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Monday 10 June 2013 –
Daily Update
– 5
have a mobile van – the “blue bus” – but
we’ve replaced it with a more advanced
vehicle,’ he says. ‘We’ve had a specially
designed, heated bus with a counselling
room for about two years now.’ All of the
service users’ files at the centre are also
managed by social workers rather than
clinicians, which leaves the doctors free to
concentrate on treatment. ‘We find it’s a big
advantage, compared to the earlier practice
when the physician was taking
responsibility for the patient,’ he says.
Things haven’t always been easy, however,
with attempts to close down his service as
recently as 2005. ‘At that time there was an
attack from some politicians in the
parliament who were very strongly against
harm reduction,’ he explains. ‘But the
programmes survived, and the funding was
always available from the Ministry of Health,
so there has been a mixed attitude. The
ministry was always supportive of harm
reduction and opioid substitution therapy,
and the government’s drug control offices
were also always supportive of these
interventions, but from time to time there
were politicians who expressed negative
opinions about harm reduction – there were
discussions in the media, as well as
between agencies and so on.’
It all depends on the political climate, ‘the
same as anywhere else in Europe’, he states.
‘We have conservative politicians who are
critical of harm reduction, and more pro-
gressive politicians who are more accepting.’
Unlike many places, however, there has
been very little resistance to the implemen-
tation of harm reduction interventions from
the public, he says. ‘I would say the
general public is largely neutral. Some
years ago there was a formal survey on
attitudes towards opioid substitution
therapy, and it found positive opinions. The
police are also quite supportive of opioid
substitution therapy and harm reduction
because they’re disillusioned about the
ability of law enforcement alone to
suppress the drug trade.’
The staging of the 23rd International
Harm Reduction conference in Vilnius is
also a significant event, he believes. ‘We
hope that the conference will attract the
attention of the media and promote dis-
cussions among Lithuanian professionals,
specialists, politicians and the general
public,’ he says.
This year we’ve been able to expand the range of services being offered,
to make them truly worthy of a harm reduction event.
Dr Emilis Subata, director of the Vilnius Centre for Addictive Disorders, has kindly agreed to
prescribe opioid substitution therapy (OST) for delegates who are unable to export medication
from their country of origin, such as Ukraine, Belarus, Kyrgyzstan, Armenia and Tajikistan.
Arrangements have also been made with a private doctor who will facilitate treatment for
delegates from Russia who are dependent upon opiates but unable to access OST, due to
methadone and buprenorphine not being permissible in Russia. We anticipate at least 20
delegates needing such treatment, which will be dispensed on a daily basis from the clinic.
I am glad to report that we have the opportunity to offer an open Needle Syringe
Programme (NSP). We have endeavoured to ensure that people’s needs are fully met, with
a variety of needles and syringes being provided, along with other injecting equipment such
as stericups (cookers), filters, citric acid and vitamin C, swabs and water. Foil for smoking
will also be available and outreach NSP provision will also be offered. Much of this
equipment has been generously donated by Exchange Supplies, the UK’s leading supplier
of specialist injecting equipment (www.exchangesupplies.org).
Sharps bins for safe disposal of injecting equipment will be available in the main toilets
within the venue, as well as in the medical room. Equally, people will be supplied with
individual disposal units, which can be handed in at the end of the conference.
A new feature of our service is the provision of naloxone – another welcome gift, this time
courtesy of Kaleidoscope Drug Services, UK (www.kaleidoscopeproject.org.uk). There will be
more than 100 kits available for distribution, and training can be provided for those who need it.
We will also be able to provide confidential HIV testing by appointment. This will include
a pre- and post-test discussion, plus screening. This is being offered by Demetra
(http://demetra.lt), an association for HIV affected women and their families.
As usual, we will undertake brief consultations relating to minor illnesses and injuries,
whereupon basic first aid will be offered along with any appropriate treatment or medication.
If more specialist services are required, we can refer on. In the event of an emergency,
people should call 112. The emergency hospital is Vilniaus Greitosios Pagalbos
Universitetin
ė
Ligonin
ė
, at Šiltnami
ų
str. 29, LT-04130 Vilnius; telephone: (+370) 5 216 9069.
The medical room (number 314 on the first floor) will be staffed by myself, a paid nurse
from the Baltic American Clinic, and volunteers, some of whom will be engaging in NSP
outreach work. The medical room staff, including volunteers, will be wearing white t-shirts
with orange writing, saying ‘Can I help?’ on the front and ‘Medical Services’ on the back,
along with the HRI conference logo.
I will be available on + 370 690 41914. This is my number for the purpose of the conference
only and is provided via a Lithuanian registered sim card, so any calls should be cheap!
Our most grateful thanks go to the volunteers, organisations that have donated the
necessary goods, EHRN and HRI staff, all of whom have worked very hard to make
this a valuable and comprehensive service.
NEWS
from the
medical room
Once again this year,
Gill Bradbury
,
registered general nurse and harm
reduction practitioner, is
coordinating the conference’s
medical and healthcare services.
She tells us what’s involved