Enhanced Harm Reduction Working Group
The Enhanced Harm Reduction Working Group is a consortium of scientific experts, academics, policy makers, treatment providers and advocacy groups, working collaboratively to reduce the harms of intravenous drug use.
Aim
To develop the evidence base for reducing drug-related harm by facilitating enhanced harm reduction services in the UK. Such services include overdose prevention centres, drug checking, and high tolerance housing.
Objectives
-
Work with partners to establish enhanced harm reduction services for evaluation.
-
Inform legal reform to enable the development of the evidence base on enhanced harm reduction services.
-
Collate and communicate the evidence-base for enhanced harm reduction services in reducing drug-related harm.
-
Provide a forum for sharing information on safe, ethical and effective provision of enhanced harm reduction services.
Rationale
There is a well-developed evidence base for established harm reduction practices, including opioid agonist treatment, and needle and syringe programmes; however further steps need to be taken to reduce record levels of drug-related deaths in the UK. We need to go further if wish to meet global aims to eliminate the transmission of HIV and Hepatitis C among people who use drugs.
Our aim is to develop the evidence base for reducing drug-related harms by enabling enhanced harm reduction services in the UK. This collaborative initiative will evaluate whether establishing such services would prove to be cost-effective, reduce crime, improve public health, reduce drug litter, and increase engagement in treatment services.
The EHRWG encourages the use of a participatory development approach in the design and development of harm reduction services. Ensuring co-production in the design, development and implementation is key to ensuring that they work, are community-friendly, and hold the confidence of local drug-using communities. This helps to ensure high quality, non-judgemental service provision, acceptability and reduced stigma and the discrimination experienced by people who use drugs.
People who use drugs are sadly familiar with experiencing discrimination in health and social care settings. As such, those developing new services need to actively demonstrate their commitment to non-judgemental, rights-based approach and participatory development is a good starting point. When a community owns and supports harm reduction, this ensures effective service user recruitment, quality management and advocacy.
Academic Experts
Prof Alex Stevens (Chair)
Professor of Criminal Justice
Prof David Nutt
Professor of Neuro-psychopharmacology
Roz Gittins
Drug Science Scientific Committee
Dr Andy Mcauley
Reader in Public Health,
Glasgow Caledonian University
Prof Fiona Measham
Professor of Criminology
Dr Magdalena Harris
Associate Professor in the Sociology of Health
Dr Adam Holland
Chair of the Drugs Special Interest Group
at the Faculty of Public Health
Ben Scher
DPhil student
Social Intervention and Policy Evaluation
Prof Charlie Lloyd
Professor of Social Policy and Criminal Justice
Dr Euan Lawson
Editor of the British Journal of General Practice
Dr Gillian Shorter
Reader in Psychology
Dr Tim Williams
Consultant Addiction Psychiatrist
Policy Specialists
Shayla Schlossenberg
Drugs Service Coordinator, Release
Mat Southwell
Managing and Technical Director, Coact
Colleen Daniels
Deputy Director, Harm Reduction International
Jason Kew
Former Detective Chief Inspector, Thames Valley Police
Martin Powell
Head of Partnerships, Transform
Kirsten Horsburgh
Strategy Coordinator, Scottish Drugs Forum
Niamh Eastwood
Executive Director, Release
Amber Moore
Diversion Scheme Policy Lead, User Voice
Treatment Provider Representatives
Claire James
Deputy Director of Clinical Practice
Change Grow Live
Paul Hughes
Executive Medical Director
With You
Martin Blakebrough
CEO
Kaleidoscope
Rob Barker
Campaigns and Communications Lead
Barod
Peter Krykant
Project Lead
Cranstoun
Lee Wilson
Regional Director
Humankind
Danny Ahmed
Clinical Partner
Foundations
Tony Duffin
Chief Executive Officer
Ana Liffey Drug Project
Paula Byrne
Chief Executive Officer
Merchants Quay Ireland
Treatment Providers
The Enhanced Harm Reduction Working Group is supported by treatment providers to ensure that the stakeholders who would be delivering these services are consulted throughout.
The Case for Overdose Prevention Centres in the UK
Part One – Quantitative Data
In Part One of this report, we describe the quantitative and geographic indicators. We estimate that there may be over 250 people in Sandwell who are in the population group that is most likely to benefit from an enhanced harm reduction service; people who inject drugs who are homeless or unstable housed.
This report strongly suggests a need for a place where people can inject drugs out of the public gaze, in a hygienic and supervised environment. This would improve the quality of life of all the residents of Sandwell, whether they inject drugs or not. It would reduce the risks of drug-related death and help to meet the complex needs of a group of people who are highly vulnerable to multiple physical and mental health problems. It would also reduce concerns about litter and other problems related to street-based injecting.
Part Two – Qualitative Data
In Part Two, we discuss the participatory consultation and research we have carried out with people who use drugs in Sandwell.
We recruited and trained a team of volunteer peer researchers, who named themselves the Sandwell Community Outreach Resources Education, or SCORE, and worked with them to find out about patterns of street-based injecting and related needs in Sandwell.
Qualitative research is essential to understand a specific local context or problem from the perspective of the impacted community.
This environment provided an ethical space within which street-based drug use could be investigated, community mobilisation deployed, and models of enhanced harm reduction discussed.
Part Three – A Rapid Evidence Review
At the core of this review lies an exploration of Overdose Prevention Centres as community facilities designed to provide a safe, hygienic, non-judgmental environment for individuals to consume their own drugs. Operating under the primary principle that supervised drug consumption enhances safety and reduces the likelihood of fatal overdoses, this review highlights the evidence that OPCs are also able to facilitate a secondary function: to promote voluntary access to a range of social, health, welfare, and drug treatment services. The synthesized research also suggests that many of the feared unintended consequences such as increased crime and increased drug use do not occur in locations where OPCs are implemented. The range of OPC models explored in this review are typically characterized as being low-threshold services—free at the point of access with minimal demands—making them inclusive and accessible to often marginalised people who use drugs.
As a concluding note, the review emphasizes the continual need for robust evaluations of OPCs to improve our understanding of how, why and for whom do such forms of enhanced harm reduction work for.
Educational Resources
