The Proposal for a Safer Drug Consumption Facility and Heroin-Assisted Treatment in Glasgow City Centre: key documents

Since early 2015, Glasgow has been the centre of a significant HIV outbreak among people who inject drugs.

The work towards introducing the new services is ongoing and an update on the actions from the draft business case will be presented to the Integration Joint Board at their meeting in June.

Here are the key documents to date;

June 2016 – Taking Away the Chaos – The health needs of people who inject drugs in public places in Glasgow city centre

October 2016 – Safer Consumption Facility and Treatment Service Pilot Proposal

February 2017 – Safer Drug Consumption Facility and Heroin-Assisted Treatment Service Draft Business Case

SDCF and HAT Frequently Asked Questions

PRESS RELEASE: Kirsten Horsburgh receives prestigious Churchill medallion in London after completing Fellowship


Kirsten Horsburgh, National Naloxone Coordinator at Scottish Drugs Forum was presented with a newly designed Churchill medallion at a prestigious biennial award ceremony in London last week (Wednesday, 18th May), after successfully completing her Winston Churchill Travelling Fellowship.

Kirsten, from Galashiels, was awarded the 6 week Fellowship to research strategies adopted in Australia to reduce drug-related deaths. During this trip she spent two weeks in the Medically Supervised Injecting Centre (MSIC) in the Kings Cross area of Sydney to gather learning from this service to inform key stakeholders and decision-makers in Scotland.

On her return to Scotland, Kirsten consolidated this knowledge and released a report entitled ‘Reducing preventable deaths among people who use drugs’ which has been well received in the drugs field.

Drug-related deaths in the UK are at an all time high. In Scotland, these deaths are among the highest in Europe, per head of population. 613 people lost their lives to accidental and preventable overdoses in 2014 with all evidence pointing to 2015’s figures being high again.

Speaking about the Fellowship, Kirsten said “The Travelling Fellowships provide opportunities for UK citizens to go abroad on a worthwhile project of their own choosing, with the aim of enriching their lives through their global experiences – and to bring back the benefit to others in their UK profession or community through sharing the results of their new knowledge.

“This has been a once in a lifetime experience which has exceeded all of my expectations. The fellowship has introduced me to new networks and opportunities, whilst creating some lifelong friends along the way. I am extremely grateful and would encourage anyone who is passionate about a subject close to their heart to apply.”


Kirsten was presented with the stunning blue cloisonné enamelled silver Churchill medallion by its designer and Guest of Honour, Professor Brian Clarke, who is a world renowned architectural artist, and himself a 1974 Churchill Fellow.  129 Fellows received  their medallions at a ceremony in Church House, in Central London. Church House has significant Churchillian associations as during the Blitz, Winston Churchill requisitioned Church House as a makeshift Houses of Parliament after the originals had been damaged by bombing.

Professor Brian Clarke praised all the Fellows for their outstanding achievements, and said that “I know from personal experience that the Fellowship represents a wonderful opportunity. I am continually amazed and inspired by the Churchill Fellows dedication and commitment to making a difference in so many areas affecting today’s society.”

 For more information please don’t hesitate to contact Andy Coffey at Scottish Drugs Forum at andyc@sdf.org.uk or call 0141 221 1175 or 07748 720 796

NOTES TO EDITORS

About the Winston Churchill Memorial Trust

In 2017 The Winston Churchill Memorial Trust will be investing around £1.3million in British citizens by awarding 150 Travelling Fellowships.

This will directly support British citizens who want to travel overseas to gain knowledge, experience and best practice to benefit others in their UK professions and communities, and society as a whole.

The Winston Churchill Memorial Trust was established shortly after Sir Winston’s death in 1965, as his national memorial and living legacy. Since then it has awarded over 5,250 Travelling Fellowships.

The application process for travel in 2017 is now open, and there are 14 varied categories – including two new ones – in which people can apply.  Visit www.wcmt.org.uk  for more details, or to apply before 5pm on 20th  September 2016, for travel in 2017.

