Chaired by Naomi Burke-Shyne, Executive Director, Harm Reduction International
Welcome to Country from Uncle Bill Nicholson
Welcome remarks: Lord Mayor of Melbourne, Sally Capp
Keynote address: Helen Clark, Former Prime Minister of Aotearoa New Zealand, Chair of the Global Commission on Drug Policy
Sione Crawford, Chief Executive Officer, Harm Reduction Victoria
The Hon. Rachel Stephen-Smith, MLA, Minister for Health of the Australian Capital Territory
The Hon. Rose Jackson, MLC, Minister for Mental Health of New South Wales
Presentation of the HR19 Carol and Travis Jenkins Award to Andriy Yarovoi
HR23 Gill Bradbury Award for Excellence in Service Provision
HR23 Carol and Travis Jenkins Award
HR23 National Rolleston Award
HR23 International Rolleston Award
Chair: Annie Madden, Harm Reduction Australia
Gideon Lasco, University of the Philippines Diliman's Department of Anthropology, Philippines
Kirsten Han, Transformative Justice Collective, Singapore
Gina Jackson, Return to the Heart Foundation, USA
Kassandra Frederique, Drug Policy Alliance, USA
Chair: Rafi Torruella, Intercambios Puerto Rico and Housing Works
James Ward, Poche Centre for Indigenous Health at The University of Queensland, Australia
Seree Nonthasoot, Committee on Economic, Social and Cultural Rights, Thailand
Phelister Abdalla, Kenya Sex Workers Alliance, African Sex Workers Alliance, Global Network of Sex Work Projects, Kenya
Yevgeniya Kuvshynova, Convictus, Ukraine
Chair: Colleen Daniels, Harm Reduction International
Tuari Potiki, University of Otago, New Zealand Drug Foundation, Needle Exchange Services Trust, Te Rau Ora, Aotearoa New Zealand
Diego Andres Lugo-Vivas, CET Academic Programs, Colombia
Ajeng Larasati, Harm Reduction International
Nerita Waight, Victorian Aboriginal Legal Service, Australia
Chaired by Naomi Burke-Shyne, Executive Director of Harm Reduction International
Former President of South Africa Kgalema Motlanthe
The Hon. Gabrielle Williams, MP, Minister for Mental Health of Victoria
Judy Chang, International Network of People who use Drugs
Paul Hunt, New Zealand Human Rights Commission, Aotearoa New Zealand
Brooklyn McNeil Rae of Hope Award, sponsored by the Centre on Drug Policy Evaluation
The Melbourne Declaration
Chair: Gaby Bruning
Pete Dawson: Bunjilwarra Aboriginal Youth Healing Service
Nilawan Pitakpanawong: Mobile Methadone Therapy for Drug Users Within Ethnic Groups in Fang District, Chiangmai, Thailand
Jackson Heraid: 24-Hour Mobile Integrated Advocacy in Remote Indigenous Territories
Chair: Annette Verster
Lisa Maher: Incidence of Primary Hepatitis C Infection Among People who Inject Drugs in Australia: Progress Towards Elimination
Margaret Bourke: Maintaining Hepatitis C Micro-Elimination through Times of Crisis: Covid Pandemic, Beneficiaries of Temporary Protection and People Seeking International Protection
Danil Nikitin: Feasibility of HCV-Specific Self-Testing, Brief Intervention and Referral to Treatment as a Model for Effective Linkage to Care of Persons who Live with Hepatitis C and Inject Drugs in Kyrgyzstan
Tom Wright: Hepatitis C Transmission Trends in a Prison System with High DAA Coverage: A Case for Stronger Harm Reduction Strategies"
Chair: Ricky Gunawan
Shaun Shelly: Imperialism through Funding: How Funding from the US Undermines Harm Reduction and Human Rights in Africa
Victoria Wynecoop-Abrahamson: Indigenizing Harm Reduction at the Intersections of Domestic Violence, Mental Health, and Substance Use
Colleen Daniels: Decolonizing Drug Policy
Christopher Abuor: Decolonizing Drug War: Establishing a Legal and Policy Framework to Enhance Access to Harm Reduction Services in Kenya - Case of Kenya
Chair: Sarah Evans
Patricia Tracey: Rapid Response to Near Fatal Overdose
Peter Davidson: Scaling Low-Threshold Naloxone-on-Release to Large Jail Systems
Haobam Nanao: Community-Led Overdose Management Success, Challenges and Way Forth
David Baxter: Ten Years On: The Evolution of Take-Home Naloxone Provision in the Australian Capital Territory
Chair: Tamika Jackson
Ann Fordham: Making numbers count –Assessing The Global Drug Policy Index as an Advocacy Tool
Benjamin Phillips: Louder Than Bombs: What Harm Reduction Can Learn from Anti-Cluster Munitions Activism and Modern Slavery Abolition for a New International Drug Treaty
Sione Crawford: Can Peer Workers Ever Be Safe in a Prohibitionist World?
