The UK Crew: What we will be taking back to the UK Alex: There is a few things but I’ll focus on one thing here and it’s about getting better information to current users about the risks involved in the injecting process and specifically – we know that people have got the message that its risky to share needles and syringes but everything else in the process of cooking up, particularly social cooking up – more than one person, I think we can do better at explaining to people that they are putting themselves at risk by sharing filters, sharing cookers, sharing the flushed water, and the most exciting thing is that we can do it cheaply, it can be user led and it could really have an impact on blood borne viruses in the UK.
Simon: I was struck by the comparisons – the United Nations, the World Health Organisation and all these other agencies and bodies, were basically giving the same message. It was quite remarkable – it was a sort of a byzantine empire, a sort of topsy turvy world in that in very advanced countries like America they have quite a punitive approach yet in extreme Muslim countries such as under Sharia law, they seem to have quite an enlightened harm reduction process. So there isn’t really a hard and fast rule, I think its an idea of public policy, health and the political will, and given the combination of those, much can and could be achieved.
Herman: I just found the conference content has been stimulating, has been thought provoking; themes running through in particular have been the partnerships working at all levels and, understanding the wider global issues surrounding drug misuse.
Oliver; influencing law enforcement policies, practical methods for influencing law enforcement regarding the improvement of harm reduction; examples Ive seen from Burma, China, Vancouver where they employ community action, self ownership and harmonisation of harm reduction and law enforcement aims.Really good examples of peer education, from china Thailand and Liverpool, use of phased peer ed training programmes, regular knowledge sharing programmes and the International element of the conference which puts into perspective the work that's going on in the UK but its also inspiring to see whats going on in Burma, Iraq, and china are able to achieve under such difficult circumstances and with little resources. Ive also gained a lot of knowledge about what the wider user involvement movement is doing around the world.
Eliot: I think the conference lived up to its title, the conference has come of age in 2 major respects. The first thing is user involvement is beginning to be cross organised on the international front which is a great thing and the 2nd thing is the serious attempt to come to grips with prohibition which has been one of the most important things for me, recognising it as the font of most drug related harms.
Sally: Ive 3 main themes, one is prisons, we really haven't got right harm reduction here and Ive 4 quick things that would be quick and cheap and easy to implement.The 2nd theme is on user involvement and how much better it is but how much more we have to do in terms of funding and training ourselves in order to get that right across the board in the UK. But my main thing is planning grids, treatment plans under harm reduction and my main points are that we need strategies for sex workers, gay and transgender people, and we need far more needle exchanges particularly in rural areas. The 3rd thing is we need strategies for methamphetamine and crack which is coming (to Cornwall/ South West England) and we are not prepared – (why aren’t condoms in treatment centres?) Strategies for HCV, it shouldn't be a postcode lottery, it should be standardised across the board and it should be available more than once if you need a series of treatments. We have a pandemic and we are just not addressing it.
Sharon: One of my key themes is frameworks of harm reduction for sex workers. Obviously in the UK there is harm reduction for sex workers but i think its quite mainstream and there is such a lot of barriers for women accessing these kinds of services. But looking at the frameworks particularly in countries like Australia, the US from Canada, and how they've been able to bring it all together and kind of have specific harm reduction for sex workers is what I want to bring back to the UK.
Jimi; the main thing that i feel really could be implemented in the UK is to do with refocusing drug testing in our prisons. There has been some examples in Scotland, of refocusing the money spent on drug testing onto support. Minimising the testing, using the remaining drug testing and making it randomised and anonymised, gaining information just to evolve treatment options. Scotland are doing it and I really really hope we follow suit in the rest of the UK.
Rick: The first one is advocacy. Advocacy has come up pretty much all the way through this conference. Advocacy for support, representation, Involvement in care planning, challenging the statutory services on medication issues, access to services, support through legal processes and statutory interventions, challenging discrimination, the list goes on. That links into drug user representation, planning, assessing, implementing service delivery and realistic interventions for once. Peer driven programmes – harm reduction and the empowerment of users to assist in all processes of harm reduction and peer support and peer education and outreach programmes and services.
The 2nd one is HCV, drug users can adhere to ART’s ARBs / treatments we need more awareness and more campaigns and no more exclusion of this group. More support groups are needed as are referrals to counselling and adequate blood works, liver screening etc. Health promotion needs advocacy available. 3rd point – prisons – needs inter grated care pathways and better continuity of care on release, we need NEPs in prisons, condoms, specialist IDU advice and information and peer support advocacy and training programmes. HCV screening, referrals and treatment and care pathways upon release. And specialist services for LGBT/ MSM IDUs, to address transgender needs in every region, their health issues, counselling, to develop programmes and policies that address their current exclusion/obstacles from accessing services. And of course - DATA, better data collection in all aspects of harm reduction.
VIV: My first point is that we need to work much more closely with the EU harm reduction recommendations 2003 which dose state that harm reduction paraphernalia should be widely available in prisons, in rural areas, a lot more mobile NEPs for homeless people and sex worker areas. The 2nd point is working to value health above law enforcement, so working alongside the police in terms of advocacy and training – there was a good quote that you can get over an addiction but you cant get over a conviction. The third one is using user reps to be involved in all public policy making, its worked really well to have both user groups and health professionals working together. 
Erin: For the user groups in the UK who are constantly developing and evolving in terms of their strategies and ideas, the opportunity for us to know what is going on with other drug user groups in the rest of the world is essential. There is a great deal we can learn from each other and it is the time now for us to start using our media and IT networks and resources to really start sharing our knowledge and ideas. But more than that, we need to support each others fights in other countries. Every single drug using country where prohibition reigns, has a constant fight and uphill struggle on their hands - and our hands are still soaked in blood. We may forget what is happening is Russia as we fight for our diamorphine scripts while methadone is still illegal for them - we have to remember to support each other and that is part of the reason behind why an international network and resource centre is crucial for our futures.2nd: We need to reevaluate the Needle exchange in the UK. We need to look closely at what drug users themselves feel they need to learn. Shame and stigma around drug use and in particular, 'self inflicted' injuries, or injuries sustained from injecting or stimulant induced picking, self harming etc, are deeply hidden but widespread and the financial, social and psychological costs of not attempting to deal with these issues in any comprehensive/confidential way at frontline NEPs, is immense. It's time we really shook up NEPs out of their complacency and made them adaptable and useful to drug users, addressing the constantly changing face of the drug scene. We need variety in front line services, not repetition.
And thirdly and just as importantly - we need to do more as a community to challenge stigma and address the relentless bad press and negative public image drug users face on a daily, yearly basis. There is no reason why the NTA and the government cannot support us here. Stigma is at the root of just about every single problem, obstacle and setback drug users across the world face. Ignorance yields prejudice which is behind social exclusion and isolation. We need to let the UK know what work we are doing as a community, we need to have a multi pronged approach in terms of challenging and changing societies attitudes towards drug users. We need to remember our dead, we need to strengthen our networks work with the media and we need to be clever to challenge the prejudice that is killing us. We must never, ever be afraid of direct action when its needed - we have a great deal to learn of the aids and gay rights movements when they were at the height of their persecution. We must never forget what is really going on underneath the multiple facade of drug user victimisation. We must work to change our future, and to make sure its a future we want.
We all had a brilliant time, thank you to everyone, IHRA, the lovely hotel staff and chefs, all the fascinating people who brought their ideas, reasearch and projects to share - and of course the NTA who funded us all to go. Thank you. x