Successful applicants must demonstrate the commitment, the character and the tenacity to travel globally in pursuit of new and better ways of tackling a wide range of challenges facing us today, and upon their return work to transform and improve aspects of today’s society for the benefit of others in the UK.

A travelling sabbatical for people with the drive, determination and desire to help others, can further their leadership and role model abilities, and enhance their personal development.

Employees who are awarded Fellowships bring great benefits to their employers, not only in terms of the positive impact on their personal development, but also with the advantage of their enhanced knowledge, new ideas and examples of best practise that they bring back to the organisation.

Applications are judged purely on project merit, and these opportunities are available to all UK residents over the age of 18, regardless of ethnicity, religion, gender, sexual orientation or disability.

Successful applicants will receive an average Fellowship grant of over £6000, covering return airfare, daily living costs, insurance and travel within the countries being visited, for approximately 6 weeks overseas.

About SDF

Scottish Drugs Forum is a membership-based drugs policy and information organisation. It is an independent centre of expertise on drug use and drug problems, supporting effective evidence based responses.

Their mission is to play a leading role in creating a Scotland where drugs are no longer causing significant harm and where people with substance problems have access to the highest quality services to support their recovery.

SDF has consolidated its role as a centre of expertise through developing the organisation as a learning and training centre, and as result provides a variety of courses that support the drugs field in Scotland and further abroad.

As well as training, SDF also has an important role in raising awareness of Scotland’s drug problem and reducing the stigma of people with drug problems.

It has won various awards for it’s work in User Involvement work and most notably for the Addiction Worker Training Project (AWTP), a program that mentors former addicts who wish to pursue a career in drug or alcohol services. SDF supervisors support trainees though a basic counselling qualification, and facilitate placements in various partner services.

For more information please visit: www.sdf.org.uk


Reducing Preventable Deaths Among People Who Use Drugs: report and recommendations

My Fellowship findings and recommendations have now been uploaded to the Winston Churchill Memorial Trust website.

This feels like quite an achievement since it was way back in September 2014 when I submitted my application, with my travels eventually taking place in October 2015 following months of preparation.

The whole experience has been incredible to date and I would recommend it to anyone. A huge thank you to everyone who has supported me along the way.

I am pleased to share with you the results of my Fellowship, which includes the following recommendations for Scotland (and the rest of the UK).

 

  •  SUPERVISED INJECTING FACILITIES:

Wherever there are significant numbers of people injecting in public, there is a clear need for supervised injecting facilities.

  •  TAKE-HOME NALOXONE:

Take-Home Naloxone should be available free of charge, and promoted widely, to those most likely to witness an overdose.

  •  ACTIVE ENGAGEMENT AND RETENTION IN TREATMENT SERVICES:

Low threshold services should be widely available across the country.

 

These recommendations are accompanied by specific actions which are detailed in my report that can be accessed here.

Of course, this is not the end! Since returning from my travels I have been presenting to and meeting with key stakeholders in Scotland to highlight the clear benefits and evidence base for the proposed actions. I look forward to the next phase…

Thank you for your interest and please do not hesitate to get in touch should you have any comments or questions on any aspect of this Fellowship.

Kirsten x

 

 

From Vancouver to Glasgow: The story of North America’s first and only supervised injecting site

I’ve spent the last few days with 13 lovely ladies from Estonia’s prison service who were visiting Scotland to find out more about take-home naloxone and healthcare within the Scottish Prison Service. I have left them in the capable hands of my Scottish Government colleagues to head over to Glasgow to catch Liz Evans from Vancouver who is here to tell us the story of North America’s first and only supervised injection site – Insite.

It’s a grim drive that takes over 2 hours due to the rush hour traffic from Edinburgh but by some small miracle I make it just in time.

Liz has been in Glasgow all day and has met with Turning Point Scotland and partners, and has also been on BBC Radio Scotland (listen here from 13:03). Around 20 people have turned up tonight with a variety of backgrounds, interests and knowledge on the subject so we are very grateful to hear the experience of Insite first hand.

 Liz introduces herself (and I’ve pinched her bio from the initial email I received!)

