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From fix to foil. The Dutch experience in promoting transition away from injecting drug use, 1991 - 2010. A case study, analysis and lessons learned
John Peter Kools, Consultant on Drug Use, HIV and Harm Reduction, Amsterdam, Netherlands
Abstract
This presentation will provide an overview of
experiences in The Netherlands with promoting route transition away
from injecting. It will describe autonomous trends among opiate and
stimulant users from injecting towards non-injecting drug use in the
early 1990s. This trend in the drug using community was initially
recorded in 1992 and became the basis for a range of health
interventions to promote route transition away from injecting.
The presentation will describe the context of injecting drug use
behavior in The Netherlands, environmental conditions, public health
responses and a range targeted interventions in order to stimulate and
facilitate route transition away from injecting. A range of health
interventions and social marketing methods were used to strengthen
existing developments of transition (e.g. explicit instruction
materials, community outreach work, peer support work, a video with
testimonials of former injectors). A key element in the inventions was
the availability and provision of aluminum foil.
Immediate and long-term health and social benefits were an important
motive for drug users to switch away from injecting. Transition to
non-injecting provided also significant additional self-management
opportunities.
By the end of the 1990s the development was nearly ended. Within a
couple of years an entire generation of drug users made a sustained
behavioral change on an area that was earlier not considered amendable
to
intervention: the mode of drug administration.
A combination of full range of health interventions (OST, NSPs,
consumption rooms, community outreach, peer support, social marketing
etc.) can lead to significant individual and public health benefits.
Promoting route transition may be a significant innovation in the
prevention of BBVs, overdoses and other injecting related harm and
provide an additional heath strategy in developed countries like The
Netherlands, but also in other regions in the world that are currently
facing high or rising rates of injecting prevalence.
TOP
Biography
John-Peter Kools is an independent consultant on drug use,
HIV and harm reduction. He studied Political Science in Amsterdam.
Since the mid-1980s, he has been involved in the development of the
grassroots delivery of services and HIV interventions among injecting
drug users. He was involved in starting the first needle exchange
service in the Netherlands and early community-based HIV responses.
He
is a founding member of the health promotion organisation Mainline, based in Amsterdam.
Since 1996, he has primarily been involved in initiating and
supporting HIV prevention services in Central and Eastern Europe and
co-ordinated a multi-country programme on HIV, drug use and poverty reduction in Asia.
Currently, John-Peter works on an independent basis for various drug
use and HIV-related programmes in transitional and developing
countries. He is a member of the Board of Directors of the
International Harm Reduction Association (IHRA) and Health Connections International
(HCI.)
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