Mary Kathryn Sison: Plea-Bargaining for Drug Cases in the Philippines: Revisiting Its Mechanisms, and Assessing Its Bureaucratic and Social Impacts
Chair: Rosma Karlina
Louisa Walsh: It’s Your Right – A Peer Led Hepatitis C Testing and Treatment Campaign Designed by People who Inject Drugs, for People who Inject Drugs
Thinzar Tun: If there is a Will, there is a Way! – A Peer-Led Women “Cost-Effective” Service Delivery in Rural Areas in Myanmar. (WHRIN Good Practice Series)
Vincent de Maisonneuve: Making a Peer Run Magazine by and for People who use Drugs: Adapting to new Realities
Petrina Hilton: W3 Project: Creating a Consolidated Evidence Base of the Effectiveness of Australian Peer-Led Organisations for People who use Drugs
Chairs: Nia Dunbar & Sjef Pelsser
Andrés Lekanger: Preventing Rape in the Norwegian Chemsex Scene using Chemsex Participants’ Real Stories in Social Media Campaign
Karin Di Monteiro: Sexualized Drug Use and Chemsex in Brazil: A Multiple Perspective Action to a Multiple Care Issue
Stephane Wen-Wei Ku: Experiences of Harm and Mental Ill Health among Gay, Bisexual and other Men-who-have-Sex-with-Men who use Methamphetamine or GHB/GBL in Different Combinations: Findings from a Chemsex Survey in Taiwan
Dawie Nel: High on HIV; Low on Retention: MSM Chemsex Drug Houses in Soweto, South Africa
Yasir Ali Khan: Chemsex Intervention in Extremely Conservative Context: The Case of Pakistan
Yannick Gaudette: Individual and Community Harm Reduction Strategies for those who Practice Chemsex in Quebec
Chair: Ernst Wisse
Marcela Jofré: How has COVID Impacted the Access to Health and Harm Reduction Services in Prisons Around the World and Lessons for a Human Rights-Oriented Approach
Lisa Boucher/Zoë Dodd, in memory of Abeera Shahid: Evaluation of Outreach Supports to People Experiencing Homelessness in Encampments during COVID-19 in Toronto, Canada
Myo Thet Oo: Myanmar: Community-Led Harm Reduction in Sex Work during the time of Coup & COVID-19
Carol Strike: Safer Supply and COVID-19: Client and Service Providers' Perspectives on Implementation Challenges and Benefits during the COVID-19 Pandemic in Ontario, Canada
Chris Gough: Isolation Blues: The Role of the Peer Based ATOD Organisation, Canberra Alliance for Harm Minimisation and Advocacy (CAHMA), in Supporting People who use Drugs during Covid-19 Lockdown and Isolation
Philippa Jones: Pairing COVID-19 Vaccination Support with Increased Access to HCV Treatment for PWID: A New Zealand Pilot
Mohammad Omar Faruque: Community is for the Community: ‘One Meal Per Day’ Initiative by the Network of People Who Use Drugs (NPUD), Bangladesh during the COVID-19 Pandemic
Chair: Aditia Taslim Lim
Gregory Taylor: The Time is Now: The Establishment of an Independent Peer Organisation in Tasmania
Bee Hayes: Emerging Interest for Peer Education in Instructional Contexts and Systemic Barriers
Wan Traga Duvan Baros: The Resurrection of Indonesia Network People Who Use Drugs through the Participation of Peers Group as the Community-Led Responses
Voravat Rugvong: National Network Strengthening Model Demonstration: Transparent Management Creates Unity, Solidarity and Empowers Strong Partnerships
Chair: Caitlin Hughes
Nicole Luongo: Decrim Done Right: A Community-Led, Rights-Based Path for Drug Policy in Canada
Teddy Wandera: Unity for Purpose: A Case on the Decriminalization of Harm Reduction in Kenya
Mary Catherine Alvarez Del Rosario: Linking Communities with the Justice System to Advance Humane Drug Policy in the Philippines
Chair: Ganna Dovbakh
Theresa Caruana: What Happens when your Pharmacy is Destroyed or Cut Off by Flooding? Experiences of Opioid Agonist Treatment Consumers and Pharmacists in the New South Wales Northern Rivers Region
Nadiia Iangol: Emergency Response Project - Shelter's Support in Ukraine
Aung Yu Naing: Solidarity! Transform Challenges into Opportunities for Harm Reduction during COVID-19 and the Profound Political Crisis in Myanmar
Chair: Ingrid van Beek
Kayla DeMong: The Little SCS on the Prairies
Peter Krykant: How to Run an Unsanctioned Safer Injection Facility
Nico Clark: Navigating the Development of a Harm Reduction Service in a Risk Intolerant Context - The Story of the Medically Supervised Injecting Room in Melbourne
