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Reflections
on
Stimulants,
OAMT, NSP,
DCRs in
England
Mat Southwell
Managing and Technical
Director Coact
Organiser with Respect
P2PNSP in Bath and
North East Somerset
Agenda
• Responses to people who use stimulants –
reflections from UNODC UNAIDS WHO Guidelines,
UNODC-HIV Training Toolkit and SIPP
• OAMT - reflections from EuroNPUD OAT Literacy
and Rights Project and SURIA CLM OAMT Project
from Ireland
• NSP and N&S Quality and Coverage – Reflections
from EuroNPUD Technical Briefing on P2PNSP and
Unitaid Hep C Portfolio
• Drug Consumption Rooms – comments from INHSU
Community Day 2023
Purpose To provide practical guidance to countries on implementing
comprehensive HIV programme for people who use stimulant
drugs, vulnerable to HIV, based on existing UN guidance
documents.
Target audience Programme managers at national and local levels
People who are planning or implementing HIV / HCV programmes
for people who use stimulant drugs, including NGOs and
community-based organisations representing /working with
people who use drugs including men who have sex with men,
sex workers, transgender people & people in prisons
Stimulant drugs that are linked to increased
HIV risk among key populations
Methamphetamine:
• Amphetamines and
methamphetamines exist in
different forms, e.g. crystals
(methamphetamines), powder or
pills / tablets.
• Methamphetamine may be taken
orally, snorted, smoked as vapour in
a pipe, inserted anally or injected in
a solution.
New Psychoactive Substances
Stimulants (NPS Stimulants):
• Exist in various forms, e.g. synthetic
cathinones, phenethylamines,
aminoindanes and piperazines.
• Sometimes referred to as “bath salts”
• Depending on the form, new
psychoactive substances are taken orally,
smoked, inserted anally or injected.
Cocaine and
Smoked Cocaine:
• Exists in various forms, e.g.
cocaine powder, smokable
cocaine, crack cocaine,
freebase, paste base, paco,
basuco.
• Depending on the form, it
may be snorted, injected or
inserted anally.
1. Condoms, lubricants and safer sex programmes
2. Needle and syringe programmes (NSP) and other commodities
3. HIV testing services (HTS)
4. Antiretroviral therapy (ART)
5. Evidence-based psychosocial interventions and drug dependence treatments
6. Prevention, diagnosis and treatment of sexually transmitted infections (STIs),
hepatitis and tuberculosis (TB)
7. Targeted information, education and communication (IEC) for people who use
stimulant drugs and their sexual partners
8. Prevention and management of overdose and acute intoxication
Critical Enablers – Community mobilisation and online outreach
The Core Interventions – Stimulants and HIV
Missing: Mental Health response to
people who use stimulants
2. Needle and syringe programmes (NSP) and
other commodities
Plentiful
supply of
sterile needles
and syringes
Silver foil
Meth pipe
Safer
“snorting”
kit
Crack pipe
or stem
Intersectionality – The Challenge and
Opportunities of Stimulants and HIV
English Drug and Alcohol Commissioners June 2024.pptx
English Drug and Alcohol Commissioners June 2024.pptx
OAT Rights & Literacy
● OAT Client Guide
○ Sweden, Scotland, France,
Spain, Catalonia, Germany,
Greece
○ Volunteer attempt to deliver
in England – strong response
medics – weak response NGOs
● Community-led Monitoring –
SURIA Ireland and Georgia
● Lessons from Scottish reforms
of MAT
● EuroNPUD OAT Project Team
meeting in Warsaw alongside
European Harm Reduction
Conference
English Drug and Alcohol Commissioners June 2024.pptx
Care Plans and
Treatment Choice
 44% do not know what a care plan is, down
from 69% 2020. ICON—49%.
 42% do not have a care plan.
 Partnership. Alliance
 Evidence Based and Best Practice.
 Difference dependent on location.
