Crucial lessons for New Zealand: Last month two Drug Foundation staff, Samuel Andrews and Gilbert Taurua travelled to Montreal, the architectural dream of Canada, to attend this year’s Harm Reduction International conference. Samuel shares his reflections on the experience.
The HR17 conference put the voice of people who use drugs at the centre of all presentations and proceedings and really re-defined what ‘nothing about us, without us’ looks like in practice. The strong peer community of people who use drugs is a bit different to what we refer to back home. In New Zealand, ‘peers’ generally refers to people who have used drugs in the past and now are in recovery. Members of the International Network of People Who Use Drugs (INPUD) are actively using and bring a more urgent perspective on the need for overdose prevention and more comprehensive harm reduction.
The conference was opened in part by Jane Philpott, the Canadian Minister of Health. Any country would be privileged to have such a strong advocate and ally for harm reduction. She spoke from her heart and was able to list the action she had taken to support harm reduction, including getting naloxone rescheduled, the rollout of overdose prevention kits, championing law change to allow supervised consumption rooms and contributing to the decision to legalise the sale of cannabis.
North America’s overdose crisis from fentanyl was evident. Many spoke about the wide scale contamination of not just heroin and opioids, but the entire illicit drug supply. Fentanyl and its analogues are highly potent – just a few specks is already a strong dose – and it is causing hundreds of accidental overdoses. It was a clear warning of what could be ahead for New Zealand, and how crucial it is to be get better access to naloxone.
The best aspect of this conference was everyone coming together to reshape and extend what harm reduction really means. The 1000 delegates represent an international evidence base of a full range of harm reduction interventions, implemented in various regions and countries.
A consistent theme across presentations was how to provide a more meaningful relationship between people using services and those providing them. Treating people with respect and giving them lifesaving equipment and information was repeatedly shown to generate meaningful engagements. What could this look like in New Zealand? If GPs were to dispense harm reduction advice, patients might feel more comfortable talking about difficult topics, or potentially emerging struggles around their substance use.
It was also apparent that New Zealand is currently lacking in essential harm reduction services. After leading the charge in the 80s, we are now sadly lagging behind. Some services that would be amazing to have are: supervised consumption rooms, legally-endorsed drug checking services, outreach by needle and syringe exchange for people injecting steroids and amphetamines, greater responses to chemsex and other practices in the LGBTQI community, and harm reduction services in prison.
While harm reduction can face (misinformed) political barriers, we need to keep pushing for greater access to the full range of services and tools available. Harm reduction needs to be at the centre of responding to drug harm and is the paradigm that will best see us into a future world of full drug decriminalisation and legalisation.
Survey participants also reported that barriers to accessing services, resources and information were high.
A group of powerful synthetic opioids that were first detected in the country just a year ago may have already been linked to several deaths.
95% of respondents reported positive effects, in a study that looked at both prescription and black market cannabis use.