Emma Maiden: Not the Usual Suspects: How we can Re-Energise the Cause for Drug Law Reform and Win
Chair: Carolina Ahumada
Ana Cristhina Sampaio Maluf: Developing a Drug Checking Service in Brazil and its Potential as a Harm Reduction Strategy
Collin Kielty: On-Site Paper Spray Mass Spectrometry (PS-MS) at a Community Drug Checking Service in Victoria, Canada
Bronwyn Hendry: CanTEST, Australia’s First Fixed-Site Drug Checking Service: Enablers, Successes, and Lessons Learnt from the ACT’s Health and Drug Checking Pilot
Rita Brien: Co-Designing Drug Alerts with Health and Community Workers as Part of an Early Warning Network
Chair: Francis Joseph
Hau Suan Piang: Glimpses of Peer Leadership as the Prevailing Solidarity Model: a Road to Peer-led Harm Reduction!
Ezazul Islam Chowdhury: Effort to Bring Professionalism among Outreach Workers to Improve Needle and Syringe Programme and other Essential Packages to Respond to a Sudden Increase of HIV Prevalence among PWID in Dhaka, Bangladesh
Liam Neale: FUSE Network Consultations- Identifying Systemic Barriers Experienced by PWU/ID Peer Workers in Victoria through Peer-Led Networks
Chair: Geoff Gallop
Machteld Busz: The XTC Shop: Using Art to Foster Dialogue and Investigate Public Acceptance of Substance Regulation
Alison Ritter: Participation and Engagement in Drug Policy Reform
Moulay Ahmed Douraidi: Advocacy and Actions in the Context of the Response to the Covid-19 Pandemic to Improve Access to Health Services for Drug Users in Morocco According to a Human Rights Approach
Erlend Opdahl: From the Stars, to the Street, to the Clinic and Beyond. The Patient and the Nurse in the Norwegian Heroin-Assisted Treatment Project.
Gloria Lai: Growing Intersectional Feminism in Drug Policy Advocacy in Southeast Asia
Augusto Nogueira: Finding Common Ground amongst Asia-Pacific Drug Policy Civil Society Organisations
Chair: Marcela Jofre
Karen Peters: Ending Compulsory Drug Treatment in East and Southeast Asia
Unchisa Eaimtong: A Year of Radical Drug Policy Reforms in Thailand: Lessons Learned and Gaps that Remain
Zoë Dodd: The Patient- Prisoner – The Experiences of People who use Drugs with Mandated Drug Treatment
Peng Xu: No Exit: China’s State Surveillance over People who use Drugs
Author: Taylor Edelmann
Despite harm reduction's origin stemming from queer and BIPOC leaders, much of that visibility and appreciation has been lost. To fully address the needs of people who use drugs, those who engage in sex work, and LGBTQIA+ communities, we need to allow spaces where they can interact. How can we create affirming spaces for queer harm reductionists to address the unique needs of our communities, and what would that look like?
Often, harm reduction or LGB/TGNC+ serving organizations are ill-equipped to meet the varying needs of these communities. Lighthouse Learning Collective offers space for strategy, support, and resources for LGB/TGNC+ folks who use drugs and engage in sex work by bringing together community members and harm reduction organizations that serve these communities to enhance services and transform systems.
Despite being focused in NYC, Lighthouse Learning Collective has amassed a following that has received significant interest beyond state lines, highlighting the need for such spaces. The collective meets monthly to discuss potential projects, network, promote community events/resources and provide a space for members to workshop their content (abstracts, trainings, presentations, discussions). Recent projects have included a monthly campaign to recognize TGNC harm reductionists and developing an 8-session learning series on queer harm reduction basics.
This presentation will give an overview of the purpose and importance of the Lighthouse Learning Collective and will offer lessons learned since its launch.
Author: Aaron Goodman
Our research team will share highlights about our innovative, community-based participatory research, which involved collaborating with 12 harm reduction workers, widely known as peers, in British Columbia, Canada, in order to assist these individuals in articulating how their jobs and lives are impacted by the toxic drug supply crisis.
We will explore how six student researchers engaged deeply with peers in oral history interviews and by collaboratively producing a podcast and graphic illustrations focused on peers’ testimonies.
The study is timely, because peers with current or past experience with substance use are playing critical roles at the frontlines of the toxic drug supply crisis across the globe. Not only do peers provide vital harm reduction services, but they are also saving countless lives.
Yet, many peers are experiencing a number of stressors, including financial insecurity, lack of respect and recognition at work, housing challenges, inability to access and/or refer individuals to helpful resources, and frequent exposure to death and trauma.
The study explores the following research questions:
i) Can sustained dialogue through oral history interviews and collaborative testimony enable peers to share nuanced information about stressors they experience?
ii) How do peers’ testimonies challenge dominant media narratives about the toxic drug supply crisis that often ignore, misrepresent, or silence peers and stigmatize PWUD?
iii) How do the podcast and graphic illustration formats help communicate information articulated by peers in order to reach people within the harm reduction community, PWUD, the wider public, and policy makers?
Authors: Joy Scheidell, Muthoni Mahachi
Women who use illicit opioids have elevated risk for adverse sexual and reproductive health (SRH) outcomes including sexually transmitted infections (STIs) and sequelae, and high burden of unmet SRH care need. Syringe service programs (SSPs) may be a venue to reach women with SRH care.
From November 2021 to August 2022, within a cohort study among people who use illicit opioids in New York City, we conducted a substudy in which 119 participants completed a survey assessing SRH conditions and care, including those received at SSPs, and we estimated the prevalence among those who identified as women (N=50) overall and by race/ethnicity.
The sample average age was 45 years (range 20-66). Approximately 28% were White, 32% Black, and 40% Hispanic/Latina. White women reported higher prevalence of STI symptoms (43%) and receipt of testing (21%) in the past year, while Black and Hispanic/Latina women reported higher prevalence of STI diagnosis (~8%); only half of Hispanic/Latina women received treatment. Over 80% of Black and Hispanic/Latina women reported using no/ineffective STI prevention and half had problems getting feminine hygiene products. About 50% of White and Hispanic/Latina women went to an SSP in the past year versus 25% of Black women; among women who went, receipt of SRH services (e.g., safer sex education: ~40%, pregnancy/infectious disease testing: ~20%) was similar across race/ethnicity. One-quarter of Hispanic/Latina women believed onsite SRH care at SSPs could address stigma compared to half of White and Black women, while the majority felt comfortable receiving SRH services from a clinic run by an SSP regardless of race/ethnicity.
Integrating SRH care at SSPs could increase access and improve health for women who use illicit opioids. Racial/ethnic differences in SRH experiences will require tailoring and targeting of services, while also identifying ways to reach women through other venues.
Authors: CISDI Indonesia/Zenithesa Gifta Nadrini
Strengthening primary health is currently seen as the key to tackle the pandemic. But when the COVID-19 virus hit Indonesia, the country's health system was not ready. The overlapping policies between central and regional governments has always hindered efforts in strengthening primary healthcare services. The budget for hospital development is six times bigger than for primary health care facilities (2017). This hospital-centric system makes primary health services responses fall short during the pandemic. As many as 45% of primary health services health workers were very poorly prepared for infection control and prevention. There were logistical shortages for N95 masks (66%), and medical dress (43%). Health workers also experienced a stigma in which they are disregarded by the community (33%), and labeled as spreaders of the virus (25%).
To bridge this gap, during the heights of the pandemic in 2021, the Center for Indonesia’s Strategic Development Initiatives (CISDI), trained 3,560 community health workers (CHW) affiliated with local health centers to perform community-based surveillance through active case finding and monitoring self-isolated patients. They could trace at least 15 close contacts of all COVID-19 patients in 72 hours, a feat never performed before in their community.
Expanding on this intervention, this year CISDI collaborated with more than a thousand CHW to provide COVID-19 vaccination for vulnerable groups. Since there has been no consensus to the definition of “vulnerable groups”, they were previously neglected. The CHWs also help to recover non-communicable diseases and nutrition services which were disrupted by the pandemic. Together, this joint effort has increased the community's habit of accessing healthcare facilities periodically and maintained their health status.
Through this presentation, we want to show that amplifying the collaboration of primary health care and community is the solution to ensure that the nation would be ready for future pandemic preparedness.
Authors: Nikolay Lunchenkov, Ada Beselia, Vitaly Djuma, Elena German
COVID-19 pandemic dramatically impacts the health and substance use of different populations, including lesbian, gay, bisexual, transgender and others (LGBTQI+). Social policies and the general atmosphere in Eastern Europe and Central Asia (EECA) tend to be homophobic and discriminative, leading to the exclusion of individuals from social protection programs. Importantly, strategic information about the impact of COVID-19 in the region is limited. The study aimed to identify the association between financial insecurity and substance use during the last six months of the pandemic.
Data were collected from "The impact of COVID-19 online survey" conducted in June - August 2022 in Kazakhstan, Kyrgyzstan, Armenia and Georgia. The survey included information regarding their socio-demographics, economic outcomes, and changes in substance use. Multivariate logistic regression was applied to identify association between substance use and economic outcomes.
The total number of eligible participants (n=914), included respondents from Armenia (n=120), Georgia (n=256), Kazakhstan (n=140) and Kyrgyzstan (n=398). The average age was 26.4 years (SD = 6.8). 10.7% self-reported living with HIV, and 34.4% were diagnosed during the last six months. A quarter of the sample (26.1%) reported an increase in alcohol consumption and 6.4% in recreational drug use. In the multivariate model, adjusting to socio-demographics, increased alcohol consumption was associated with job losses and difficulties in buying food (AOR = 1.47, 95%CI: 1.05 - 1,88; AOR = 0.58, 95%CI: 0.13 - 1.03). The increase in recreational drug use was not associated with economic outcomes.
The study findings highlight the vulnerability of LGBTQI+ individuals caused by the COVID-19 pandemic. It adds to evidence that financial insecurity is associated with alcohol consumption. The results show importance of developing economic empowerment programs and increasing social protection. The increase in recreational drug use requires adjusting the existing HIV programmes and adapting services to the new challenges caused by COVID-19.
Authors: Daniel Bear, Ashley Hosker-Field, Marilyn Cresswell
The legalization of cannabis in Canada in 2018 provided a new context within which discussions of harm reduction and cannabis consumption could take place. This required the development of new harm reduction focused education materials. Our team conducted a mixed methods study involving 1,598 survey responses from Canadians 18-30 who consume cannabis, and ten focus groups with the same population.
With the data from that research, we asked students in a Bachelors of Creative Advertising program to develop initial ideas for a public education campaign focused on harm reduction and young cannabis consumers, and utilizing a human-centred design approach. This presentation reports on the reaction from three different groups that reviewed the initial campaign materials produced by those students during a series of follow-up focus groups; cannabis consumers, budtenders (sales associates in retail stores), and cannabis policy/health experts.
We identified that consumers focused on the perceived stigma present in some of the ideas and were interested in building more interaction into the materials. Budtenders were much like consumers in most respects, but often focused on how information in the campaign could be used to make their jobs easier and the experiences of newer consumers more enjoyable. Cannabis policy and health experts were most focused on scientific accuracy and ensuring the campaign materials spoke from a voice of a peer, not an academic.
The views of all three groups helped shape the final materials into a successful campaign that rolled out online and in retail stores across several Canadian provinces. This research highlights the importance of engaging a variety of stakeholders during the development of harm reduction campaigns.
Authors: Michel Perreault, Guillaume Tremblay, Diana Milton, Shoghig Tehinian
“Prevent and Reduce Overdoses – Training and Access to Naloxone” (PROFAN) is a community-based peer-led training program initiative which uses a harm reduction approach developed to empower peers in responding to opioid overdoses they are likely to witness in the context of the growing opioid crisis in Quebec. It is also the leading opioid overdose prevention program for the training of community staff.
Designed as a “by peers-for peers” program, PROFAN uses an innovative knowledge transfer approach in which one peer and one intervention worker are paired together to educate the community sector as well as people who use drugs (PWUD) and their families/friends about harm reduction principles, underlying risks of overdoses, and how to act in the event of one.
PROFAN has been implemented in 16 jurisdictions out of 18 across the province of Quebec and has reached 950 PWUD and their families/friends as well as 935 community workers while fostering the creation of strong partnerships between major stakeholders, including public health authorities, community organizations, peer groups, and researchers.
Among a sample of PWUD and their families/friends, 88% has reported beneficial outcomes including improved self-esteem, greater sense of responsibility towards others, feeling in control in situations of emergency and able to overcome stigma. As for community staff, 91% of the sample felt better equipped to intervene in the event of an overdose while helping a few change their perceptions of PWUD.
PROFAN has been able to reach the PWUD population and has widely gained acceptability not only from governmental actors, but the end-users as well. In a collaborative process, all stakeholders are developing a new version of the program following an evidence-based “train-the-trainer” design to improve organizational and individual capacities and empower communities in their response to the opioid crisis.