The Global State of Harm Reduction for 2014

We Must Not Be Left Behind 

“In most communities, people who inject drugs don’t have access to syringes to prevent infections, opioid substitution treatment, or naloxone to prevent overdose. Moreover, people who use drugs are denied basic health services. They have no access to non-judgmental primary care, mental health and drug treatment services, and the support they need to maintain stable, healthy lives. And yet, harm reduction has been proven time and again to be extremely effective in curbing HIV transmission. In settings where comprehensive harm reduction has been implemented, HIV rates among people who inject drugs are low—in some cases, almost negligible.”  The Global State of Harm Reduction 2014

So why, why why  are such effective solutions still being left behind on the political table? We can see the results of what being ‘Left Behind’ really means – burgeoning disease and death. It’s all so avoidable!

One of the sectors most useful and interesting reports released its 2014 data, last week.  The report -The Global State of Harm Reduction which was first published back in 2008 by Harm Reduction International, provides independent analysis of the state of harm reduction across the world.  This enabled a really useful baseline to be developed, against which we can now measure actual progress of harm reduction in its global march of common sense. It now allows us all to see much more clearly,  the actual mapping  of harm reduction policy adoption as it occurs, as well as programme implementation globally. It has also permitted the documentation of the various, associated responses to the HIV and hepatitis C epidemics that are related to  injecting and non-injecting drug use and perhaps most importantly, we can see the results of  implementing harm reduction practices on the health of drug users across the world.

About US $ 2.3 billion annually is estimated by UNAIDS to be required to fund HIV GSHR-2014-coverprevention among people who inject drugs in 2015. At the last estimate, only US$ 160 million was invested by international donors – approximately seven per cent of what is required. In contrast to the lack of funding for harm reduction, each year governments spend over $100 billion on arrest and imprisonment of people who use drugs, destruction of drug crops and other drug control measures. HRI argues that if just a tenth of this money were redirected to harm reduction, it could fill the gap in HIV and Hepatitis C prevention for people who use drugs twice over.

Eliot Albers, our Executive Director at INPUD,  wrote the forward for the Global State of Harm Reduction 2014, and explained just how profoundly linked are the entwined issues of donor funding, prevention spending and the epidemiological spread of HIV and HCV disease. Investment in harm reduction as part of overall prevention spending is nowhere near proportionate to the reality affecting people who inject drugs on the ground, illustrating, Eliot says, that “donor priorities are out of alignment with epidemiological trends”.

It seems clear that as long as governments refuse to invest equally in prevention, those incredible strides forward during the last 30 years of HIV, end up being whittled away.

The INPUD Executive Director added, “Whilst the retreat from investment in harm reduction places the lives, health, and rights of millions of people who use drugs around the world in jeopardy, the international drug users’ movement has never been stronger, having successfully fought to occupy our rightful place as a vital partner in every debate that impacts upon our lives and health on the global, regional and national stages”.

However, he went on to say that success of this agenda is contingent upon investment in community systems, strengthening and empowering organisations, networks, and communities of people who use drugs.  Eliot also stated  “If [harm reduction] services are to be truly accessible, acceptable, and appropriate, they must be returned through a process of power-shifting to the communities they serve.”

We must fight to be seen as the solution to improving the health of our communities, and to never to be framed as the problem. And we must never accept the reality of what it means to be ‘Left Behind’.

“Every person left behind is a fellow human being – someone’s child, someone’s parent, someone’s friend, someone’s partner. Every one of them has a right to life and to health. Every one of them deserves compassion, and dignity, and love.” (David Furnish, Elton John Foundation: Forward in the Global State of Harm Reduction, 2014)

Some of the main points to emerge from this report over 2014 were (actually this report is a biennial document -all relevant links below)

Main Points to Emerge Over 2014:

