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Wednesday 14 May 2008 – DAY FOUR –
Daily Update
– 5
‘Everything comes together with pregnant drug using
women,’ said social justice advocate and educator
Wyndi Anderson in her session on uniting harm
reduction and women’s rights.
‘They are the perfect storm. We haven’t figured out what
harm reduction is with pregnant drug using women, and
many in the women’s movement don’t want to advocate for
them.’ They had also become a perfect vehicle for the
conservative agenda in the US, she said.
‘A lot of the women’s rights folks would say “we’re dealing
with abortion – that’s enough. We don’t want to deal with
drugs.” But they eventually got that it’s not just a drug policy
issue, it’s a women’s rights issue.’
Just over a decade ago saw the launch of the South
Carolina Advocates for Pregnant Women, which evolved into
the National Advocates for Pregnant Women, and out of this
had come an advocacy model for drug users, the legal
community, communications and media, healthcare providers,
policy makers and others. Women’s rights and harm reduction
met in the criminal justice system, the social services system,
rape crisis centres, domestic violence centres and women’s
health care, she said.
Bringing together the two agendas made a much bigger
base for political advocacy, and more opportunities for
funding, she said. It was essential to make connections and
build strong networks between local women’s rights and
harm reduction projects. ‘It can be tense when you work
across movements, but you need patience, long-term vision,
persistence and to stay focused on the bigger picture.
There’s more to it than just conferences. But that’s a good
place to start.’
Pregnant, drug using women
– the ‘perfect storm’
proven otherwise, and drugs for drug
dependency should be no exception.’
There was undoubtedly a genuine need
for new treatments for heroin dependency
however, he said. ‘Opioid substitution is
effective, but we need new options. The
problem with ibogaine is lack of evidence.’
What was needed were a range of studies
from use in different countries, with rigorous
designs including randomised controlled
trials and published in reputable, peer
refereed journals, he said. ‘Evidence that
ibogaine is effective as a treatment is
minimal - there are few studies, they involve
small numbers of subjects, are mainly self
reported, with short follow up and lots of
‘mights’, ‘maybes’ and ‘could haves’.’
Dr Wodak then moved on to consider
whether ibogaine could be used in
detoxification to aid short term, safe,
comfortable withdrawal. ‘There are more
studies on ibogaine for detoxification than
for heroin dependency treatment, but these
are still only preliminary and the evidence is
still unconvincing,’ he said.
‘Supporters of ibogaine make a number
of claims – that it reduces drug cravings,
opioid withdrawal symptoms and the
sustained complete withdrawal of opioid
withdrawal symptoms,’ he acknowledged.
‘In terms of safety we’d like to see lots of
laboratory studies in animals and human
studies, both short and long term.’ Deaths
and severe illnesses had also been
reported, he said, and the data for safety
was still at a minimal stage. ‘We should not
make the mistake of thinking its safe
because it’s organic,’ he stressed.
There were insufficient resources to
research every drug and funding decisions
were often made using hard nosed criteria,
he said. ‘So, should people just go ahead
and use ibogaine anyway? There have been
too many tragedies from cutting corners in
drug regulation. We have to accept the
assumption that ibogaine is ineffective and
unsafe until evidence to the contrary
emerges. In 2008 we really do not have
evidence that it is an effective and safe
treatment for heroin dependence and for
use in heroin detoxification.’
The Caucus’s first statement
has been drawn up to represent
the group’s thoughts on harm
reduction and human rights, using
materials from Canadian sex
worker rights group ‘Stella’ as a
starting point. The statement
asserts that sex work is not itself
inherently harmful, and should be
recognised as work to give sex
workers safe working conditions.
‘We are resolute that any harm
associated with sex work results
from repressive environments in
which sex work is not recognised
as work, and because sex workers
lack basic human rights and
access to appropriate health
services,’ says the group.
In the spirit of the service users’
slogan ‘nothing about us, without
us’, the Caucus is also keen to
encourage empowerment, which
they say is essential to fight HIV
and discriminations without stigma:
‘Sex workers are their own best
resource – they should be at the
forefront of developing and
implementing the programmes and
policies that impact on their lives.’
Among various presentations
and workshops on safer sex work
taking place this afternoon, Kitten
Infinite from SWOP in Chicago will
look at how sex workers can ‘work
smarter not harder’ by managing
their own risk.
An example is encouraging sex
workers to share clients, she told
The Daily Update
. ‘Clients tend to
revolve around a ‘family’ of sex
workers if they can give appropriate
referral,’ she explained. ‘This lends
a receptive relationship and
negotiates prior knowledge and
wisdom about a client, such as
rates, preferences and tips. Sharing
information with another sex worker
negotiates control over situations…
it fosters community. Many sex
workers experience isolation within
their work and seeking out other
sex workers to share the dividends
creates relationships that keep sex
workers safe.’
St James Infirmary had publish-
ed a study that showed sex work-
ers within a community experienced
lower instances of violence, sexually
transmitted infections and HIV. It
also sent important messages to
the client, Kitten Infinite pointed out:
‘Clients who acknowledge a sex
worker has the support of com-
munity are less likely to exploit or
harm them as well.’
More information about the Sex
Worker Harm Reduction Caucus is
at www.bestpracticespolicy.org/
caucus.html.
Sessions on sex work are
held today at 14.15-15.45 in
Room 4 and 16.15-17.45 in
Room 11
.