IMPORTANCE OF PEER-BASED SERVICES & NEEDLE & SYRINGE PROGRAMS (NSP)

Transcription

1 IMPORTANCE OF PEER-BASED SERVICES & NEEDLE & SYRINGE PROGRAMS (NSP) Annie Madden Executive Officer Australian Injecting & Illicit Drug Users League (AIVL)

2 SUMMARY Who is AIVL? 2 Harm Reduction Approaches: Peer-based services Needle & Syringe Programs (NSPs) Useful resources & contacts

3 WHO IS AIVL? National peak organization for the state and territory peer-based drug user organizations and Represents people who use/have used illicit drugs at national level. Work on all issues affecting people who use/have used illicit drugs including HIV, hepatitis C, harm reduction, drug treatment, overdose, welfare reform, housing, police, courts, prisons, parenting issues, etc.

4 TUF WASUA AIVL works through member organisations & networks QUIHN & QuIVAA NUAA SAVIVE CAHMA VIVAIDS TASCAHRD AIVL

5 WHO IS AIVL? AIVL operates on a peer-based philosophy, which means the organisation is run by and for drug users and ex-drug users. AIVL promotes the health and human rights of people who use/have used illicit drugs. AIVL believes drug users have the right to be treated with dignity and respect. And to live their lives free from discrimination, stigma and human rights violations.

6 PEER-BASED SERVICES What are peer-based services? Why are peer-based services important? Some examples of peer-based services.

7 WHAT ARE PEER-BASED SERVICES? Illicit drug users (and particularly injecting drug users) are one of the most marginalized groups in the community. Illegality, shame and stigma force illicit drug users away from information, support and services. Long term effects of being locked outside of mainstream society are: Serious health problems; Unemployment; Family and community breakdown; and In many cases, premature death.

8 WHAT ARE PEER-BASED SERVICES? Peer-based services play a crucial role in linking people back into society and to support and services. How? Peer-based services are run by and for drug users and ex-drug users. Peers understand and can empathize with the issues drug users experience and this creates credibility and trust. Have unique ability to reach highly marginalized people and groups that other services cannot reach.

9 WHAT ARE PEER-BASED SERVICES? Peer-based services are based on the concept that: drug users can and do educate and learn from each other; these interactions are part of the everyday lives of drug users and can be utilized as an education, advocacy and support tool; drug users/ex-users can manage their own programs and speak on their own behalf; and drug users have first hand knowledge of the issues that affect them vital in the targeting, planning & delivery of services and in policy development.

10 WHY ARE PEER-BASED SERVICES SO IMPORTANT? Peer-based services are important because: they are based on the philosophy of empowerment; they encourage drug users and ex-users to take an active role in their health & wellbeing; they are cost-effective - capacity to reduce long term health & social costs through effective prevention; they WORK! How do we know? Australia has maintained one of the lowest rates of HIV among IDU in the world for over 20 years; and has a declining hepatitis C rate among IDU; The difference? Australia is world leader in peerbased services and organisations.

11 SOME EXAMPLES OF PEER- BASED SERVICES Many different forms of peer-based services/programs: Peer education formal and informal Peer support groups and individually based Peer advocacy - advocating on behalf of individuals Peer representation advocating & representing on behalf of drug users & ex-users as a group Peer-based needle & syringe programs Peer-based primary health clinics Peer training formal skills & capacity building courses Peer resources and materials incl. magazines

12 NEEDLE & SYRINGE PROGRAMS (NSPs) How & when did NSPs start? What range of services do NSPs offer? What s the picture in Australia? Are NSPs effective? Frequently Asked Questions

13 HOW & WHEN DID NSPs START? First NSP in Sydney in 1986 NSP has been in operation for 22 years Australia now has NSPs in all states and territories Primary outlets, secondary services, pharmacy, vending machines Over 900 NSP outlets in Australia (does not include pharmacies)