  • Good and Bad: In 2014, 90 countries and territories implement Needle and Syringe Programmes (NSPs) to varying degrees but another 68 countries with reported injecting drug use, do not provide any NSP services
  • Good: Malaysia, along with Iran and Australia, had experienced the steepest increase in the number of NSP centres, from 297 sites in 2012 to 728 in 2014.
  • Bad: The provision of NSP in prisons globally has declined since 2012 with only 43 countries provide OST in the prison setting;
  • Good: In 2014, 80 countries and territories implement OST (Opiate Substitution Therapy/treatment -mainly methadone and buprenorphine);
  • Bad: An estimated eight percent of the world´s injecting drug users can actually access opioid substitution therapy such as methadone or on a global average they are only able to access two clean needles per month.
  • Worrying: New and emerging patterns of injecting drug use in sub-Saharan African countries such as Tanzania, Uganda, Senegal, Zanzibar and Kenya will require a further scaling up of the provision of opioid substitution therapy (OST) such as methadone and buprenorphine and needle syringe programmes (NSP) in order to effectively respond to the growing HIV/AIDS epidemic amongst people who inject drugs in the region. In 2012 the Kenyan government announced the initiation of NSPs within the country, resulting in ten newly operational sites in 2014.
  • Worrying: It also notes the concerns over the documentation of high-risk injecting practices, including that of flashblood occurring in Tanzania and Zanzibar (see link) and the marked increase in stimulant use that is evidenced in research into increased risk behaviours for sexual transmission of HIV. It cites as an example, that in Western Cape Province, the proportion of admissions to drug treatment facilities for methamphetamine as the primary drug used increased from 0.8 per cent in 2001 to 52 per cent in 2011.  The recent establishment and scale up of community based opioid substitution therapy (OST) in Tanzania is a significant step forward, rising from one site to three in the city of Dar es Salaam. This makes the OST programme in Tanzania the largest government-run programme in the region, with over 1,200 people receiving methadone in 2013.  There has also been a scale up of NSPs in Dar es Salaam, Tanzania, increasing from one site in 2012 to seven in 2014.
  • Good: In 2014 there were 88 drug consumption rooms (DCRs) operating worldwide – outside of Europe two DCRs are in operation, one in Australia and one in Canada. In Western Europe, Denmark saw the implementation of five DCRs, and both Spain and Switzerland, who had previous DCRs in operation increased their site provision by six each.
  •  Good: The provision of overdose prevention medication (e.g. Naloxone) has increased most markedly in North America.In the United States, as of June 2014, there are 30 states plus Washington DC that have at least one point of access for laypersons to obtain Naloxone for people who use drugs – or friends and family;
  • Worrying: In the Middle East and Northern Africa region (MENA), one of only two regions in the world that continue to experience increases in HIV infection rates, harm reduction coverage is non-existent in many countries. However, small scale implementation of needle syringe programs now operate in Egypt and Jordan.
  • Good: Iran continues to be word leader both in and outside the region – OST and NSP are widely available in the community as well as prisons;
  • Worrying: The Eurasian region is home to an estimated 3.1 million people who inject drugs, with two of the largest populations living in Russia (1.8 million)) and Ukraine (310,000). Eastern Europe and Central Asia is one of two regions globally where rates of HIV infection are continuing to rise. Opioid substitution therapy (OST) is available in 26 countries of the region, with only three countries reporting evidence of injecting drug use not providing OST: Russia, Turkmenistan and Uzbekistan. In Russia it is a criminal offence to promote or supply methadone;

To download your copy of the Global state of Harm Reduction 2014, click here.

INPUD discusses the International Harm Reduction Conference, 2015

Twitter: @HRInews / http://www.twitter.com/HRInews

Posted in Eastern European Countries, Europe, Hepatitis C, HIV/AIDS, IHRA, Latin Countries, law enforcement, methadone | Tagged , , , | Leave a comment

My Treatment, Their Treatment, My Hell

poppy4

 

I’m sitting here, furious. My anger is palpable it’s so real and although I was thinking no, I won’t have time to do this blog tonight, I have changed my mind because my fury is now driving me. The Mental Health System in the UK? Yeah, I can tell you about that lets see where shall I start?