Liz trained as a nurse. She worked in a low-income inner city community in North America where, for years, she operated housing for people who were poor, mentally ill and addicted. She watched as a wave of disease and death spread across the community among injection drug users. Looking for a more humane way to approach this situation she worked with her community and organized to open a space where people who were struggling to survive in the face of their addiction could find hope to live another day.

In a precedent-setting case that was ruled on in 2011, Liz and a dedicated team took this battle all the way to the Canadian Supreme Court–where a legal right was enshrined for this site to be granted an exemption from the criminal code. Here, Drug Users can come inside, inject illegal drugs under the supervision of a nurse, and find access to support and life saving care. This Centre has been operating since 2003.

I was inspired by her story of the early days when she operated the hotel that catered for some of the most marginalised people in the community. The project had a strong inclusion policy, did not exclude people from help and the emphasis was on creating a space where people could just ‘be’. It was not focussed on drugs, the level of the person’s drug use or drug using patterns – the main focus was on the person.

“Wherever you are right now, we accept.”

Between 1988 and 1998 there were 2413 deaths from heroin overdoses and the crisis peaked in 1998 when 413 people lost their lives to preventable deaths.

Strong advocacy and activism commenced and a conference ‘Out of Harm’s Way’ was held with international speakers encouraging new ways of thinking. Harm Reduction was added to create a four pillar drug strategy approach from the existing Prevention, Treatment and Enforcement with eventual support from all parties to introduce a safe space for people to inject drugs.

The drug users union, VANDU, were incredibly influential in this process and were given practical support to assist them to amplify their voices. The stories of family members who had lost loved ones also helped to highlight the need for change.

After 6 years of lobbying, Insite finally opened in 2003.

There was a huge sense of ownership of the service from drug users, mostly due to the fact that they had been heavily involved in the process.

Insite was heavily evaluated over the coming years and despite all of the positive evidence, the Federal Government battled to close the project but lost in a unanimous Supreme Court decision on September 30th, 2011. 

  

You can view the video of the Insite story here.

  
The celebration of this success was not about celebrating drug use, but was about celebrating drug users and the rights of people who use drugs to be treated with dignity and respect. The message from this decision was clear;

“The sentence for being a drug user is no longer death”

Liz described Insite as so much more than just a place for people to inject. Families know it’s a safe place for their children. People feel welcome, cared for. Time and time again people say ‘the staff are so nice to me, it made me want to start caring more about myself and start to reduce my drug use.’

Following the presentation, questions were invited from the audience, which resulted in a great discussion about what needs to be done in Scotland.

One of the main pieces of advice was to try to open a site that provides many different services in addition to an injecting room, such as an inhalation facility, opiate replacement therapy and heroin assisted treatment.

Insite – the numbers;

  • ZERO overdose deaths
  • 2667 lives saved through overdose intervention (2003-2011)
  • 2 million injections
  • 3416 referrals to detox (residential treatment directly above Insite)
  • 2047 estimated HIV infections averted
  • $1.8 million estimated annual savings from the prevention of HIV infections alone
  • 905 average number of visits to Insite each day
  • 587 average number of daily injections
  • 35% decrease in overdoses in the neighbourhood around Insite (9% in the city overall)

So the evidence is yet again clear, supervised injecting has no negative consequences.

In our efforts to reduce drug-related deaths and improve the lives of people who use drugs we need to utilise ALL evidenced-based strategies to produce positive outcomes.

You can find out more about Insite by viewing the HCLU film – Insite, Not Just Injecting, But Connecting here.

 

The Case for Supervised Injecting Facilities in Ireland: A Day with Ana Liffey Drug Project

The morning after a great night at dinner with colleagues from Scotland and Wales, facilitated by the Ana Liffey staff and I’m looking forward to the day ahead. (It’s also doing wonders for my fitness plan having managed to reach 25,000+ steps yesterday, bonus)

We’re all staying in the same hotel so we make our way to the Dublin Dispute Resolution Centre and in a momentary lapse of judgement somehow I’ve managed to declare myself as the person who knows where they’re going – which almost results in an additional 10,000 steps – but we arrive on time.



