The Swedish Drug Users Union annual conference began this morning and I hope to give you an overview of some of today’s more poignant moments, with the added dimension of Swedish drug policy and its impact on its drug users. Only the 2nd annual conference to be organised by the Union, it has been quite a feat to pull off, and the caliber of speakers attending gives credit to the Unions importance here in Sweden.
Pat O Hare gives the Swedes a wee dig.
The first speaker of the day was Pat O Hare, who many of our INPUD members will already know. Someone who has done an enormous amount of work for the cause of harm reduction for over 30 years, it is something he believes in firmly and unshakably. He is married to Annette who works in UNAIDs and has 2 daughters, both also working in harm reduction. It is, as they say, in the genes.
Pat spoke animatedly and personably to the Swedish audience and happily for us, pulled no punches. His technique was quite well thought out. He began by gently spoon feeding the audience harm reduction – what it is and what it actually means to each of us in our lives; It is the filters in our cigarettes, it is the pin holes bored out of the tops of bic biros so babies won’t choke to death from swallowing pen lids. It is a bandaid he explained – not a solution to solve all our problems but one that can reduce potential harm.
He then looked exasperated and asked the obvious question; But why is it that Sweden, a paragon for the presevation of human rights – are no-where when it comes to harm reduction? This zero tolerance approach of Sweden seems to lie in massive contradiction to their wildly more humanistic view of people and the part they should play in the community. Its a massive paradox. What, O’Hare asked, lies behind this? A question I had been curious of myself. He answered however by suggesting that it was Sweden’s roots in the temperance movement, that rather puritanical shade of moralism that grew out of the earliest days of Swedish society, that has meant that their societys views on drug use, is today still totally out of step with 90% of Europe. They EXPECT a drug free society, and they are hanging onto this with the dogged determination of the religous zealot.
Heroin (Campaigns) Screw You Up
Pat went on to talk about the history of harm reduction, where it sprang from in the UK, the Liverpool experiment, now well known and referred to around the world, and the general shift of approach in the UK from the ‘Heroin Screws You Up’ campaign of the mid 80’s, to the Advisory Council on the Misuse of Drugs seminal report that stated AIDS was more of a risk to society than drugs, therefore we needed to look at how to encourage people to modify their own behaviour in order to protect themselves and their communities.
The heroin screws you up campaign – didnt work. He paused. ‘Don’t tell people lies about these things, heroin CAN screw you up, but dosent always”. The campaign was not based on truths and so very quickly lost credibility and the posters of wasted youth staring off into space soon adorned the bedrooms of teenage girls who found the junky look alternative and risque.
The development of harm reduction however, has lasted and has worked. Giving people the tools to change their behaviour is what lasts – not the tricks or scare tactics which have no longevity then or now.
Then out came some stats;
13million drug users worldwide.3 or so million HIV positive. 63 countries now providing bupenorphine or methadone.
Yet Sweden still remains baffling. He reeled of some of the information I had heard the Union speaking of over the last couple of days. No one under 20 years old permitted to access a NEP. If you had a blackmarket Bupe habit, you were not allowed to get bupe on prescription. You had to be a heroin addict first – and then you could get assessed to get Bupe. The Union staff, as Kicki said later, would have to advise blackmarket bupe users to go out and use a bit of heroin in order to be accepted to get a bupe prescription.
Then Pat stepped up the tempo; “In 35 cities with NSP there was a mean decrease in HIV rates of 18%. Yet in 67 cities without NSP they had a had a mean increase in HIV of 8.1%” Then, looking directly back at the audience he said, “And you are saying there is NO NEEDLE EXCHANGE in Stockholm? This is disgraceful”
Then, looking directly back at the audience he said, “And you are saying there is NO NEEDLE EXCHANGE in Stockholm? This is disgraceful”
Pat outlined the cost savings of harm reduction, the UN declarations and politics surrounding HR and finished by turning to the Swedish User Union and in front of an audience of clinicians and politicians, spoke of his solidarity with the Union and that they have his unerring support.
Pat finished his speech and the next speakers were Swedish, so without translation at this point I had to do some reading between the lines and I took a break to recharge my laptop. I went and got a coffee and spoke to another Union member, this time Pierre from Halmstad. He told me there are 90,000 citizens living in Halmstad and only 17 people on the methadone programme, ‘Although, now there’s 16’, he said, ‘one died last week, a young girl, she was only 23’. I asked him how they coped with having no needle exchange. He told me people have to travel around 200kms to one of the 2 NEPs in Sweden (MalmÖ or Lund) or, more likely, many have to reuse their works over and over and naturally end up sharing with each other. A truely shocking state of affairs in western europe in 2009.
Lunch beckons, the speakers have concluded and Ill take a break here to suss whats been happening on the stage. Look forward to it heating up later on, I think Berne wants a few hard questions fired at the pollies!