MentalAnguish_scissors

Art from iloveaks (click for link)

 

 

 

Me

I’m a survivor of incestous sexual abuse, of domestic violence/abuse, of the realities of sex work…I am a “problematic” drug user,  a crack injector who’s spending in the region of £300.00 a day in the hope that the next hit is gonna be the one – the one that finally sends me over but no, oh no ….. I’m still here!  Still here, after years of abuse and bullying and what have my local mental health team done for me? Nada, absolutely fucking nothing!

My diagnosis? What does it even matter because MentalAnguishSillouettelike so many others before me I’ve had no choice but to learn how to live with this alone! But for those interested I’ll list my ills which include post traumatic stress disorder and underlying anxiety disorder, night terrors and insomnia, chronic fatigue syndrome (CFS) and an ‘antisocial personality disorder’ diagnosis.

Instead of being assessed and medicated correctly by my local Community Mental Health Team (CMHT) and GP, they take one look at my drug using history and they make an immediate judgement; “I did this to myself” and therefore I don’t deserve to be listened to or cared for.

My Husband

My late husband was in the same situation. He killed himself. It happened 2 years ago but it might as well as have been yesterday; I walked into the living room and found him … dead, still sitting upright on the sofa.

Just four days before I had had a huge argument with the Community Mental Health Team and I told them I was not leaving until they put some treatment in place for Joe! They palmed him off with a referral to some inadequate  project .

It was too little, too late for Joe.  The plain and simple fact is that for 18 months no one was hearing him or me and four days later he was dead because they did not care!

The fact is that in my country today if you have mental health problems coupled with ‘drug use’ you are invisible as far as professionals (I believe thats what they call themselves?) are concerned. It really feels like they have to ‘put up with you’ whilst working out ways in which to discharge you out of their care. I truly believe that the reason this happens is because the whole issue of dual diagnosis is perceived as just too complicated to manage.

MissU

 

 

 

 

 

 

However, mental health nurses for the most part, are not trained in addiction psychology, their training ends when they acquire their degrees and from there on in it’s a journey of crisis management. Many look upon it as a self imposed disorder that appears to divert the resources from mental health’s more deserving patients. Therefore, the often simpler route for them is to make a referral into the care of a drug service regardless of whether or not the drug service has the skilled professionals available to work with such complex needs .

It’s easier for many to use the  psychiatric professions’ standard excuse that ‘we need the individual to be drug free in order to assess the state of mind’. However, today’s recommended treatment for co-occurring disorders is now an integrated approach, where both the substance problem and the mental disorder are treated simultaneously.

 The ignorance surrounding drugs and drug users and the resulting prejudice shown towards this client group is now so entrenched in the institutional culture that it has become the norm to just dismiss those drug users who are suffering from severe mental distress.

The ignorance surrounding drugs and drug users and the resulting prejudice shown towards this client group, something the profession would never of course admit to, is now so entrenched in the institutional culture that it has become the norm to just dismiss those drug users who are suffering from severe mental distress.

Most, if not all CMHT’s are under funded so expecting any innovative or forward thinking approaches regarding improving the quality of life for people who suffer with mental health problems is nothing more than wishful thinking. What we need are proper multifaceted treatment centres with a range of different approaches and interventions that can deal with prescribing regimes and are not influenced by a ridiculous notion that most patients do nothing more than engage in pleasure seeking behaviours.

We need the mental health system to become a vocation once again, for it to employ staffmental-illness that actually care, staff that want to engage in partnership work and listen to their patients and their families in order to create care plans that include the views and needs of the patient/client. Then they must refer patients to the right places for continued care and support in the community. Money needs to be invested into our mental health services, the majority of them look like wash houses, they’re drab, falling apart, and look gloomy and depressing. My God, if you wanted to kill yourself before you go into one of these facilities you’ll make sure your suicide plan does not fail the second time round, just so that you don’t end up back inside one of these hell holes!

