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)
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).