Harm Reduction Is giving out needles to addicts really still "harm reduction" in this age of Fent and Nitazenes?

[moshforjesus]

Apparently so. I guess the individuals might rotate the stores they target, or leave it a couple of days.

If certain individuals kept on targetting the same store on a daily basis, even the store's staff and poilice which have effectively been made powerless and told not to intervene, they would be more likely to be take matters into their own hands in such cases.

I'm not making this up. There are countless videos on you tube about it. (Yeah I know about 'the algorithm'.) Check out the likes of Peter Santanello who has made several videos about San Fransisco since the Covid pandemic, for some higher quality content.

The downtown area has effectively been wiped out with so many stores closed down and empty as a result of all of this.

It is generally estimated that the number of problematic heroin/crack users in the UK is somewhere between 300k-400k, so a tiny proportion of the overall population (roughly the size of a medium size city a la Coventry, if you will). However, as per the government's own data:

1) The most recent estimate of the annual social and economic cost of Class A drug use in England was £15.4 billion, for the year 2003/04. Of this, problematic drug use (defined as use of heroin and/or crack cocaine) accounts for 99% of the total, and the costs of Class A drug-related crime is 90% (estimated £13.9 billion) of that total.

Furthermore, the most recent Home Office research estimated that between a third and a half of all acquisitive crime is committed by offenders who use heroin, cocaine or crack cocaine. There are no equivalent figures for Class B and Class C drug use.

Giving these people clean needles is still harm reduction, regardless of how dangerous the street opioid market gets, firstly because it will stop lots of them from dying or contracting life-limiting diseases/health conditions. More importantly though, needle exchanges act as a vital first point of call for chaotic individuals accessing/being signposted to other health and social care services - most of those engaged with needle exchanges will carry on with their lifestyle, but at least some of them every year will begin to make positive changes based on their conversations with professionals at chemists and in other settings whilst picking up clean works

I have to be honest, and fully apologise if this is an unwarranted statement, but the fact you are even asking the question implies that you have had very little contact with problematic Class A drug use at the street level. Of course clean needles are an example of HR ffs

 

[Shinji Ikari]

(not even sure exactly what Scotland had going on to be totally honest, but it sounds like they were at least doing something right

This is what I was thinking about. It was set up by volunteers in 2020 without any authorisation from the local council. Vigilante harm reduction.

Mobile injection van is saving lives across Glasgow

DRUG users in Glasgow have been receiving lifesaving support from volunteers running a mobile injection van amid the coronavirus pandemic.

www.glasgowtimes.co.uk

Apparently the 'pilot' was so successful that they were able to attract funding for a second van which was also licenced to distribute naloxone, but this was in 2020 so I don't know what the current state of things is.

Life-saving needle-exchange van receives green light

Following the success of Glasgow’s only Injection Equipment Provision (IEP) van, funding has been granted for an additional mobile unit to help tackle the city’s drug crisis by providing crucial healthcare and harm reduction services. The van, funded by the Scottish Drug Deaths Taskforce will...

www.nhsggc.scot

 

[Shinji Ikari]

I have to be honest, and fully apologise if this is an unwarranted statement, but the fact you are even asking the question implies that you have had very little contact with problematic Class A drug use at the street level.

To be fair this description does apply to most people in the developed world and there's absolutely nothing wrong with not knowing. Nobody knows anything until they do and discussions like this can help educate people on aspects of drug use and harm reduction that they may simply have not been exposed to before.

 

[3DQSAR]

Needle exchanges provide information, test kits and often initial contact between an active user and those who seek to render aid where possible. I've also noted that informally, if a regular drops off the map, their friends may be asked if the person is OK. Not much of a safety net, but the isolation of addiction makes users targets for certain criminal activities. 'Cookooing' being one example.

I believe a fentanyl class, nitazene class and even a specific carfentanil test-kits are now available.

NERDNOTE: Now I'm guessing that modern test kits are more likely to use engineered antibodies to detect a class rather than a single drug. I suspect that the sheer potency of some drugs would make presumptive testing difficult because in some cases, a dose may contain only micrograms of active.