My Son

Eye

Art by iloveyaks.deviantart.com

My son…For god’s sake, it has taken them 12 years to give him the correct diagnosis of autism. From the age of 16 he was incorrectly labelled as a paranoid schizophrenic and after countless sections’ in the psychiatric ward and a pointless number of rehabilitation centres later they finally give him the correct diagnosis, but guess what? They can’t find a suitable rehab for him because they don’t exist in this country!  Bloody marvellous isn’t it? Apparently his condition has a component related to language which has just recently been identified and there are not enough facilities or trained staff to be able to work with this disability.

You may be thinking “oh she’s just mad because both her and her family have been shunted back and forth from one service to another without any positive effect” but no, this is not the case.  I am angry, of course I am but something has to happen, this type of patient negligence cannot continue.

Yes, this is our “big society” Britain today, make sure you tick all the boxes else you don’t belong here!

Anon

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INPUD LAUNCHES FOUR NEW DOCUMENTS OF THE DRUG USER PEACE INITIATIVE

17 JANUARY 2015

The International Network of People who Use Drugs (INPUD) has launched four key

Dr

Drug Peace

documents as part of its Drug User Peace Initiative campaign, each with a specific focus, and preceded by an Executive Summary and Foreword:

- Human Rights Violations of People who Use Drugs
– Stigmatising People who Use Drugs
– A War on the Health of People who Use Drugs
– A War on Women who Use Drugs

The Drug User Peace Initiative is a unique contribution to the growing global debate about, and demand for, a critical rethinking of the prevailing dogmas of punitive drug prohibition. The Drug User Peace Initiative’s uniqueness springs from the fact that it is a major statement from the perspective of the drug using community itself. The four separate, but interlinked, documents, show clearly the systemic harms done to the health, civil liberties, human rights, dignity and autonomy of people who use drugs from our perspective, and demand an end to the war waged on our community on our terms. The documents will serve as INPUD’s principal advocacy tool as we prepare for the2016 UN General Assembly Special Session on Drugs (UNGASS), and lay out a clear and compelling case for progressive change from the community most adversely affected by the militarised war on drugs.

The Drug User Peace Initiative demonstrates that the war on drugs has served as a pretext for social control, has been endemically racist, and has impacted most extremely on women who use drugs, young people who use drugs, poor people and communities of colour. Demanding a drug war peace is an essential element of any comprehensive agenda for far reaching systemic change based on human rights, civil liberties, equity, and a concern for the empowerment of marginalised communities.

Please invite your friends, community and family to sign up to and support our campaign. Together, we can end the war on drugs.


The International Network of People who Use Drugs (INPUD) is a global peer-based organisation that seeks to promote the health and defend the rights of people who use drugs. INPUD will expose and challenge stigma, discrimination, and the criminalisation of people who use drugs and its impact on our community’s health and rights. INPUD will achieve this through processes of empowerment and international advocacy.www.inpud.net

The papers of the Drug User Peace Initiative are part of INPUD’s work under Bridging the Gaps – Health and Rights for Key Populations. In this programme, almost 100 local and international organisations have united to reach 1 mission: achieving universal access to HIV/STI prevention, treatment, care and support for key populations, including sex workers, LGBT people and people who use drugs. Bridging the Gaps is funded through the Netherlands Ministry of Foreign Affairs. Go to www.hivgaps.org for more information.

The production of the of the Drug User Peace Initiative documents has been made possible with the financial support [in part] of the Robert Carr civil society Networks Fund and supported [in part] by a grant from the Open Society Foundations.

http://www.druguserpeaceinitiative.org/

http://www.inpud.net/INPUD_Press_Release_Drug_User_Peace_Initiative_17Jan15.pdf

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The lives behind the diagnosis

Here is a bit of interesting information from the world of HIV and drug / alcohol use.

