“The stigma attached to drug use is causing further marginalization”

The message below from Massimo Barra of the Italian Red Cross describes the amazing work currently taking place in Italy to reduce stigma faced by HIV-positive drug users. This message was sent yesterday to the Stigma-AIDS eForum which is an international eforum open to all who are interested (inside and outside the Red Cross) and currently has over 3000 members. The forum is currently running a discussion on stigma, HIV and drug-related harm reduction.
Massimo Barra, Key Resource Person, Italy
Da: “”, Wed, 13 Aug. 2003.

The stigma attached to drug use is causing further marginalisation of this most vulnerable group who are already living on the fringes, and this is directly impeding efforts to prevent the spread of HIV. If we are to put a stop to this trend, communities need to treat drug users in a more humane way respecting them as people with rights and needs.

The Red Cross in Italy and some other countries is leading the way in advocating for and implementing harm reduction strategies and in doing so is leading a good example to others. At the Villa Maraini, a foundation of the Italian Red Cross in Rome, we have been providing treatment to drug users within the framework of the Italian Red Cross for more than 25 years. By working to improve the lives of drug-users by, for example, advocating for their better treatment by police forces, we are creating an enabling environment for harm reduction activities to be carried out, and this means less HIV transmission.

Importantly we are also advocating for their humane treatment so as to reduce human suffering; we must respect that all drug users are different and that addiction is a disease that requires treatment in just the same manner that other diseases require treatment. The stigma that drug users face not only leads to their treatment needs not being met, it leads to them frequently be treated in unbearably degrading and often totally barbaric ways reminiscent of medieval torture, and this is no exaggeration. The conditions where drug users are held in by law enforcement in are often damp, dark and completely unhygienic. In some parts of the world prisoners facing drug related charges may be chained up for extended periods of time or even executed.

Adding to the problem is faith-based organisations that condemn the use of condoms. They may single out high risk groups for blame leading to stigma and discrimination. It is irresponsible of these organisations to give information that is misleading.

There is no denying that safe-sex works as does needle exchange – and needle exchange, not only reduces HIV transmission, it opens the door for drug dependence treatment and sometimes total recovery. The Red Cross is well placed to advocate for the just treatment of drug-users and for harm reduction in general.

Our respected name and emblem enables us to reach a wide audience the world over and our compassion and concern for human health and dignity have earned us the trust of the most marginalised groups. One way that we are fighting the stigma faced by drug users here in Italy is to use the mass media. Five police officers who are also all world or Olympic sports champions have appeared in advertisements organised by Villa Maraini advocating for the humane treatment of drug users. Once the police force fully understood the issues that surround drug use, their humanitarian nature was appealed to and they have been more capable of understanding the harm reduction approach.

Despite all the research findings supporting harm reduction, it is still met with protest by governments all over the world. This is because of a prevailing attitude that drug users are somehow inferior or even evil and that they therefore deserve to be punished. This is what we must challenge over and over if we are to be successful in changing these attitudes that in turn do so much harm to individuals, families and communities alike. Remaining silent on the issue is only adding to the unjust treatment of a vulnerable group of people and the spread of HIV.

I appeal to all of you on this forum, from within and outside the Red Cross, to embrace this issue and advocate governments who are denying drug-users access to research based harm-reduction strategies. It is often the same governments are fuelling the stigma faced by drug-users, as well as causing immeasurable suffering to drug users and their loved ones and communities, by implementing unjust and often cruel policies. We must let them know that we will not stand by silently and let these ill-informed inhumane activities continue.

Dr Massimo Barra
Founder and Director, Villa Maraini Foundation Italian Red Cross