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The reality of injecting, sharing and accessing needle exchange
Colin Stewart, Drug Advisor, Release
Abstract
Twenty years of needle exchanges, protection for the whole lifetime of many younger addicts and many middle agers, should make us feel this is something to celebrate, but the reality is, I think, far different!
The needle exchange system looking back, was such a positive move, being able to go to my little local pharmacy and having the option of an orange or green pack given politely by the pharmacist and being treated with a level of respect, unknown for those of us injecting in the seventies having been used to almost having to ‘croak’ (addict slang; To obtain by deception, often a two way process’), a pack of 1mls using any criteria we could think of so we could, if lucky, be allowed to purchase our paraphernalia.
Having watched a works go round a room, each user trying to get their hit before the next user started moaning, barbed old blunt ‘sharps’, often used so much the numbers had long since rubbed off the barrel, needle sharpened on matchboxes, plunger degraded making it even harder to get a fix, these were the good old days?! But read on.
These friends are now mostly long gone due to HIV/AIDS from sharing. We sit on the cusp of a rise in HCV symptomology and treatment is finally being made accessible. This was greatly changed by the opening of needle exchanges, even enterprising illegal small scale retail outlets in Kings Cross got in the act by selling you a new one ml with a lemon for 50p but at 3am when you had just scored. A life saver in more ways than one.
The situation in the UK changed and clearly we got this intervention accepted at Government level just in time to prevent the terrible infection rates from Scotland, Dublin, Italy or the Iberian Peninsula, many users coming to the UK for work, benefit and treatment. Oddly, infection rates have increased among IDU’s, on the NTA’s watch. (A situation Chief Executive Paul Hayes describes as unacceptable). The situation varies from county to county even town to town, Glasgow has a 24hr exchange but try getting a works in parts of London any time of day. Seriously, in the age of the disinhibiting, repetitive ‘speedballing’ as drug of choice across the UK. The conditions and the dynamic is there for a major increase in the infection pool. Scoring and keeping a supply of clean works can be a time consuming expensive exercise. Services used to want just a first name. Now a lot demand full name and address, with a war on drugs advertising yourself as the enemy engaged in committing a crime, with the backlash around anti social behaviour and the areas you score in under community pressure to move you anywhere else. So to be able to get a new pin is unlikely to be easy.
These are often areas of urban renewal, with social conflict if you are a social drug user who wants friends to be safe and allow access to use. Let alone get clean works from your home running a shooting gallery and risk losing your liberty along with your tenancy, using with mates in social settings does not always suggest your flat’s a crack house but you can’t argue the toss with the authorities. I learned a great deal and probably owe my life to older addicts who would advise you how to get a hit and the dos and don'ts of using. For example, the groin was always the last resort for my peer group. Now it is sometimes one of the first places used. Crack with its rush has possibly led users who had not felt the instant buzz of a hit to speedball or do the smack iv and flirt with the neo romance of needle fixation. With so much at stake we now find a majority of chemists will not dispense packs. Some will sell packs but not with citric and even clean water amps have been denied.
Abstinence is being pushed by many as the only way to go. As a result, people whose careers are still, and may remain active trying to get 17/20 new works a day and struggling to return any on a regular basis increase their risk of (re) infection, DVT, endocarditis, and reports of people using matchboxes for the one barbed works is coming back.
During this presentation, I will look at a number of these issues.
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Biography
Colin Stewart has been working at Release as the drugs helpline assistant since 2003. He has a long history of involvement with users groups, advocacy and the last days of the old West end private clinic system. He has used various drug services for over Thirty years. He sees little overall forward progress and fears for the teenage injectors he meets in the course of his work.
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