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Nigel Brunsdon

I’m HIT’s Community Manager, it’s a very grand title that doesn’t quite explain the work I do. I’m responsible for managing HIT’s social media accounts (Facebook, Twitter etc.), putting together the community focused websites we run like the Naloxone.org.uk and encouraging people to use these services. I’m basically the guy who’s job it is to let you know what we’re doing here at HIT from day to day. I’m also the resident photographer for out events at HIT like the Hot Topics Conference.

I’ve been working in drug services for over a decade with previous jobs including Project Worker up to Area Manager and Trainer. Setting up needle programmes, doing one to one work and managing projects. As well as my day job I’m also the deputy chair of the National Needle Exchange Forum.

I’ve been working at HIT since the end of 2011, Pat approached me to join the team because of the work he knew I did on social media and on my own personal site (injectingadvice.com, now retired as an active site). I can honestly say I love my job, I get to work with people who are passionate about harm reduction and meet many of the people whose work I’ve followed over the years at the conferences, seminars and training we run.

When it comes to me as a person, outside of my obsession with harm reduction, I’m a proud father, husband, photographer and self-confessed geek.

Drug Consumption Rooms

HIT Seminar Archive

Drug Consumption Rooms

The world’s first drug consumption room was opened in Berne, Switzerland in 1986. Dr Robert Haemmig and Dr Jakob Huber were among the founders. Dr Haemmig spoke about their history and rationale and Dr Huber spoke about the development-oriented approach that bridges acceptance/harm reduction perspectives and abstinence based services.

Neil Hunt spoke about the past, present and future of Drug Consumption Rooms in the UK including the support shown to them by David Cameron. He also spoke at length about the legal landscape in the UK and how this may impact (or not) on the possibility of these services.

Speakers

Dr. Robert Haemmig

University Psychiatric Services, Berne, Switzerland

Dr. Robert Haemmig is a Swiss Psychiatrist and Director of Integrated and Drug Services, University Psychiatric Services, at the University of Bern, Switzerland, since 1994. Dr. Haemmig opened the first safer consumption site in Bern in 1986 and was a pioneer in the development and provision of heroin-assisted treatment in Europe. He has been a Member of the Safety Assurance Group for Heroin Prescription in Switzerland since 1996. He is a world authority on innovative harm reduction approaches to injection drug use, patient-centered care and the incorporation of evidence-based approaches into the treatment of addiction. Dr. Haemmig is the founding and past President of the Swiss Society of Addiction Medicine.

Jakob Huber

CONTACT NETZ

Jakob Huber managing director of Contact Netz (Contact Foundation). He played a key role in shaping the addiction aid organization Contact and Swiss harm reduction. In the 80s and 90s, which were characterized by distressed open drug scenes, CONTACT did pioneering work in Swiss drug policy and work. With bold, innovative harm reduction

Neil Hunt

Freelance Researcher and Trainer

Neil Hunt a Freelance Researcher and Trainer; Honorary Senior Research Associate at the School of Social Policy, Sociology and Social Research, University of Kent; and Honorary Research Fellow with the Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, UK.

Jon Derricott

Video Credits

All the films of sessions appearing on this page have been recorded and edited by Jon Derricott.

HIT Seminar

Gallery

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Motivational Interviewing (Online Delivery)

Our Motivational Interviewing course delivered by Pip Mason has always been one of the most popular courses here at HIT, and now following a successful pilot in Birmingham the course has been adapted for online delivery allowing you to still have your team.

You can see the full course on our training page, but while you’re here these are the learning outcomes:

  • To understand the concept of motivation and how it relates to a model of behaviour change
  • To improve skills when assessing a drug user’s motivation
  • To improve interventions with drug users who are resistant to changing risk behaviour
  • To improve interviewing and counselling skills to promote the client’s wish to change

Full course details

Russian Harm Reduction NGO Declared “Foreign Agent”

The Andrey Rylkov Foundation (ARF), the only NGO that provides sterile needles and syringes to injecting drug users in Moscow, has been declared a “foreign agent” by the Russian government. This means that the Russian government regards as presenting a threat to national security because they receive funding from international donors.

The ARF have released this press release:

Press Release

By The Andrey Rylkov Foundation For Health And Social Justice, Regarding It’s Inclusion Into The List of Organizations Carrying Out Functions Of A Foreign Agent

Citizens, keep alert – this press-release is issued by the organization carrying out functions of a foreign agent!

