Policy and advocacy to improve the health of people who use drugs

In the INHSU 2021 session ‘Policy and advocacy to improve the health of people who use drugs’ we heard from various experts on the role advocacy plays in the health of our community. Below is the write up from the session, which took place on day one of the conference.

The rate of mortality is six to seven times higher among people who use stimulants (mainly methamphetamine and cocaine) than the general population. Polysubstance use often includes prescription opioids which exacerbate risk of overdose. According to Rebecca McKetin, National Drug and Alcohol Research Centre, there is lack of encouraging evidence on the value of both pharmacological and non-pharmacological interventions in reducing stimulant use.  

“We have to target people who use stimulants because from the modelling, for every ten per cent increase in stimulant injection, we see an additional three to ten per cent of new HIV and hepatitis C infections in the following year,” Rebecca stated. 

Proven interventions to reduce HIV or hepatitis C include safe sex, providing sterile injecting equipment, treatments for HIV and hepatitis C as well as PreP. 

Where to next? Rebecca said that we need better evidence and better implementation. We also need to target high-risk groups with harm reduction strategies and tailor interventions to ensure access/service coverage of the broader population who use stimulants. 

Marianne Jauncey, Uniting Medically Supervised Injecting Centre, spoke about supervised consumption sites and how they are part of the suite of harm reduction strategies. Sites should be welcoming and non-judgemental spaces and adopt a harm reduction approach. In terms of what makes an appropriate supervised consumption site, we need to consider location, model of service delivery (be it a tent, van or building), the politics of the day, the media, peer involvement, stigma, advocacy and drug laws. 

“It is beholden on all of us to fight the good fight, influence within our sphere of influence and not shy away from the conversation,” Marianne said. 

There is also related on-demand content about the establishment of a drug consumption room in central Canberra, Australia. 

Carrie Fowlie, Hepatitis Australia, discussed the role of advocacy and civil society in progressing action to improve the health of people who use drugs. Advocacy is about values, although it is important to note not everyone has the same values. Carrie stated, “It is critically important in civil society to understand one’s own values, the organisation’s values and the values of decision-makers.” 

“Civil society is diverse, messy and experimental but it is a precondition for democracy and can potentially strengthen democracy and make people more accountable,” she added. 

Of related interest is on-demand content that discusses how civil society organisations must be included in strategic planning for hepatitis C continuum-of-care and monitoring progress towards elimination goals.