English Drug and Alcohol Commissioners June 2024.pptx
English Drug and Alcohol Commissioners June 2024.pptx
English Drug and Alcohol Commissioners June 2024.pptx
Integrating NSP in a drug treatment system where
recovery models dominated has been a disaster for
PWID
UK decided that harm reduction was not an essential
service during COVID-19 pandemic unlike many other
European countries
25 – 50% reduction in needle and syringe coverage –
slow to recover
Bath P2PNSP key example of how things could be done
differently – described in EuroNPUD’s forthcoming
Technical Briefing on P2PNSP
Hep C Trust – playing key role in recovery of NSP and
harm reduction including dialogue around people in
recovery and active drug users working together
Needle and Syringe
Programmes – decline and
recovery
English Drug and Alcohol Commissioners June 2024.pptx
Mat Southwell
• mat.southwell@coactsupport.com
• 07969269395 – WhatsApp Signal
• Extending the policy dialogue around the needs
of people who actively use drugs
• Prof. Magdalena Harris and SIPP study findings
and iHost study

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English Drug and Alcohol Commissioners June 2024.pptx

  • 1. Reflections on Stimulants, OAMT, NSP, DCRs in England Mat Southwell Managing and Technical Director Coact Organiser with Respect P2PNSP in Bath and North East Somerset
  • 2. Agenda • Responses to people who use stimulants – reflections from UNODC UNAIDS WHO Guidelines, UNODC-HIV Training Toolkit and SIPP • OAMT - reflections from EuroNPUD OAT Literacy and Rights Project and SURIA CLM OAMT Project from Ireland • NSP and N&S Quality and Coverage – Reflections from EuroNPUD Technical Briefing on P2PNSP and Unitaid Hep C Portfolio • Drug Consumption Rooms – comments from INHSU Community Day 2023
  • 3. Purpose To provide practical guidance to countries on implementing comprehensive HIV programme for people who use stimulant drugs, vulnerable to HIV, based on existing UN guidance documents. Target audience Programme managers at national and local levels People who are planning or implementing HIV / HCV programmes for people who use stimulant drugs, including NGOs and community-based organisations representing /working with people who use drugs including men who have sex with men, sex workers, transgender people & people in prisons
  • 4. Stimulant drugs that are linked to increased HIV risk among key populations Methamphetamine: • Amphetamines and methamphetamines exist in different forms, e.g. crystals (methamphetamines), powder or pills / tablets. • Methamphetamine may be taken orally, snorted, smoked as vapour in a pipe, inserted anally or injected in a solution. New Psychoactive Substances Stimulants (NPS Stimulants): • Exist in various forms, e.g. synthetic cathinones, phenethylamines, aminoindanes and piperazines. • Sometimes referred to as “bath salts” • Depending on the form, new psychoactive substances are taken orally, smoked, inserted anally or injected. Cocaine and Smoked Cocaine: • Exists in various forms, e.g. cocaine powder, smokable cocaine, crack cocaine, freebase, paste base, paco, basuco. • Depending on the form, it may be snorted, injected or inserted anally.
  • 5. 1. Condoms, lubricants and safer sex programmes 2. Needle and syringe programmes (NSP) and other commodities 3. HIV testing services (HTS) 4. Antiretroviral therapy (ART) 5. Evidence-based psychosocial interventions and drug dependence treatments 6. Prevention, diagnosis and treatment of sexually transmitted infections (STIs), hepatitis and tuberculosis (TB) 7. Targeted information, education and communication (IEC) for people who use stimulant drugs and their sexual partners 8. Prevention and management of overdose and acute intoxication Critical Enablers – Community mobilisation and online outreach The Core Interventions – Stimulants and HIV Missing: Mental Health response to people who use stimulants
  • 6. 2. Needle and syringe programmes (NSP) and other commodities Plentiful supply of sterile needles and syringes Silver foil Meth pipe Safer “snorting” kit Crack pipe or stem
  • 7. Intersectionality – The Challenge and Opportunities of Stimulants and HIV
  • 10. OAT Rights & Literacy ● OAT Client Guide ○ Sweden, Scotland, France, Spain, Catalonia, Germany, Greece ○ Volunteer attempt to deliver in England – strong response medics – weak response NGOs ● Community-led Monitoring – SURIA Ireland and Georgia ● Lessons from Scottish reforms of MAT ● EuroNPUD OAT Project Team meeting in Warsaw alongside European Harm Reduction Conference
  • 12. Care Plans and Treatment Choice  44% do not know what a care plan is, down from 69% 2020. ICON—49%.  42% do not have a care plan.  Partnership. Alliance  Evidence Based and Best Practice.  Difference dependent on location.
  • 16. Integrating NSP in a drug treatment system where recovery models dominated has been a disaster for PWID UK decided that harm reduction was not an essential service during COVID-19 pandemic unlike many other European countries 25 – 50% reduction in needle and syringe coverage – slow to recover Bath P2PNSP key example of how things could be done differently – described in EuroNPUD’s forthcoming Technical Briefing on P2PNSP Hep C Trust – playing key role in recovery of NSP and harm reduction including dialogue around people in recovery and active drug users working together Needle and Syringe Programmes – decline and recovery
  • 18. Mat Southwell • mat.southwell@coactsupport.com • 07969269395 – WhatsApp Signal • Extending the policy dialogue around the needs of people who actively use drugs • Prof. Magdalena Harris and SIPP study findings and iHost study