What concerns me is not so much that carfentanil specifically has turned up, but that there are hundreds of novel compounds which one might term 'highly potent'. Compounds not explicitly controlled anywhere. I would term anything more than one hundred times more potent that morphine.

 

[ShulginsReincarnation]

This is what I was thinking about. It was set up by volunteers in 2020 without any authorisation from the local council. Vigilante harm reduction.

Mobile injection van is saving lives across Glasgow

DRUG users in Glasgow have been receiving lifesaving support from volunteers running a mobile injection van amid the coronavirus pandemic.

www.glasgowtimes.co.uk

Apparently the 'pilot' was so successful that they were able to attract funding for a second van which was also licenced to distribute naloxone, but this was in 2020 so I don't know what the current state of things is.

Life-saving needle-exchange van receives green light

Following the success of Glasgow’s only Injection Equipment Provision (IEP) van, funding has been granted for an additional mobile unit to help tackle the city’s drug crisis by providing crucial healthcare and harm reduction services. The van, funded by the Scottish Drug Deaths Taskforce will...

www.nhsggc.scot

Nice. Thank you for sharing. I wonder what part (if any) the Scottish Drugs Forum had to do with this, or what their thoughts are on the matter.

Hopefully we see much more of this in the future throughout the entire UK (not just Scotland.)

 

[Jnowhere]

I know it's always been a controversial topic, but up until very recently I'd always understood the logic, that it helps prevent the risk of spreading infections / diseases, as being the main driver behind the schemes.

But I heard someone legitimately question the other day, how can it still be called "harm reduction", when facilititating easy access to injecting street drugs cut with things like fent and nitazenes? Injecting these things is going to kill a lot more people, a lot more quickly, than any infectious diseases!

He's not wrong!? I think he seriously has a very good point.

It might it be time to re-consider this policy, at least in areas where the prevalence of fent or nitazenes is known to be very high, and the area is seeing lots of fatalities. Mostly in certain areas of some of the big US cities, like San Fransiscos' Tenderloin, Philadelphias' Kensington, and Los Angeles' Skid Row, seeming to have the most catastrophically out of control problems.

Not sure if it's media bias on YouTube etc, but the political leaders of San Fransisco, mayor London Breed etc, are constantly getting a terrible reputation for being on the ridiculous side of "woke" with being far too soft on crime and other issues. But as far as I can tell it really does seem to be such woke policies that are at least playing a part in the problem.

I really hope that European's can learn from the stupidity in parts of America.

They just hand needles out in places. Plastic straws illegal, but used infected needles in certain area of California are all over the place.

Exchange, not give out. They are doing this and so many other tax payer funded programs that only encourage and help maintain the fent and meth problems in certain areas, almost always leftist areas and California, Portland Oregon in particular along with the once great and beautiful city of Seattle Washington.

Why do tax payers, have to get stuck paying for others drug abuse dysfunctional lifestyle?

There are plenty of Alcoholics and drug addicts who hold down jobs and are taxpayers and other than personal use of certain drugs, being a crime in most areas of America; why does the hardworking and functional members of society have too suffer and pay for people who can't function. Move and learn your lesson if you voted for them. Mayor's, city council, ect..

I am not talking about helping those who seek help, and basic services. I mean subsidizing and ruining cities because of a small number of people who just want to be taken care of so they can get high and relax all day at the taxpayers expense and many have no real goal or are trying to get help. In the process many people move to these areas that are being destroyed.

California is only livable in many areas if you make a lot of money or you are dirt poor. I thought the Democrats cared about the middle class and small businesses, but I guess that has changed and people in so many areas, are actually getting what they voted for, the destruction of the middle class.

Many have fled. Hopefully these' refugees of many areas of California, Seattle, Portland and many areas on the left coast have fled. So have jobs. Hopefully people in these areas being destroyed by ridulous laws aimed at subsidizing failure, criminal activities and a big government entitled addicts mentality, will leave their politics in the toilets from where they fled.

Hopefully Europe will not go down these same paths of destruction. Learn from the mistakes and take notes or you will end up with your very own Kensington's and ruined Great cities.

