Users are the solution, not the problem

Da: “On Track” 14¡ International Conference on Drug Related Harm monday 6 april 2003 Chiangmai (Thailand)

Until drug users are treated with dignity and respect, and are seen as part of the solution rather than part of the problem, harm reduction programmes will never succeed. This was the resounding central theme of the opening ceremony of the 14th International Conference on the Reduction of Drug Related Harm, which began yesterday in Chiang Mai.

Speaking on behalf of people who have used or are using drugs, 3l yearold Wassawut Yimchaem from Thailand, himself a user for over five years, set the tone for the conference with a firsthand account of the stigma and discrimination that users face. Injecting drug users (IDUs) are often blamed for social disorder, violence, crime, promiscuous behaviour and the spread of HIV/AIDS and other sexually transmitted diseases.

Different power groups including health care providers, the media and society elites perpetuate the stigma and discrimination faced by users. Unbalanced government policies also play a role in these judgemental attitudes. “No matter what our methodology or background, the starting point for all our efforts must be to ensure the basic human rights of those we wish to help,” said Wassawut. “People who use drugs are almost never seen as people with dignity.

They are viewed as dangerous, untrustworthy, irresponsible people; people to be feared,” he continued. “As the Thai Prime Minister’s recent programme to eliminate drugs has demonstrated, drug users and dealers are viewed as people whose very lives are of no concern or value.”

International agencies taking part in the conference are also keen to emphasise that injecting drug users are human beings and, as such, they occupy multiple identities as fathers, mothers, brothers, sisters, sons or daughters. “We need greater global recognition of the fact that ostracising and marginalizing groups of people makes them especially vulnerable to harm and disease. Singling out injecting drug users as people deserving of punishment drives drug use and drug users underground.

This encourages the sort of unsafe practices that can result in public health disaster,” said Massimo Barra, from the Italian Red Cross. “The only way to reverse this trend is for governments to implement policies that bring about a deliberate shift from social exclusion to social inclusion of injecting drug users.

Strategies to reach out to them and make their practices safe are essential. The provision of clean needles is just a start,” added Barra. Thailand’s Minister of Health, Mrs. Sudarat Keyuraphan, stressed the urgency of the situation in her address. “We can no longer afford to limit responses to supply and demand reduction measures alone.

Therefore the region urgently needs to enable harm reduction policies, strategies and programmes for both licit and illicit drug use. In their absence Thailand and Asia may face an epidemic that can threaten both the economy and society.”

Appealing for a more compassionate and equitable approach to injecting drug users she continued: “Lessons learned from many places in the world show that a successful way of addressing these issues is to ensure access to our target group – those individuals who use drugs. Once this relationship is established we can start working with clients on other issues, bearing in mind that they are important actors in solutions we provide.”