From October 2007 through to April 2010, researchers conducted a cross-sectional analysis of participants looking at HIV’s Evolution in Russia; called Mitigating Infection Transmission and Alcoholism in a Growing Epidemic (HERMITAGE), the study was based in St. Petersburg, Russia.

They managed to recruit 700  HIV positive people, who were also identified as  ‘risky drinkers’. This seems to have meant that the participants did not mind regularly having unprotected sex and indeed all had reported unprotected sex within the previous 6 months. Data were collected through interviews and self-administered questionnaires. This analysis included 605 of the participants enrolled on the HERMITAGE study.

in_bed2gether

To tell or not to tell? Is that the only question?

It was, I thought rather disturbing to note that more than half of the participants reported not disclosing their HIV serostatus to their sexual partners. The participants reported a total of 958 sex partners, and ‘48.9% of these actual partners were not informed of the participant’s HIV status’.

However the researchers felt that society could not lay the blame at the feet of alcohol, or alcoholics or even a drunk person. The idea that a drunk person is less likely than a non drinker to tell their sexual partner that they were actually HIV positive is in fact as the data showed,  completely wrong.  The researchers found no association between alcohol dependence, risky alcohol use in the past 30 days or drinking at the time of sex – with nondisclosure of HIV status.  They added “Among casual partners and seroconcordant couples, alcohol use at the time of sex was associated with decreased odds of nondisclosure.” In other words, alcohol use at the time of sex was actually associated with people being MORE LIKELY to tell their sexual partner of the HIV positive status.

BUT! This still leaves us with a POTENTIALLY disturbing figure that the majority of this particular Russian HIV-positive population did not disclose their HIV serostatus to practically half of their sexual partners, a figure that I expect is mirrored in many countries around the world. But before you recoil in horror, remember that people should not really have to tell anyone of their positive status -if couples are using condoms (and/or anti retrovirals) then there is no real risk of HIV transmission.

Now we would all like to assume that people DO and WOULD tell a sexual partner if they had HIV, especially if one was about to engage in unprotected sex. But who’s responsibility is it? Sex is a 2 (or 3, or 4!) way street, which means it is up to everyone involved to look out for themselves -but also, ideally, for each other too.  Sometimes we just have to weigh things up -am i putting myself at risk of violence or abuse by disclosing? If not, does the other person deserve to know the whole story before we sleep together so they can make an informed decision? Would their decision though, be properly informed? Most people don’t really know the whole facts on HIV transmission, and how would you deal with a person freaking out on you and grabbing up their clothes while calling a cab home!

possie and neggie? Now what?

possie and neggie? Now what?

Sex is a messy business: perhaps we could hope to ask that people would at least not lie about their status, or that if they did not wish to disclose it they could at least ensure that they used protection to protect both parties from problems down the line.  However, the discrimination that surrounds HIV is still such a degree that many simply cannot afford to divulge their status quickly, easily, regularly without the possibility of awful repercussions from family, or society.1347367131-1hivol_aids_pill_condom_retroviral

The result of these studies reiterated the importance of counseling of HIV positive persons about HIV disclosure to their sexual partners, something which should, according to the researchers, become standard practice. If however, people decided not to take anyones word for it but insisted on safer sex at all times, then one could avoid finding themselves in such difficult dilemmas. But of course, love and life are not black and white, and things are never that straightforward. It always behooves us to be as honest and trustworthy, caring and compassionate as we can be in this life, even if it is not returned. Yes we have to weigh things up, but it is also up to each and every one of us to educate our friends whenever we can on discrimination and its effects. We owe it to each other and our communities to try and be honest and open as often as we can, including in the bedroom, but we also have to allow people to feel able to share what can be frightening news, while feeling safe to do so.

One more thing before we leave the subject of HIV: 

hiv-aids-dating

Edelman EJ. AIDS Behav. 2014;doi:10.1007/s10461-014-0948-z.

