Stigma and older injecting opioid users

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Jenny Kelsall (AIVL) reports on AIVL's research into the experience of older injecting opiod users in Australia. She identifies the harm-reduction policies, including needle-and-syringe programs, as contributing to the 'unexpected' improved life-expectancy of people who inject drugs.

This presentation was given at the AFAO Positive Services Forum 2012.

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Stigma and older injecting opioid users

  1. 1. Older Opioid Users + Stigma AFAO Positive Services Forum March 19-20 2012 Melbourne Jenny Kelsall 1
  2. 2. Double Jeopardy –Older Injecting Opioid Users in AustraliaThe process: Informal discussions among AIVL members Establishment of steering committee to oversee development of discussion paper Involvement of AIVL staff & peer consultants as well as researchers and clinicians Examination of several national data bases to establish existence of an ageing cohort of IDUs Literature review - few published studies in the literature AIVL Study of Older Opioid Injectors 2010 2
  3. 3. Double Jeopardy –Older Injecting Opioid Users in AustraliaFindings (1): Clear evidence of large & growing number of older opioid users in Australia & the changing demographic of illicit drug users Decreased number of participants in younger age categories Harder to quantify or calculate how many older opioid injectors in Australia 3
  4. 4. Double Jeopardy –Older Injecting Opioid Users in AustraliaFindings (2): There could be as many as 30,000 regular opioid users in Australia aged 40 years or more & up to 80,000 non-dependent opioid users The trend towards ageing in Australian surveys is supported by international research A number of different theories are put forward to explain the trend towards ageing among injecting opioid users 4
  5. 5. Double Jeopardy –Older Injecting Opioid Users in AustraliaAIVL Study of Older Opioid Injectors 2010: Key themes included: Stigma & Discrimination  Health Issues  Pain management  Pharmacotherapy  Hepatitis C and other BBVs  Financial Issues  Housing  Family  Employment  Social isolation 5
  6. 6. Double Jeopardy –Older Injecting Opioid Users in Australia‘The morning he died (from hep C relatedliver failure) we were pleading with thenurses to give him some morphine. Theywanted to wait another 30 minutes. WhenI asked why, they answered ‘because it’snot good for his liver ! Ten minutes later . .. . . . he slipped off into the ether’.G. McGuckin (2010) So long Soldier. User’s News No. 60: 15 6
  7. 7. Double Jeopardy –Older Injecting Opioid Users in AustraliaAIVL Study of Older Opioid Injectors 2010 (3): The majority of respondents raised issues relating to: Poverty  Unstable housing  Social isolation 7
  8. 8. AIVL’s Anti-Discrimination Campaign Stage 1: AIVL contracts a Market Research Company to undertake consultations with key stakeholders and the general community, including healthcare providers Stage 2: AIVL conducts a comprehensive review of the literature and publishes a report to understand the history of stigma and discrimination towards PWID – ‘Why wouldn’t I discriminate against all of them?’ Stage 3: AIVL is about to launch a short film to address stigma and discrimination towards people who inject drugs – for use in training sessions with healthcare providers 8
  9. 9. AIVL’s Anti-Discrimination Campaign (2) WHY WOULDN’T I DISCRIMINATE AGAINST ALL OF THEM? A Report on Stigma and Discrimination towards the Injecting Drug User CommunityAUSTR A L I A N I N J E C T I N G A N D I L L I C I T D R U G U S E R S L E AG U E JUNE 2011 9

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