9/6/2014 Reducing Harm with People Who Inject Drugs Damon Brogan Manager, NTAHC Harm Minimisation Program

9/6/2014 Indigenous sexual health program Care and support for people living with BBVs Campaigns, events, Health promotion and community education Sex worker outreach program and SWOP shop Harm Minimisation program: NSP Darwin, Palmerston and Alice Springs About NTAHC

HMP - NSP Renewed focus on Health Promotion: enhance PWID self-efficacy in reducing risk and managing health Peer-based empowerment model: equality between service users and HMP workers Fundamentally Harm Reductionist: taking the service users where they are, no expectations or agenda around abstinence Provide resources and info to facilitate reduction of risks, access to services at client’s choice 9/6/2014

We provide: Needles, syringes all sizes, sterile filters, sterile water, medi swabs, winged infusion sets, condoms and lube, syringe disposal containers and 24 hour disposal facilities Information and education on BBVs, injecting related injury and disease (IRID), overdose prevention and management, drug properties and interactions Information and referral to health and social services, at clients’ request 9/6/2014

Needle and Syringe Services in the Territory 3 primary (stand alone) NSP outlets: NTAHC Darwin, Palmerston and Alice Springs 6 secondary NSPs: Clinic 34 Darwin, Alice Springs & Tennant Creek, CDC Nhulumbuy& Katherine AND Alice Springs Hospital 10 community (Fit Kit) pharmacies working with NTAHC & CDC Undisclosed number of community pharmacies who sell syringes but are not affiliated with organised programs 9/6/2014

Our service users: Drug last injected: [12 moths to February 2013] Prescribed opiate analgesics: 38.79% Meth/amphetamine36.17% Benzos (not Xanax) 0.56% Steroids (Watch this space!) 7.67% Heroin 1.62% Methadone & Bupe 4.88% Cocaine 0.3% MDMA 0.22% Other 8.67% (incl. xanax, insulin, prefer not to answer) 9/6/2014

Where do we sit? NTAHC is funded under public health / BBV prevention. Many of service users’ expressed needs are AOD and general health, social services etc Taking a holistic view of the health of each PWID and being client-focused means serving as a referral pathway to AOD and a range of other services. We need to be better linked in to a number of sectors and networks. A strong, evidence-based policy framework that articulates the linkages between public health, alcohol & drug treatment and education and even social participation would be useful. 9/6/2014

AOD Framework Principles wish-list Primacy of reducing harm above ideological or utopian goals Address the whole continuum of AOD related risk and harm, not just the severe dependence segment. Interventions and strategies based on best available evidence, including the experiences of consumers and respected practice. A revised balance between the three pillars based on strong evidence of tangible community benefit and reduced harm to individuals and families. Bi-partisan support > long term effort and < political posturing Flexibility, diversity in service system, in recognition of the diversity of consumer needs, goals and philosophies. 9/6/2014

3 Pillars NTAHC has little engagement with supply reduction, which in the illicit drug context manifests as interdiction and criminal prosecution. Ignoring the debate about whether prohibition fuels the black market and increases the quantum of harm, it is fair to say that SR receives an inordinate proportion of funds and resources, leaving treatment and education (DR) and HR impoverished and overburdened. In these fiscally straightened times, it should be incumbent upon communities and governments to ensure that there is a functional balance between the 3 pillars of our AOD policies. 9/6/2014

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Thank You Damon Brogan, Manager, NTAHC Harm Minimisation Program 46 Woods Street Darwin, /6/2014