E. Jennifer Edelman, MD, of Yale School of Medicine, said in a press release:

CD4 counts lower in occasional heroin users with HIV than in consistent users

Dr Edelman studied the data to emerge from a group of 77 HIV patients who were already enrolled within the HERMITAGE  trial ( mentioned above). Participants  were, as we said, in the class of ‘at-risk’ heavy drinkers,  drinkers who were not enrolled in anti retro viral treatment and reported unsafe behavior during the 6 months before the study began. Participants’ substance use was also self-reported at 6 and 12 month follow-ups as either no use (n=39), intermittent use (n=21) or persistent use (n=17).  (Note: Change between baseline and 12 month CD4 counts was the primary endpoint).

Dr Edelman found that, listen up positive junkies,  “Occasional heroin use, as opposed to persistent or no use, could lead to lower CD4 counts in people with HIV, according to recent data.”

“Our findings suggest that heroin withdrawal may be particularly harmful to the immune system, as measured by CD4 cell count.”

“We expected that HIV-positive patients who abused heroin on an ongoing basis would

Check out a terrific Canadian site on HIV and drug use - click this image -thanks to CATIE

Check out this Canadian site on HIV and HCV – just click this image -thanks to CATIE

have the greatest decreases in their CD4 count, but this preliminary study showed that those who abused heroin intermittently had lower CD4 cell counts, indicating a weakened immune system,” Edelman said in the release. “Our findings suggest that heroin withdrawal may be particularly harmful to the immune system, as measured by CD4 cell count.”

Well, we could have told you that Dr Edelman! Us junkies just KNOW that hanging out is bad for us! Okay, Okay, they do say that good research bears out what is already known to be true.

Dr Edelman continues, “This manuscript represents an important step toward identifying the need for future study of the effects of heroin withdrawal on HIV disease progression, as it may have unique effects compared with chronic and no heroin use,”

Therefore, HIV positive heroin users who are constantly going up and down in their use and thus their habits,  or, in other words, regularly ending up in cold turkey -sick, not sick, sick, not sick etc, seems to show that this on off approach is significantly worse on the immune system that consistent heroin use is.

In fact, the greatest change during the study period was seen in intermittent heroin users with a mean decrease in CD4 count of –103 cells/mm3, while those who reported consistent use had a mean increase of 53 cells/mm3.  And for those who reported no heroin use at all, a smaller mean decrease of –10 cells/mm3 was seen in this group.

Another piece of research that should underline the importance of HIV positive people being brought into either OST (Opiate Substitution Treatment) or given access to a continued, regulated supply of the opiates they need until they feel ready to stop using completely. Until then, it seems some kind of OST is essential. But again, we all knew that didn’t we?

Happy new year friends,

Erin at INPUD x

Here’s a good blog from a possie person talking about relationships and stuff and some of the things both possie and neggie people grapple with on the subject. Worth a read.

And here, if you want to start looking at the Swiss Study and the fallout from that -the one that finally said out loud that if you are on HIV anti retroviral treatment, your chance of transmitting HIV is virtually nil…

 

 

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Harm Reduction Workers Union Takes Off in Toronto

NEWS: INPUD SUPPORTS TORONTO HARM REDUCTION WORKERS UNION (THRWU)

12 NOVEMBER 2014

The International Network of People who Use Drugs (INPUD) is pleased to support and show our solidarity with the Toronto Harm Reduction Workers Union (THRWU) who went public on 11 November 2014 with the first ever harm reduction workers’ union.  Members of INPUD have been involved in this campaign.

Toronto Harm Reduction Workers Union -A template for global change! What are YOU waiting for?!

The Toronto Harm Reduction Workers Union  is a city-wide organization, representing over 50 employed, unemployed, and student workers. At the launch workers at two of the city’s largest harm reduction programs went public with their affiliation to the Union which is a part of the Industrial Workers of the World (IWW). The IWW is a fighting union for all workers that organizes workers regardless of skill or trade and it is member (not staff) run, with a long history of fighting for the most oppressed and marginalized workers in society

The majority of these workers have been hired for their lived experience of using drugs, incarceration and homelessness and are continuing to organize with the goal of unionizing all of the city’s harm reduction workers.

