Tuukka Tammi Drug User Organisations in the Nordic Countries What Do They Want?
Drug User Organisations in the Nordic Countries What Do They Want? Tuukka Tammi tutkimuspäällikkö/research Manager A-klinikkasäätiö/A-Clinic Foundation tuukka.tammi@a-klinikka.fi
Further reading: Asmussen Frank, V., Anker, J.& Tammi, T. (2011). Drug user organizations in the Nordic countries local, national and international dimensions. Forthcoming in Substance Use and Misuse Journal. Anker, J., Asmussen, V., Kouvonen, P., Tops, D. (eds.) (2006). Drug users and spaces for legitimate action. Helsinki: NAD Publications. Tammi, T. (2006). Who is the expert? The patient groups and the Finnish substitution treatment policy. In: Asmussen, Vibeke, Jørgen Anker, Dolf Tops & Petra Kouvonen (eds.) Drug Users and Spaces for Legitimate Action. Helsinki: NAD publications Nr 49.
Starting points: Before - and largely still so - Drug Users have been regarded only as targets for control, prevention and treatment i.e. not regarded as competent partners in decision-making or service design. What are reasons for that? Drug user is not capable (addiction as a disease of the will?)?; or he/she should not have rights for that (->moralistic views drug user as a wrong-doer/criminal?)?; some other reason? At the same time almost every other chronic disease category (different cancers, diabetics, celiacic disease, skin diseases, mental health patients, etc. etc.) has their own patient interest groups, and they are increasingly powerful. Drug addiction also classified as a disease
What do we mean by Drug User Organisations (DUOs)? Organisations that represent and advocate for active hard drug users, mainly opiates, but also other drug users. The first drug users interest organizations came into being in the late 1970s in Holland, called Junkiebonds. In other European countries, drug user associations evolved in the mid-1980s when AIDS became a major concern, due to the fear of an epidemic among injecting drug users. Today drug user organizations are present in over 40 countries around the world. In the Nordic countries, drug user organizations emerged from the beginning of the 1990s (in DK). International networks of drug users strengthened since 2005.
Who are the drug user organisations (DUOs) in Denmark, Finland, Norway and Sweden? What kind of political agendas they have in four different, but also in many ways similar countries; the Nordic welfare states. DUOs in in Nordic countries: The Swedish Drug User Union (SDUU) Suomen Lumme ry in Finland The Danish Drug User Union (DDUU) FHN, RIO, LARnett n Norway
SDUU http://www.svenskabrukarforeningen.se/om
Suomen Lumme ry Established at the end of 2005. About 80 members, of which half are active drug users. The core group consists of clients and peer educators of the needle exchange programme in Helsinki. The goals and activities of SL are somewhat similar to its Nordic sister organizations in Denmark and Sweden In general, the main goals of SL are to gain more respect and better treatment of drug users in both public services and elsewhere in society. SL aims to give voice to users; to show that drug users are also responsible citizens; to advocate specific harm reducing measures; and to provide fellow drug users with support and advice. SL is closely connected to the Needle Exchange Programme (NEP) in Helsinki.
In Norway the field is more fragmented: FHN (Association for Human Drug Policy): For both active drug users and others that lobby for general drug political changes in Norway, moving away from a repressive policy towards a more human as they call it drug policy. RIO: Ex-drug users organization. LARnett: A patient group, mainly run/entirely run by patients in substitution treatment.
Typically DUOs advocate harm reduction measures (health care and health skills and information, especially in relation to infectious diseases and overdosing); but also promote drug users rights and position in society; support that drug users have easy access to drug treatment; seek to decriminalize or de-penalize drug use and possession of drugs for own use and to lower the penalties for drug-related crimes. function as a place to meet and socialize with other drug users. Some of them have drop-in facilities and organize different forms of activities for their members.
What Do They Want? One can say that drug user organizations have a double purpose: 1) they have a political aspect where they try to influence drug policies; to represent the interests of drug users in national or local political arenas; and to spread information about drugs, the risks of drug use, etc. 2) they have a social aspect where they provide self-help and support to drug users; provide social networks for drug users; create identity and recognition for drug users; and establish a free space, without stigmatization and control. Our review of DUOs show that drug users are both willing and able to step out from their externally given role as only passive targets, to the direction of serious and organised actors in decision-making and service design about them. So: Nothing about them without them?
Opportunities & challenges for DUOs 1. The role of drug policy approach: (public) health/harm reduction orientation opens up space for DUOs, whereas in abstinenceoriented prohibition only ex-users are regarded as legitimate actors. 2. The role of welfare services: clients and patients as lay experts and partners in service design. Also funding opportunities available. 3. Vulnerability: small core groups/individuals, often city-based, danger of being co-opted by public services and to loose autonomy? 4. The importance of international networks: INPUD, ENCOD, IHRA, NAMA, CORRELATION.