On June 29, 2016, The Ministry of Justice of the Russian Federation included our organization, the Andrey Rylkov Foundation for Health and Social Justice http://www.rylkov-fond.org in its list of “foreign agents” and has published an official announcement on its website. According to the announcement, the “fact that the organization has characteristics of an NGO carrying out functions of a foreign agent was established by the Main Department of the Ministry of Justice in the Russian Federation in Moscow during a regularly scheduled document check.”

Our organization works on issues related to public health: prevention of HIV, Tuberculosis, hepatitis C and drug overdoses. We also provide social support to people who suffer from drug dependence, helping them to stay healthy, referring them to medical and social services in Moscow, rehabilitation centers, and narcological hospitals. We make contact with people who use drugs through street based social work and we are the only organization in the city which has constant access to this group. This group is very vulnerable to health problems and their access to medical services throughout the city is restricted. Almost no one wants to work with them. People who are drug dependent often can’t receive the medical help they need whether it is treatment abscesses or TB\HIV. Most of participants of our project are denied access to the hospitals, refused help and left to suffer. Together with our participants and supporters we fight for the accessible medicine, effective treatment, improved health care and protection of rights. These were the actions that Ministry of Justice considered to be a political activity.

We work on the streets of Moscow every day. Last year we served 3854 men and 1096 women, carrying out over 300 consultations on HIV and hepatitis; providing consulting to 371 people on drug dependence (including consultation with a psychologist and referral to treatment); and many received consultations regarding overdose and abscesses. In only the last two years, through our work due to promote the use of naloxone, a medication for overdose deaths prevention we received confirmation that we had saved 417 lives! And these are just the ones that we know about. It is harder to count the number of HIV or hepatitis infections that we prevented.

Yes, we do carry out our work using foreign funding, donations from private foundations and crowdfunding. But this is not because we want to work this way. Over the last few years, we applied for President’s grants 4 times so that our work could be funded from Russian sources but our projects were never financed. For a long time already, HIV prevention is not funded from public funds. But we will try to continue to work as we have in the past, helping drug dependent people on the streets of Moscow, and trying to promote the drug policy based on humaneness, tolerance, public health, human rights and dignity.

Recently we received the administrative offence report from the Ministry of Justice clarifying exactly which of our activities were considered political. These include:

  • Participation in the “Support. Don’t Punish” campaign in 2015. This is a global advocacy campaign calling for better drug policies that priorities public health and human rights. We participate in this campaign for many years. In 2015, in addition to us, 160 other cities took part in it. Within this complain we hold one-person pickets in front of the office of the Federal Drug Control Service (which since been disbanded) demanding for the introduction of opioid substitution therapy (a cost-effective evidence based approach to deal with drug dependency) in Russia.
  • Publication on our website of an Open letter from the Eurasian Network of People Who Use Drugs (ENPUD) to the Prime Minister of the Russian Federation (RF) on the results of a special session of the Government Commission of the RF on the response to the HIV epidemic and public health.. The Ministry of Justice payed particular attention to those parts of the letter which called for the introduction of the opioid substitution therapy in Russia
  • Interview of the President of the Andrey Rylkov Foundation Anya Sarang given at TV Rain on 26.11.2013. In this interview Anya provided a negative feedback on the law introducing the forced treatment of the drug dependent people. In the opinion of the Ministry of Justice, the expression of the expert opinion on the “policy pursued be the public authorities” also is considered as a political activity.

In spite of the much higher risks we face now due to numerous traps hidden in the law of the foreign agents which could lead to significant administrative fines, at the moment, we are planning to continue our activities including those focused on prevention of HIV and other health related problems among people who use drugs. And we will appeal the decision of the Ministry of Justice. The legal support will be provided by the NGO Lawyers Club.

Best regards,

Andrey Rylkov Foundation

Follow us on Twitter @AndreyRylkov and in Facebook.

The Andrey Rylkov Foundation needs Your help more than ever – the only way to ease the isolation and stigmatisation of the organisation is support from the international community. Please go to the Global Giving website and make a donation today!

Prohibition And Harm Reduction

As the eventful 24th Harm Reduction Conference entered its final day, I feel a great sense of pride that we have arrived where we are, but at the same time sad that in some countries harm reduction is not on the agenda, and In others such as England it has slowly been dismantled.  Harm reduction in England was described to me recently by one of the early UK pioneers as a “cottage industry”.

On the other hand, there was a tremendous enthusiasm in the air in Kuala Lumpur.  Harm reduction’s tentacles have spread far and wide.  The International Rolleston Award was won by Edo Augustin from Indonesia, and Abdur Raheem Rejaey won the Carol and Travis Jenkins Award.  The truth of the matter, however, is that scale up has not really happened in the majority of countries. Then there is the shameful situation in the USA in which the Federal Government won’t fund needle and syringe programmes.

In our host country, Malaysia, thanks to the Malaysian AIDS Council, winners of the National Rolleston Award and the many brave activists, many of whom were at the conference protesting about the lack of Hep C treatment, in the last 10 years harm reduction programmes have dramatically reduced the incidence of HIV among people who use drugs. 

Despite this, drug policy in Malaysia continues to include imprisonment of people who use drugs, judicial corporal punishment, and compulsory detention, which make harm reduction service delivery more difficult. 

This brings me back to my take home message.  Mass incarceration, the stigmatisation and marginalisation of people who use drugs added to the denial of the basic human right of access to the same quality of health care will never be eradicated under the prohibitionist regime.  This won’t happen until prohibition is repealed, until drugs are legalised. 

If you believe in harm reduction, you must believe in reducing all of the harms. Not to believe that is cognitively dissident. You cannot reduce all of the harms in a prohibitionist world.  If you don’t believe it, maybe it is because, deep down, or maybe not so deep down, you believe that drug use is wrong.  

If you believe in harm reduction, you must believe in getting rid of all criminal and administrative sanctions for the production, sale, possession and consumption of drugs.  Drug policy reform is harm reduction.

Photo: Pat at the Harm Reduction Conference in Kuala Lumpur with the fantastic team from Myanmar who distribute 5,000,000 needles and syringes every year.

Early Days Of Harm Reduction in Liverpool

In the mid 1980s, the Mersey Health Region, which consisted of the counties of Merseyside and Cheshire in the UK, became the focus of attention because of its radical and pioneering approach to dealing with the problems connected with drug use. Most of this focused on Liverpool, the biggest city in the region. Liverpool has a proud history of public health and was the first city in the world to appoint a Medical Officer of Health in 1847.

At that time it was identified as the unhealthiest town in Britain. In the early to middle 1980s, John Ashton of the University of Liverpool, Department of Public Health, and later Mersey Regional Director of Public Health and Howard Seymour, Head of the Health Promotion of the Mersey Regional Health Authority (MRHA), had been developing the ideas of the New Model for Public Health. This brought together the old ideas of environmental change, prevention and therapeutic interventions. But they went further and recognised the importance of those social aspects of health problems, which are caused by lifestyles. In this way it seeks to avoid the trap of victim blaming.

They were interested in applying it to a then emerging public health problem, drugs and AIDS. Liverpool, actively promoting a shift towards the promotion of healthier lifestyles through its prominent involvement in the World Health Organisation’s ‘Healthy Cities’ project, was one of the first two British cities to participate in the project launched in 1996. Under he leadership of John Ashton, a number of effective community-based projects aimed at creating healthier lifestyles were created.

In the mid-1980s, an influx of cheap brown heroin gave Liverpool another bad reputation as “smack city”. Other parts of the Mersey Region, including the areas of the Wirral and Bootle had similar high levels of heroin use. It was estimated that there were about 5000 heroin users in the Wirral out of a total population of about 300,000, and that there were about 20,000 drug users in the region in a population of about two and a quarter million people. Services were much as they were in the rest of the UK, with detoxification being the prevalent treatment. According to one drug worker at one Drug Dependency Unit, one person was detoxified 14 times in 12 months.

In 1985, Ashton and Seymour attended the World Health Education Conference in Dublin and met Glen Margo from San Francisco who was working on AIDS prevention. He made such an impression on them that they invited him to Liverpool to give a series of lectures to sensitise decision makers and potential activists across the community to the issue of AIDS and to present a model for organising prevention programmes.

Extensive media coverage raised awareness in the general public of an issue that had not been taken seriously in the UK. A subsequent visit to the USA revealed a difference in approach between New York and San Francisco, the latter being a classic public health approach involving political organisation, market research of groups at risk, creative use of mass media, activism, the involvement of the risk groups in programmes and community support. At the same time other key individuals—including the late Sir Donald Wilson, Chairman of the Mersey Regional Health Authority, John Marks, a psychiatrist in the region and Allan Parry, a health promotion worker found themselves in the right place at the right time. Parry was responsible for the implementation of the strategy and played a crucial role in its development. All of these factors facilitated the implementation of a harm reduction approach to drug use in the region, especially the threat of HIV through the sharing of infected injecting equipment.

This was based on public health principles that influenced the later historic recommendations of the UK’s Advisory Council on the Misuse of Drugs (ACMD) 1988 report. Services were created from 1985 involving the consumer, which gave drug users the information and the means to protect themselves, especially those drug injectors most at risk. The Mersey Harm Reduction Model was taking shape.