With the increase in bad and deadly( talking about what the drugs are cut with and subsidizing drug addiction and ruining cities for the vast majority of people because of a small number of people who take advantage of well intentioned idiots and others who get elected and don't give a shit).

Also this will only give more power to the right that European media is so scared of. Well look at the far looney left in America and if the European's want this, Then Welcome to The Jungle.

 

[chippermonk]

They just hand needles out in places. Plastic straws illegal, but used infected needles in certain area of California.

Exchange, not give out. They are doing this and so many other tax payer funded programs that only encourage and help maintain the fent and meth problems in certain areas, almost always leftist areas and California, Portland Oregon in particular along with the once great and beautiful city of Seattle Washington.

Why do tax payers, have to get stuck paying for others drug abuse dysfunctional lifestyle?

There are plenty of Alcoholics and drug addicts who hold down jobs and are taxpayers and other than personal use of certain drugs, being a crime in most areas of America; why does the hardworking and functional members of society have too suffer and pay for people who can't function. Move and learn your lesson if you voted for them. Mayor's, city council, ect..

I am not talking about helping those who seek help, and basic services. I mean subsidizing and ruining cities because of a small number of people who just want to be taken care of so they can get high and relax all day at the taxpayers expense and many have no real goal or are trying to get help. In the process many people move to these areas that are being destroyed.

California is only livable in many areas if you make a lot of money or you are dirt poor. I thought the Democrats cared about the middle class and small businesses, but I guess that has changed and people in so many areas, are actually getting what they voted for, the destruction of the middle class.

Many have fled. Hopefully these' refugees of many areas of California, Seattle, Portland and many areas on the left coast have fled. So have jobs. Hopefully people in these areas being destroyed by ridulous laws aimed at subsidizing failure, criminal activities and a big government entitled addicts mentality, will leave their politics in the toilets from where they fled.

I live in the Bay Area and have a very middle class income and find it quite liveable. I love it here

 

[ShulginsReincarnation]

NERDNOTE: Now I'm guessing that modern test kits are more likely to use engineered antibodies to detect a class rather than a single drug. I suspect that the sheer potency of some drugs would make presumptive testing difficult because in some cases, a dose may contain only micrograms of active.

Correct, and this is my concern even more so than the possibility of the substances being present. The extremely small amounts make test kits almost pointless as they are in the case of etorphine or carfentanil. This is something that needs to be addressed by the companies designing the LFTs for these type of drugs. Maybe (hopefully) we will see better testing methods available soon as these chemicals become more widespread in their distribution now that the markets are shifting again toward such things becoming popular.

Sadly, I am still just working to make people aware of the nitazenes yet, and in the meanwhile the chemists seem to keep producing newer compounds that will eventually be entered into the markets due to their availability which are more difficult to detect due to lack of resources. Eventually, the harm reduction community gets the shift to happen in terms of awareness and testing measures (and its happening quicker than ever before now.) But, in the meanwhile, people's lives are at risk due to us all playing catch-up.

 

[ShulginsReincarnation]

They just hand needles out in places. Plastic straws illegal, but used infected needles in certain area of California.

Exchange, not give out. They are doing this and so many other tax payer funded programs that only encourage and help maintain the fent and meth problems in certain areas, almost always leftist areas and California, Portland Oregon in particular along with the once great and beautiful city of Seattle Washington.

Why do tax payers, have to get stuck paying for others drug abuse dysfunctional lifestyle?

There are plenty of Alcoholics and drug addicts who hold down jobs and are taxpayers and other than personal use of certain drugs, being a crime in most areas of America; why does the hardworking and functional members of society have too suffer and pay for people who can't function. Move and learn your lesson if you voted for them. Mayor's, city council, ect..

I am not talking about helping those who seek help, and basic services. I mean subsidizing and ruining cities because of a small number of people who just want to be taken care of so they can get high and relax all day at the taxpayers expense and many have no real goal or are trying to get help. In the process many people move to these areas that are being destroyed.

California is only livable in many areas if you make a lot of money or you are dirt poor. I thought the Democrats cared about the middle class and small businesses, but I guess that has changed and people in so many areas, are actually getting what they voted for, the destruction of the middle class.

