HR23 Diary: Visiting harm reduction services in Australia

Hello from Australia!

TJC members are in Australia at the moment to attend the Harm Reduction International conference, where we are learning about harm reduction approaches in relation to drug use and drug policy.

We’ll be posting updates as the conference progresses. Today Kirsten shares about her day trip to Canberra!

Visiting CAHMA

CAHMA = Canberra Alliance for Harm Minimisation & Advocacy

The first place we visited was CAHMA’s drop-in centre in Canberra. They adopt an integrated harm reduction approach, which means they’re a one-stop spot for services that people who use drugs might need. The drop-in centre is a safe space without discrimination nor stigma, which drug users may face every day in other contexts. The staff in CAHMA also have lived experiences of drug use, so there’s no judgment and they can relate and communicate with service users who come in. There’s no pressure or demand for abstinence from drug use. If/when the individual is ready and wants to seek treatment, CAHMA can link them up with a variety of resources to meet their goals for their own health and well-being.

This approach respects individual agency; the individual gets to decide, and CAHMA will support them where they’re at. It’s about minimising harm and keeping people safe.

Pill testing at CanTEST

Our next stop was the CanTEST Health and Drug Checking Service! It’s run by Directions Health Services in partnership with Pill Testing Australia, the Australian National University and CAHMA. They do pill testing, where people can check the drugs that they’ve obtained.

By doing this, they can find out the purity of the drug, and be warned if it’s been cut with anything dangerous. The whole process takes about 20 minutes and it’s completely anonymous, so people feel safe to use the service. They can also get advice about safe(r) dosages or ways to use more safely. Such work prevents overdose deaths and saves lives!

Reflection

Places like CAHMA and CanTEST felt like a completely different world from Singapore, where we continue to tout a ‘zero tolerance’ drug policy based on criminalisation and punishment. Anything less than rejection is seen as “enabling” or “encouraging” drug use.

But harm reduction isn’t the same as enabling drug use. This is from a previous TJC post:

Harm reduction is rooted in care, dignity and autonomy, and is life-saving in many instances. Harm reduction is actually a highly flexible and dynamic set of principles and strategies that aim to reduce harm and maximise the well-being of individuals.

Decades of prohibition-focused drug policy have failed to eliminate drugs from society. There are many reasons why people might use drugs, and that’s not going to go away.

When our response is rooted in punishment and shame, we aren’t meeting people where they are to keep them safe. Instead, we drive drug use deeper underground, where people become more exposed to harm, because they are too afraid or ashamed to reach out and seek help when they need it. They’re left with no access to adequate healthcare, and become more at risk to unsafe practices like sharing needles and syringes, or consuming substances that are unsafe or much more potent than they are aware of. Because Singapore’s laws require medical practitioners to report people they suspect of drug use to the police, users might be afraid to seek help even if they have overdosed, which is extremely dangerous and could be fatal.

Harm reduction recognises people’s bodily autonomy, and seeks to provide measures that can minimise and mitigate harm as much as possible.

My visit to CAHMA and CanTEST showed me what could be possible if we stopped believing that we can police and surveil and punish and shame drugs out of Singapore, and started focusing on people’s well-being instead.

It is powerful and empowering to respect people’s agency and dignity, and work with them to meet the goals they set. There’s more buy-in and commitment when people are able to make their own decisions — research has shown that voluntary treatment options tend to be more effective in the long-term than compulsory drug detention.

Singapore has such a long way to go. So much of what I saw in Canberra would be illegal in Singapore; our laws prohibit even providing information on consuming drugs, so harm reduction measures like giving advice on how to inject more safely or how to decide on dosage would be in breach of the Misuse of Drugs Act. Yet this is life-saving information.

I wish people who use drugs in Singapore had access to such services. We could be so much better than we are now.