1. The Changing face of Drug Use & the Role of Needle Exchange Programmes; Ensuring NEP’s are equipped to meet the hidden and emerging needs of drug users. Erin O’Mara Editor Black Poppy Magazine

2. NEP’s - Perfectly Placed to Respond Good reputation, non judgemental, generally trusted amongst drug users (rare commodity!) People ‘volunteer’ to attend, not forced By working closely with drug users, on the front line, vital changes in the health and welfare of the drugs scene will be picked up NEP’s are an excellent background for effective user involvement, developing work opportunities & volunteering for users, bridges for community concerns.

3. Its all legal! On 8th July 2003 a press release announced that the ACMD recommendations on paraphernalia supply had been accepted, and that 'The Government will be laying a negative resolution statutory instrument to implement changes to section 9A of the Misuse of Drugs Act 1971' with effect from 1/08/03. This will make legal the supply to drug users of '5 types of items': ampoules of water for injection; swabs; utensils for the preparation of a controlled drug (spoons, bowls, cups, dishes); citric acid; and, filters.

4. Questions, Questions & Answers? Should I be using a green, long/short blue or long orange spike for my groin? What direction to I inject in when using my feet? Where should i go now my arm veins are gone? How do i keep my groin hole clean, its always weeping?

5. Essential Injecting Information Better knowledge about the right syringe for the job.... Better knowledge about how to deal with anxiety episodes in injecting... Good knowledge about the issues around using and sharing tourniquets –.... What to do when a syringe becomes filled with a bloodclot – And, of course, a good understanding of location and functions of veins and arteries.

6. User Involvement Intrinsically and historically linked for the drug using community with the rich and complex issues that are ‘our lives’. User involvement has stemmed from how we are treated - medically & emotionally How we are seen – through ignorance and labels How we are affected – by discrimination and years in drug treatment and How we are affected by finally having a voice How we are affected by finally having a voice

7. The Power of Personal Experience By definition, no one else – no matter how well trained or qualified – can possibly have had the same experience of drug treatment, the same initial contact with services or the same journey through the mental health, legal and drug treatment system. These experiences are an important resource in developing services.

8. Be Mindful... It is important to remember when being courted for your views, there can be a propensity by services/health professionals, to ask to much for too long, with too little in return. The exclusive ‘inside knowledge’ that users have developed through lived experience, has often been at huge emotional, familial and financial cost and people can forget or ignore the price users have paid, exploiting this fragile ‘privilege’.

9. Harm Reduction Equipment -1 Water: An essential resource. Steriboxes: see demo Swabs: Important but in the scheme of things but steriboxes, water, tourniquets, are more important if funds are an issue. Filters & tourniquets: see demo The sterifilt: see demo Citric Sachets: Pill filters – research this valuable equipment. All legal – all available – all absolutely necessary -

10. Harm Reduction Equipment -2 Syringe I.D – New from Exchange supplies: Prevents accidental sharing Crack Pipes: Utilise the research from USA & your User Groups and clientele to research equipment Mouth pieces: Utilise the research from USA & your User Groups and clientele to research equipment Plastic packs of Vaseline: Easy to put together, cheap and very useful for dry and burnt lips Naloxone tablets: Now allowed to be dispensed under PGD (Patient Group Direction) and legal for anyone to administer! TRIAL EVERYTHING – NEVER ASSUME – ALWAYS ASK YOUR CLIENTS 4 REVIEW

11. Essential Health & the NEP Hep B vaccinations… Clear Hep C information… Safer using/injecting consultations... Food… Wound management… Contraception… Condoms AND lube…

12. Opening Times: Be innovative. The fact is drug users don’t live within a 9-5 existence, sex workers, homeless users, and many IV and drug users would make use of a service that is open for a few hours at night, even if it is only for HR equipment. Relinquish a couple of hours in the day in order to respond to needs and be open for a couple of hours at night – 8-10pm for example. Or work hard to get a vending machine on site – (there is someone here today with info on them)

13. Workshops, chats, groups Hep C treatments… Coinfection issues… Wound management … User involvement… Injecting practices… Contraception: Overdose prevention:

14. Workshops, chats, groups Safer using… Vein care… Mixing drugs and medications… Information collation and production... Bacterial issues...

15. Training, Volunteering and Work Programmes NEPs are perfectly placed to take the forefront in UI. Because real UI will involve mechanisms to support and encourage users to get into the drugs field for work or volunteering. Our ‘specialist knowledge’ is extremely rare and almost always culturally and regionally specific - you wont get a service that responds to injectors needs, without fully considering & involving the injector.

16. OUTREACH Slowly dying, must be resurrected! Will be essential in how effective services are in responding to current & future changes in the drugs scene Especcially effective when address the most isolated and vulnerable users – A lifeline for those with mental health issues or suffering from violence.

17. Information Work with your client base to find out what’s going on in your area and respond to it Engage your closest user group to define and create the information you need Be creative in your information – ‘Up the bum’ campaigns Subscribe to magazines and look out for the best leaflets – ask your clienst for advice as to what they find helpful or useful

18. The End! Thank You

19. Notes available