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Inject, smoke, sniff, swallow, insert.
People elect to use different
drugs in different ways. Quite often we also choose to use the same
drugs in different ways, according to the situation, the quality or
formulation of the drug. This is the normal ebb and flow of drug
taking. We may have preferences, but these aren’t necessarily rigid.
Sometimes these shifts are very striking. Witness the impact of the
shift away from injecting in The Netherlands and parts of Spain, or the
way that methamphetamine use seemed to partially replace heroin
during Australia’s heroin ‘drought’.
In a global context in which prohibition aggravates the risks and
consequences of injecting, it is helpful to appreciate the alternatives
that exist and the reasons why these may sometimes be preferable.
Smoking base heroin, crack or crystal methamphetamine on foil using
a home constructed pipe can offer advantages that people value. It’s
good to have choices.
Chasing heroin instead of injecting can reduce overdose risks on
occasions when you are also using benzos or have been drinking
alcohol. Chasing crack rather than injecting or piping it reduces the
intensity, but makes it last longer and can leave a large residue in the
pipe to enjoy at the end of smoking session – ‘Best Til Last’, as an
early HOT Team social marketing project put it. When veins are shot
and hard (or almost impossible) to get, chasing may get more of the
drug to your brain and faster, than repeatedly chasing and missing
finer and finer veins. Or it may help avoid using veins that some
people prefer not to use in the groin or neck and give other veins a
chance to recover.
If you are trying to get a hit together and withdrawing, a little smoke
first can calm things down and take some of the agitation and urgency
out of the situation. Then you have more time to put the hit together
carefully and better options to avoid using in risky environments where
you will be in a hurry, and the dangers of wasting the drugs through
missed hits or rushed preparation also increase.
Some people’s preference for injecting means that alternatives
such as smoking on foil are of no interest, but the evidence shows
that others value having more options. One way in which needle and
syringe programmes and drug consumption rooms have begun to
extend their range of services, is to provide foil that can be used on
site (DCRs) or taken away (NSPs and DCRs). In NSPs this addition to
services also means that people who chase, but don’t inject, also
start coming to services for the first time, improving engagement and
opportunities for harm reduction with non-injectors.
Please join us to learn how to make foil pipes and some of the
techniques for their use. This is a participative session, so if you have
a better or different pipe design, come along and show everyone –
especially if you have good designs for using crystal meth. We’ll be
delighted to learn from you.
The foil pipe making demonstration will take place in the
dialogue space today at 12.00–13.00.
6 –
Daily Update
– Tuesday 11 June 2013
Sharing techniques
Join us for an interactive dialogue session collecting and demonstrating
foil pipe making techniques from around the world, and discussing their
potential as an alternative to injecting, says
Neil Hunt
Challenging brutal
treatment in India
Manipur was a small state but with a long, porous border with
Myanmar and the highest proportion of people who use drugs in
India, Rajkumar Nalinikinata, of CoNE (Community Network for
Empowerment) told delegates in Monday’s
Users’ choice
session.
It also had one of the highest rates of HIV in India, standing at 28
per cent among people who used drugs and with hepatitis C rates
as high as 90 per cent in some districts. There was, however, ‘no
response’ in terms of prevention, testing and treatment, he said.
People identified as drug users were also frequently penalised,
harassed and extorted by the police, he said. ‘Some of us are also
forcefully admitted to treatment centres without our consent.’ These
were characterised by a lack of proper medical care, forced labour
and physical abuse, with people chained to beds for the first 15 days
of their stay. ‘When we try to put in any kind of complaint, the
consequences will be physical abuse or torture in some form,’ he
said. ‘It’s clearly not a treatment centre but rather a detention centre.’
The consequences were that few people sought treatment, and
treatment outcomes were very
poor, he stated. ‘People are also
developing mental problems as a
result of this, and there are in-
creasing numbers of people dying
in treatment centres. Families fear
sending people to treatment
centres – 16 people died in one
month in one centre, because of
lack of medical care.’
His organisation, CoNE,
however – a state-level network of
people who use drugs in Manipur – had formed a fact-finding team
to investigate deaths and human rights violations in treatment
centres, producing a report which had been shared at state level.
An advocacy campaign had been launched, with press briefings
and consultations, which ultimately led to a state declaration to
immediately stop chaining inmates in the name of treatment, and
other violations of human rights, alongside a commitment to
ensuring quality services.
‘We were able to bring about changes after the community
came together to address these issues,’ he said.