THRWU speak about the need to organise around many of the issues affecting the industry – of which many harm reduction workers who come from a drug using background, will know a lot about. THRWU point to some of the main areas on their website:

  • Discrepancies in wages, with workers doing similar work taking home vastly different pay.
  • People work for years without raises, and have limited to no access to benefits, vacation and sick days.
  • Management depends on social assistance to provide the basic benefits that workers need (such as emergency dental and drug benefits). This is especially detrimental for those of us hired because we live with HIV and/or Hep C, or use opiode substitution therapy.
  • Workers are discriminated against based on the lived experience they are hired for.
  • Many positions are extremely precarious, with grants and funding threatened by conservative and anti-science ideology, and austerity budgets that endanger public health.

These are very real issues affecting the daily lives of people who’s work is not just a job, but a ’cause’,  a life, based on their lived experience and a way to put their heart and soul back into their communities, funneling years and years of privileged insight into their work, which has gone such a long way towards stemming the HIV epidemic in the drug injecting community. And damn right they deserve paid work or a raise along with everyone else! Damn right their should be the chance of promotion from volunteer to worker, to team leader to manager. Let’s all be clear here, harm reduction would not work saving the lives it does, reducing the harm it does, stemming the tide of infectious diseases that it does, without the world’s harm reduction workers and many of these are our peers. People who use drugs, used drugs, are on prescriptions etc.  The majority of work is unsung, underpaid and under acknowledged for the real impact it has on the community.

So who are we talking about exactly? Well, let’s let THRWU speak for themselves!

We are the workers that make harm reduction work.  We are the kit makers, outreach workers, community workers, and coordinators that reduce the harms associated with bad drug laws, poverty and capitalism.  As working class people, our communities have been hard hit by the War on Drugs, the epidemics of HIV, Hepatitis C and overdose deaths. We are organizing to better our working conditions and improve the services we provide. And we are organizing to fight for a society free of oppression and injustice.”

Below is THRWU’s mandate and definition of harm reduction:

“THRWU is an organization of Harm Reduction Workers who are united together in solidarity, to improve our working conditions and to strengthen equality in the workplace for the betterment of the workers and those who access the services. We are a union of employed and unemployed workers committed to harm reduction with a range of skills, education and lived experience. We have come together in our common concerns to form a non-hierarchical democratic labour union with a commitment to mutual aid, social justice and the principles of harm reduction.”

“Harm reduction is an evidence-based and practical approach to dealing with the harms associated with drug use…Harm reduction also aims to respond to harm experienced on a structural or societal level (such as stigma, discrimination and criminalization). This work should be grounded in the values of respect, non-judgment, and in the promotion of self-determination and self-empowerment for folks involved!

We recognize that many healthcare and social service providers endorse a ‘harm reduction framework’ in name only. Our union will prioritize those workers who are actively engaged in harm reduction work, as defined above!”

INPUD, the International Network of People who use Drugs are positive about the future as more drug users self organise. In a statement of support INPUD said, “In the context of the War on Drugs, in which our fellow workers are the casualties, an organizing campaign of this nature is exciting. The THRWU is setting itself up to be a powerful voice for harm reduction workers in the workplaces as well as in broader political struggles”. Last word to THRWU: “We need to organize ourselves to demand an improvement in wages and in workplace conditions. We love the work we do but we also know we need to be treated more equitably. There are many of us working in harm reduction and we can work in solidarity with each other to improve this.”

Boy oh boy, lets wish them luck with their new unionised labour force and their further organizing efforts!

How do I organize a Harm Reduction Workers Union in my city?

If you are interested in building a Harm Reduction Workers Union in your city, get in touch! thrwunion@gmail.com

For more information don’t miss visiting their website www.thrwu.org or by email  and  – if you are in Toronto – JOIN UP!!

Check out more of their news and events on their FaceBook page herehttps://www.facebook.com/thrwu
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