User rights and peer-led harm reduction


In this article, Stuart Munckton shares how people with lived experience of drug use in NSW are paving the way in developing and implementing effective harm reduction measures. When it comes to user's rights, ending the criminalisation of drug use would be the single biggest measure to reduce the harms associated with drug use. By Stuart Munckton, NSW Users and AIDS Association.

Post-it notes reading 'many struggles one fight', with notes around it reading 'users rights', 'prison abolition' and 'climate defence'.

User rights and peer-led harm reduction

The NSW Users and AIDS Association is a peer-based drug user organisation whose vision is ‘advancing the rights, health and dignity of people who use drugs illicitly in NSW.'

Our approach to harm reduction is strongly guided by the fact we are peer-based — that is, we are run by people with lived experience of drug use. We are guided by the principle that there can be no effective drug policy that excludes the voices of people who use drugs. Peer-run harm reduction measures have a proven track record because we have direct experience of the issues and, as a result, are listened to seriously by other peers.

The NSW Users and AIDS Association was founded in 1989 as a direct response to the HIV epidemic, when injecting drug users took to distributing sterile equipment to other injecting drug users in Sydney. At the time this was illegal, but today Needle and Syringe Programs – including our one in Surry Hills – are official government policy. This is evidence of how the actions of peers can help effectively push harm reduction measures. 

Today, we run a wide array of peer-based harm reduction programs. Our nationally distributed magazine User's News features writing by, and for, peers, and discusses the whole gamut of issues facing people who use drugs. In partnership with Justice Health, we also publish Insider's News, which discuss harm reduction for people currently incarcerated. 

As well as our peer-run Needle and Syringe Program, we are involved in programs to promote Hepatitis C testing and treatment, helping organise peers to distribute equipment and promote harm reduction in their communities across rural NSW. We also run DanceWize NSW, which promotes harm reduction and offers help in the festival space. Last year, we launched PeerLine, a help line where people who use drugs can get confidential assistance from peers.

We recognise the need to change government policies that adversely affect people who use drugs — the biggest of which is the criminalisation of drug use.

Every measure of interdiction and control that seeks to reduce drug use and modify the behaviour of people who use drugs causes unintended harms. Banning pipes increases injecting, blood borne viral illnesses and injecting related harms; shutting down music festivals and unregulated events creates less safe conditions for patrons and staff; banning pregnant women from the Medically Supervised Injecting Centre forces them to inject in circumstances that are far less safe; making prescribed drugs more difficult to inject means more injecting-related injuries – the examples are frequent and vary according to setting.

NSW does not currently have an Alcohol and Other Drug Strategy, and the police approach of targeting individual users across a wide range of settings is ineffective and causes harm to individuals. Instead we are left with an unofficial “just say no” policy. We are involved in a range of advocacy to change this, including co-hosting a street protest in 2018 in favour of pill testing, and a protest last year along with Greens MP David Shoebridge for an end to the criminalisation of drug use. 

NSW Users and AIDS Association had significant involvement in the Ice Inquiry in 2019, including a written submission, gathering evidence via round-table discussions, and supporting individuals to give evidence. Our CEO Dr Mary Harrod also made three appearances before the Inquiry. We also had significant involvement in the NSW Coronial Inquest into the deaths at music festivals.

Ending the criminalisation of drug use would be the single biggest measure to reduce the harms associated with drug use. Criminalisation promotes secrecy in drug use, can make people reluctant to seek help, and fuels stigma and discrimination. This is why our harm reduction work is bound up with the push for broader societal and legislative change. 

Photo courtesy of NSW Users and AIDS Association.

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