Many have fled. Hopefully these' refugees of many areas of California, Seattle, Portland and many areas on the left coast have fled. So have jobs. Hopefully people in these areas being destroyed by ridulous laws aimed at subsidizing failure, criminal activities and a big government entitled addicts mentality, will leave their politics in the toilets from where they fled.

I try not to feed into the political divide with regard to discussion of such in the USA. Its the system that's fucked in the USA, not the people who are being voted in. Until Americans realize this, then they'll keep getting puppets put into power by the shadow government like they have now. Again, I am not getting into the politics because it just encourages more bad behavior and thinking, but if you follow the money its obvious that the shadow government in the USA is doing all of this on both sides. Its not a conspiracy theory either; just follow the money, and you will see what I mean. Its literally common sense in my opinion, but most Americans don't have this it would seem to me...

 

[ShulginsReincarnation]

I live in the Bay Area and have a very middle class income and find it quite liveable. I love it here

I love the people in the Bay Area; very influential in my life. Thanks to the internet, I have learned so much from my communications with those who live there. I took this for granted until recently, but yes... Bay Area has a very good vibe about it from my experience anyway

 

[canadianpeduser]

Coming from a past user of those services; I believe it’s a huge burden on taxpayers. When you give literally unlimited amounts of supplies to street addicts who already have the “take as much as I can get” mindset; this equates to normal congregation points for street level addicts and dealers to meet and do their thing right in front of the public eye-at all times of day and night. During school hours, outside of daycares and churches etc. not to mention the ridiculous amount of paraphenelia shamelessly strewn about the public sidewalks, streets and city parks. People half in OD , hanging off the side of a garbage can or a city sidewalk flower planter, picking through the garbage and the dirt. Leaving capless needles and countless cookers and ties fucking everywhere.

Personally I used IV before those services were available and I was always able to put aside the 5$ to grab my shit if I wanted to use that way.

I understand people are going to do this stuff whether or not the free gear services are available to them. I just never saw the point of supervised consumption; then after they’ve been shot up; narcanned; then shot up again, they’re sent out the door with a grocery bag full of yet more gear to litter all over the streets, oh yeah and maybe a juice box and a granola bar to keep ya going just that couple hours longer. Or maybe some gloves and hand warmers for people in cold places. We need more help to deal with the core of the issue, not bandaid it with enablement and going a quarter of the way to help somebody.

Just my thoughts on the matter

 

[3DQSAR]

Why do tax payers, have to get stuck paying for others drug abuse dysfunctional lifestyle?

On the purely pragmatic https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-01037-3

 

[ShulginsReincarnation]

Coming from a past user of those services; I believe it’s a huge burden on taxpayers. When you give literally unlimited amounts of supplies to street addicts who already have the “take as much as I can get” mindset; this equates to normal congregation points for street level addicts and dealers to meet and do their thing right in front of the public eye-at all times of day and night. During school hours, outside of daycares and churches etc. not to mention the ridiculous amount of paraphenelia shamelessly strewn about the public sidewalks, streets and city parks. People half in OD , hanging off the side of a garbage can or a city sidewalk flower planter, picking through the garbage and the dirt. Leaving capless needles and countless cookers and ties fucking everywhere.

Personally I used IV before those services were available and I was always able to put aside the 5$ to grab my shit if I wanted to use that way.

I understand people are going to do this stuff whether or not the free gear services are available to them. I just never saw the point of supervised consumption; then after they’ve been shot up; narcanned; then shot up again, they’re sent out the door with a grocery bag full of yet more gear to litter all over the streets, oh yeah and maybe a juice box and a granola bar to keep ya going just that couple hours longer. Or maybe some gloves and hand warmers for people in cold places. We need more help to deal with the core of the issue, not bandaid it with enablement and going a quarter of the way to help somebody.

Just my thoughts on the matter

I agree with this sentiment; the whole point of harm reduction measures and DCRs is supposed to be guiding people toward recovery from addiction (though this is quite a difficult process.) My theory is if DCRs started offering substitution of street drugs like fentanyl/heroin/nitazenes, then the addicts would be more receptive to going to rehabilitation programs in exchange for such. This would help plant the seeds necessary to see some begin to get better, but of course there will be a certain level of failure. And, this is just a small small part of the equation as far as my vision for how this situation should be approached. The DCRs within the EU seem to be reducing harm though, so maybe it would be best to look into how and why the techniques very between US approach and the approach taken by the EU with guidance from the EUDA. One thing that is certain is that the US model is very reactionary, whereas the EU model is proactive about the problems associated with drug use.

