted away in front of you, on parade for all of us to see.

 

Episode 2 will tell you more from David of the shameful story of Edinburgh and HIV/AIDS in the 1980’s and should be about a week behind this.  

HOWEVER!!!

You can see more about David Graham Scott’s exemplary career in filmmaking, covering various issues but covering brilliantly his experiences as a junkie, or indeed battling ‘junkdom’.

In particular the famous ‘Detox or Die (his personal experience of undergoing an Ibogaine detox on film a decade ago (available to view today free online and on DGS’s Vimeo channel to this blog on INPUD’s webpage. This just released film (which you can read about on the link provided) called Iboga Nights. It is the culmination of three long years of in-depth research into the drug Iboga and the lives and detoxes of the accompanying clutch of courageous, wonderful characters involved in the film, the much called for sequel Iboga Nights (google it but we will review it shortly) was a big success on the documentary film circuit recently winning much deserved awards and acclaim.  BP will cover this next in more detail. If this has whetted your appetite, look for David Graham Scott on Facebook and speak to him directly! Or you will find much covering both films and more by googling it.

 

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