It’s an impressive meeting space and the day starts with Marcus Keane, Head of Policy, setting the scene and describing the Irish context regarding drug use, drug policy and the Ana Liffey Drug Project (ALDP) strategy.

  • About 50% of ALDP client group inject drugs
  • Polydrug use is the norm
  • Over 400 people mostly injecting in public in Dublin City Centre, evidence of which we saw yesterday

Two of the main services they advocate for in their Strategic Plan are;

  • Medically Supervised Injecting Centres
  • Low Threshold Residential Stabilisation Centres


Dawn Russell, Head of Services, goes on to describe the service delivery of ALDP, which was founded in 1982 and incorporated in 1985, now employing around 35 staff. They provide an impressive range of services, more of which you can read about here, all within a low threshold, harm reduction ethos.


Last, but not least, Tony Duffin (Director) talks to us about how the ALDP has been influencing policy in relation to Medically Supervised Injecting Centres (MSICs).

ALDP announced a statement of intent regarding the drive towards MSICs, highlighted the evidence of public injecting, produced an organisational position paper which was followed by some fantastic work by Marcus Keane, also a Barrister, to produce a legal opinion. This led to legislation being drafted with the Voluntary Assistance Scheme which was formally handed over to the Drugs Minister, Aodhán O’Ríordáin, last year and is currently being considered under the Misuse of Drugs Act amendment bill which they hope will be passed by the Summer of this year.

Tony shows us the video from Sydney’s Medically Supervised Injecting Centre – he too was lucky like me to have spent time in the centre. I’ve seen the video many times and shown it to several people in Scotland – it is an incredibly useful tool, particularly for those who have never seen a service like this before. Everyone is impressed, as I knew they would be.

Some of the advice from Ireland which has been useful in their experience is;

  • Establish the evidence for your proposed change
  • Speak to the self-interest of the various stakeholders
  • Find common ground with your detractors
  • Engage with the media and promote your goal at every opportunity

I am enthused by the work taking place here, for a clearly evident need, and I am positive that they will be successful in implementing Supervised Injecting Facilities in the near future.

Many thanks to the ALDP for sharing their experience with us and congratulations to everyone involved so far, keep up the great work! I look forward to sharing this information with colleagues in Scotland 😉

 

 

Not Your Typical Sightseeing Trip: Exploring Public Injecting in Dublin City Centre

19,757 steps later (thanks Apple Watch) and I’ve seen more evidence of the need for supervised injecting facilities (SIFs), this time in Dublin. 

I am privileged and thankful to have been invited along on this trip by Turning Point Scotland to hear about the work taking place with the Ana Liffey project to support the SIF agenda. I’m also here with one of my Scottish Drugs Forum colleagues, Trish, and there’s a delegation attending from Wales. 

We’re due to meet Tony Duffin at the Ana Liffey project later this afternoon so we decide to go exploring. No historic buildings or open-top bus tours for us, but lots of alley ways and dead ends on the rake for discarded injecting equipment – not your usual sightseeing trip. 

We seem to have a nose for the right places and before long we’ve come across a very open lane just next to shops and restaurants. It’s quiet with only a couple of people hanging around – one who appears to be on look out and another who is obviously injecting while attempting to conceal this fact under a blanket. As soon as we leave the lane, multiple people appear from nowhere – a sign that they got out the way when they saw us coming. 

   

   
We get out of their way and soon find another area, again just off one of the main streets. This time there is equipment right next to human excrement. It really is so degrading for people to be in this situation. 

   
 
We head round to the office and meet our colleagues for some brief introductions before heading back out in groups, each with a ‘tour guide’, ours being Darryl. Darryl takes us round some of the main public injecting areas and talks us through the issues people face, with lots of similarities to Scotland- particularly in relation to polydrug use. The majority of people injecting in public places are homeless, often roofless and some of the most vulnerable and marginalised people in society. 

Having spent recent time in Sydney’s Medically Supervised Injecting Centre it is incredibly frustrating to visit an area without one with such obvious need. 

I look forward to tomorrow where we’ll hear from the staff in more detail regarding the progress in this area. That’s if I don’t interrogate them too much this evening at dinner! 

To be continued…