14 RANGE OF SERVICES NSW NSPs OFFER? Access to new injecting equipment Needles & syringes Other equipment (spoons, swabs, water) Disposal containers Specialised equipment (large barrels, butterflies, pill/bacterial filters, etc) Education & harm reduction information Ancillary services BBV & sexual health screening, Hep B vaccination, vein care, etc. Referrals to drug treatment and other health, social and legal services

15 WHAT S THE PICTURE? Primary outlets NSP specialist services Secondary outlets community health, youth & AOD services, A&E Depts. Mobile Outreach & Pedestrian Outreach Pharmacy outlets majority under Pharmacy NSP Scheme, small number (2-5% of total distribution) independent. Over 35 million N&S distributed nationally each year. Almost 95% of respondents in National NSP Survey reported using new N&S for all (72%) or most injections (22%)

16 ARE NSPs EFFECTIVE? Nationally Return on Investment Study 2002 between 1991 and 2000 Australian NSPs are estimated to have: Prevented approximately 25,000 HIV transmissions among people who inject drugs; Saved over $7 million in HIV/AIDS lifetime treatment costs; Prevented approx 21,000 cases of hepatitis C transmissions among people who inject drugs between 1988 and 2000; and Saved an estimated $783 million in HCV lifetime treatment costs.

17 ARE NSPs EFFECTIVE? Nationally Return on Investment Study 2002 between 1991 and 2000 Australian NSPs are estimated to have: Provide a return on investment of $7.7 billion for Provide a return on investment of $7.7 billion for an investment of $150 million over 10 years. Major cities that implemented NSP prior to 1997 have seen an 8% decline in the rate of HIV & HCV infections. Major cities without NSP have seen an 18% increase in HIV & HCV infections in the same time period.

18 ARE NSPs EFFECTIVE? NSW Return on Investment in HIV/AIDS Programs 2007 found that: Return on investment in HIV prevention programs direct cost to direct benefit ratio of 1:13 (every $1 invested/$13 saved); Compared to 1:2 (Tobacco) and 1:0.70 (Heart Disease) Prevented 44,500 cases of HIV with 75% of these among IDU; Representing a 99% reduction in HIV cases that would otherwise have occurred among IDU; Saved an estimated $18 million in HIV lifetime treatment costs through prevention programs.

19 FREQUENTLY ASKED? Does NSP increase/encourage injecting drug use? Answer: No. International research (WHO) has shown NSP does not increase rates of or recruitment to injecting drug use. Indeed research has found NSP attendees are more likely to cease injecting due to access to drug treatment referrals. Does NSP send a message that society has given up on preventing drug use? Answer: No. NSP is only one strategy among many and can work along-side law enforcement, drug treatment, etc.

20 FREQUENTLY ASKED? Does NSP increase needles & syringes discarded on the streets? Answer: No. Most Australian NSPs have regular return rates of over 90% Levels of discarded used injecting equipment has decreased since introduction of NSP. NSP can run programs to collect and clean-up local hot-spots Never been a recorded case of HIV, hepatitis C or hepatitis B by a member of the Australian public following a needle-stick from a publicly discarded syringe.

21 FREQUENTLY ASKED? Do NSP save lives? Answer: ABSOLUTELY!!! NSP is about keeping people alive and as healthy as possible while they are using. You cannot refer a person who has died from a drug-related overdose or HIV/AIDS to drug treatment. NSP = a humane, compassionate and pragmatic response to a global public health issue.

22 FURTHER RESOURCES IHRA Global State of Harm Reduction Report May NSP - Questions Answered & NSP - Review of the Evidence National NSP Survey Returns on Investment in NSP Study NSW Return on HIV/AIDS Investment AIVL Disposal Report & NEP in Prisons

23 CONTACT DETAILS My Details: Annie Madden Executive Officer Australian Injecting & Illicit Drug Users League (AIVL) Ph: (02) Website: