Category Archives: NCIDU 2010
NCIDU 2010 – Day Two
Claire began by distinguishing between Adulterants, Contaminants and Dilutants.
Adulterants – pharmacologically active ingredients
Contaminants – by-products of manufacturing
Dilutants – inert substances added to provide bulk
There are perception and myths around the adulteration of drugs that include the idea that there are adulterants added at every step. Apparently the evidence does not actually comply with the perception that all adulteration is ‘haphazard or toxic’.
She then divided the substances again: -
Benign substances – which add bulk and are relatively cheap and in low doses relatively safe such as Caffeine, Sugar, Paracetamol
Enhancing or Mimicking – substances which give similar effects or feelings as the drugs they’re being sold as, and may have the same taste or look
Substances that facilitate administration – For example substances that make a drug easier to smoke or inject etc.
There can also be adulteration from poor manufacturing processes which increases by products and residues. Bacteria may also be present due to unsterile and unsafe manufacturing spaces.
Some common adulterants Claire mentioned by drug type: -
Amphetamines – heavily contaminated with Caffeine at importation stage
Cocaine – Levamisole pre import, Benzocaine post import
Crack – as Cocaine plus Phenacetin
Heroin – Caffeine and Paracetamol.
Dealers have moved away from inert substances in favour of pharmaceutical substances.
Harm Reduction Messages
- Early warning systems would be useful
- A standardised reporting system
- Evidence based intervention
- Improved awareness and general information available especially for emergency services and drug treatment personnel
You can see the full presentation here.
Jenny Scott fed back on an analysis of Crack Cocaine in Swindon following an anecdotal report of low quality Crack.
A team analysed 50 samples of Crack in total.
Some of the findings were as follows:
80% contained Cocaine
20% contained no Cocaine at all (5 were Heroin, 1 possibly citric acid and 4 unknown)
Average purity was 39%
81% also contained Phenacetin (which can be toxic to the liver)
You can see the full presentation here.
NCIDU 2010 Day Two – October 8th 2010
Chair: Roweena Russell, Developer and Manager, Hiwecanhelp
Presented by my Twitter friends Nigel and Allison I didn’t really need to go to this as it was more around convincing other drug workers why Twitter is a good idea for networking within the field. Most people listening in were not yet on Twitter so it was good for them to be thinking about how it may help them.
I think Twitter is actually underused in the Drugs & Alcohol field and so this was a welcome addition to the conference agenda and I hope it is something that will take off on a larger scale. Information sharing is so important especially for harm reduction messages and encouraging discussion. Twitter makes it easy!
See their brilliant Prezi presentation here.
Martin Barnes delivered the afternoon’s opening session focusing on the impact the new coalition Government will have on the future of drug services. He initially gave an overview of Drugscope’s work and how they play a part in influencing policy and the importance of accurate information in the media. He reiterated the message that the impending national cuts will certainly effect drug services and then gave a history of the various Government appointments which will also affect future policy. A mention was given to the impending abolishment of the NTA and their new stance on Methadone maintenance to ‘champion abstinence focused treatment’. Whilst none of this was new news as such his tone suggested a call to arms in a sense, for us all to be prepared for the changes ahead whilst also encouraging that if people are unable to receive the treatment that they require to speak up.
See his presentation here.
NCIDU Day One
I’m always on the look out for useful videos to show in training sessions. I have long been a fan of Lifeline Publications for their no nonsense approach and informing in a targetted way. Mike Linnell began by giving us a history of Lifeline publications and indicated the trouble he has caused along the way with people who may be shocked by the content of his brilliant campaigns. Oh well. I think they are great. I like them because there’s no messing around. They do what they need to, making their point in a direct and relevant way. Having used the Mr Mange Goes Over video in my Heroin training sessions I was looking forward to seeing ‘The Ballad of the Two Charlies’. The usual humour combined with subtle and not so subtle messages.
I was not disappointed. As with a lot of Lifeline Publications, both the booklet and the video is not something I would choose to show to a class of Year 7′s but then anyone can use their common sense when choosing resources if they thinks carefully about their target audiences. It focuses on the transition from Cocaine to Crack Cocaine and highlights the difference in attitudes between the use of Heroin and Cocaine. It shows the effect of Crack addiction on one of the Charlie’s. It has been shown in prisons and I think it will be something I will be able to use when training Probation/Police Officers as well as service user groups in Cocaine and Crack training. Unfortunately there is no link for this as yet but I’ll provide one as soon as there is.
NCIDU Day Two
BBV prevention for young people: ‘The Waiting Room’. A BBV prevention film and education toolkit for use with vulnerable young people
Colin Tyrie, Senior Public Health Development Advisor (Substance Misuse), Manchester Public Health Development Service, NHS Manchester
I warmed immediately to Colin Tyrie from the beginning of his session. ‘The Waiting Room’ is a series of three short educational films aimed at prevention of BBV’s in young people. The three characters are shown putting themselves at risk of Hep C, each in a different way.
The first scene is two lads sharing the same note to snort Cocaine, the second a teenage girl who was making the choice whether or not to have sex with a (very eager) young man and the last showed a lad being injected with Heroin.
It was this last one that provoked the most questions and discussion at the end of the session. Mike Linnell was very vocal at suggesting that this scenario was not realistic. In the majority of cases when people inject they are making a conscious choice to do so. The film as you will see does provide a rather sterotypical predatory older man injecting him. I felt though that rather than invalidating the use of the video it could be a good tool for debate around the issues by asking young pwople what they think. Is it realistic? Do they have the choice most of the time? What can they do to prevent being put in similar vulnerable situations etc etc. The Waiting Room also comes with a PDF toolkit on how to utilise the video within a school setting. More needs to be done about raising awareness of BBV transmission through methods of drug use other than injecting. I’m sure a lot of young people are unaware of the risk of sharing notes/straws when snorting Cocaine and need to know how much easier it is to contract Hep C than things like HIV which they are more fearful of.
There we go. Two lovely resources for you to think about.
Thanks for reading.
More from the NCIDU 2010…
Day One – October 7th 2010 am
These are purely the presentations I decided to go to listen to.
You can see the full programme of speakers from Day One here.
Jim McVeigh, Head of Substance Use, Centre for Public Health, Liverpool Moores University
Gettting drug dealers involved in harm reduction
Ross Coomber spoke about a Plymouth pilot study which involved drug dealers in harm reduction. Makes a lot of sense really doesn’t it but can’t see the Daily Mail ‘getting’ it.
The pilot study involved engaging drug dealers who provided space for users to inject their gear. Inevitably a lot of these spaces aren’t always going to be the most hygenic and so prove an additional risk to users such as Blood Borne Viruses and infections. The premise is that if the dealers can be given access to better information, needle exchanges and so forth then those they are selling to will also be influenced to use more safely and understand why.
Dealers’ houses can essentially be public injecting galleries. Our helpful drug laws of course prevent safe areas like these being officially set up but unofficially is the only way IV users can be helped to be at less risk in terms of safer spaces. Ross also put forward the fact that not all dealers are neccessarily the media stereotype predator, especially in the case of user-dealers. Amazingly dealers are humans too, fancy that! User-dealers may only deal to a close circle of friends and aquaintances and therefore can be instrumental in promoting safer practices.
My conclusion: Controversial it may be, ‘pushing the boundaries’ of harm reduction too but anything that can reduce the transmission of blood borne viruses is another way forward. How anyone can argue against something that can save lives is beyond me. It would be a shame if this Plymouth pilot ends up a one off.
I think what ‘some’ (let’s not prejudge them all) of the general drug ignorant public may hold the view that if people want to inject then let them just catch whatever comes, it’s their own fault blah blah blah. I’ve heard this opinion being voiced in training sessions before. My response to them will always be , ‘It’s not just injecting drug users that spread BBV’s is it?’ and ‘What if it was your son or daughter? Would you want them to be using safely if they have to use at all?’. Soon shuts them up : )
Just another thought too, where would these people prefer their loved ones to be injecting (again, if they were going to anyway). In an unlit stairwell, behind a skip (see Swansea Love Story), in a dirty squat or somewhere clean and safe?
More than Anabolic Steroids
Martin Chandler gave an eye opening talk on the phenomenal amount of growth hormones and products that Steroid users are now using in addition to the Anabolic Steroids they may be taking.
A lot of these substances are used to combat the side effects of others. For example Anti-Estrogen drugs are used to combat the likelihood of gynecomastia (AKA Bitch tits or my preferred word, Moobs). Some of the side effects of Steroids are irreversible and it was amazing to learn just how many of these other Performance Enhancers there are. Not all of them illegal, some OTC, some available on dodgy websites from across Europe with little if any advice.
Martin then went on to explain Stacking and Cycles which are the regimes users will incorporate into their day to day lives in order to acheive their desirable muscular image. It seems you have to be very organised and motivated to be a successful Steroid user. To be honest a lot of this part went over my head. Very complicated. I have to take two separate pills every morning, that’s enough for me to get my head around!!
My Conclusion: There are just so many! Services need drug workers dedicated purely to this client group. It needs to be something drug services can respond to and they need to look at ways of getting users of Performance & Image Enhancing Drugs (PIEDS) to access needle exchanges and harm reduction advice just as they would for all drugs. They will only access services if they are confident in the worker’s knowledge. A big task!
Well that’s the morning done. I’ll try my best to do the rest as soon as I can.
Peace, love and ALWAYS empathy.
Thanks to winning the Hiwecanhelp competition I had the opportunity to attend the National Conference on Injecting Drug Use (NCIDU) at The Sage, Gateshead, Newcastle. The venue itself is pretty impressive.
I was kindly put up for two days by Roweena, Managing Director of Hiwecanhelp who was exhibiting at the conference as well as chairing day two. As I was staying with Roweena it was nice to have a base at the Hiwecanhelp stand also with the lovely Barbara. On Day One I made the mistake of wearing my high heeled boots as I hadn’t realised The Sage was on three levels with a crazy amount of stairs. My buttocks certainly got a workout! My Skecher’s were a better alternative on Day Two despite them making me look like a bit of a short arse next to Nigel (see below!).
I’ll be writing separate posts about some of the presentations I attended and found the most useful and interesting to share.
It was great to be able to meet some of the Drug peeps I have known for a while through Twitter such as Nigel Brunsdon of Injecting Advice fame, Allison, a harm reduction worker who works with Nigel on the brilliant Hooked podcasts, Tony Lee, and Maddie O Hare from HIT.
Being the social butterfly that I am I enjoyed walking around and chatting with the services that had stalls there which included HIT, Lifeline, Concateno, NNEF and loads more. I was also interested to see that South London has an addictions clinic specifically aimed at users of party drugs.
Throughout the conference as well as the plenary sessions in the main conference hall there was a choice of different presentations to attend. This made it more flexible and I found that I was able to concentrate much better on the information as I could pick and choose the sessions that were most relevant to me.
Staying with Roweena and Ruth (rather than being lonely in an overpriced hotel!).
Meeting my Twittery folk.
Viewing the new Lifeline animation ‘The Tale of The Two Charlies’.
The presentations on Drug Purity.
Seeing how chuffed Tony Lee was at getting thought his very first conference presentation. (Well done!)
Nigel and Allison’s Twitter presentation – despite the fact they had tweets up on the big screen including mine, one of which was: -
Watch this space for more info on the content of the days, I’ll plough through my notes and get things blogged in my very own special Stacey way over the next few days : )