 

[Jnowhere]

I live in the Bay Area and have a very middle class income and find it quite liveable. I love it here

What is your definition of middle class?
What is your definition of middle class if it 6 figures than you are out of touch and then the working poor, or working class, also 2 incomes and 6 figures and no kids and little extra money. Do you have a mortgage or pay rent in San Francisco? Do have a two decent newer cars if more than yourself aka a couple?
Also which city, because San Francisco and Oakland are toilets and really expensive. What area, maybe you are are in one of the few areas, or have an income you consider middle class for California but not most of America.

 

[Jnowhere]

On the purely pragmatic https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-01037-3

All the free stuff given out in Portland, Seattle, San Francisco ect.. Yes they were even giving out free cigarettes in S.
F. plus money, free food, medical care, other stuff at the tax payers expense as these people, San Francisco in particular subsidize their 'lifestyle' and no law enforcement of thefts under$950? Someone has to pay and it is in everything they can tax. Which these people steal, without consequences.
Ruin streets, small businesses, driving out major employers, look for the list on Companies that have fled. They( the homeless addicts)cause nightmare to many small businesses.( theft, living right in front of their store fronts)

 

[GulpingBatteryLiquid]

It might be simpler if drugs weren't criminalised so we can just get on with treating it as a public health issue rather than conflating it with crimes of necessity. Shoplifting is a symptom. Address the cause.

Crack and heroin will still be quite expensive even if legalised. Maybe they'd be a bit cheaper, but you need huge fields to grow that stuff.

In the UK, you can get generous amounts of methadone for free. People still do H, because they prefer H

 

[Jnowhere]

I try not to feed into the political divide with regard to discussion of such in the USA. Its the system that's fucked in the USA, not the people who are being voted in. Until Americans realize this, then they'll keep getting puppets put into power by the shadow government like they have now. Again, I am not getting into the politics because it just encourages more bad behavior and thinking, but if you follow the money its obvious that the shadow government in the USA is doing all of this on both sides. Its not a conspiracy theory either; just follow the money, and you will see what I mean. Its literally common sense in my opinion, but most Americans don't have this it would seem to me...

No it is the leftist cities and you don't even see this shit in Detroit, which is known as one of the most dangerous and is per capital many years the murder capital. But the kinda shit going on in California is not tolerated, so just the usual gang and drug related and personal violence and revenge stuff.

But the conservative cities don't have these problems in red and non leftist states, like the usually blue but not leftist state I live in Michigan, near Detroit.
It is political and if you don't live here and haven't seen these places and even spent a few nights alone stuck sleeping on them, then you have no clue.
I have lived in many areas and it just depends on who is in power and if they are strong or are cowards who pander to the left then you get, these toilets of cities. Philly, leftist. New York improved greatly under a moderate but tough on crime mayor, now the whole mayor's office is under investigation and crime and corruption follow, wimpy leaders, and stupid policies that some think are of good in intentions. Do I really need an old clichè?

 

[ShulginsReincarnation]

Crack and heroin will still be quite expensive even if legalised. Maybe they'd be a bit cheaper, but you need huge fields to grow that stuff.

In the UK, you can get generous amounts of methadone for free. People still do H, because they prefer H

The reason methadone even exists is because of this problem. Hitler had it developed due to inability to access opium during the Second World War. But, as you say, it is not so euphoric to match heroin. Netherlands has a good heroin program if all else fails a person, and the heroin issue is very very small in NL as a result despite there once having been a major issue many decades ago. So, it can work, but taxes will be higher, sure. However, they have found once heroin addicts are treated properly they begin to be able to contribute to society.

So, what needs to be done is find an ACTUAL 1:1 type replacement for heroin as opposed to methadone or buprenorphine. This can be made cheaply and given free as long as the person is complying with instructions to become a functional member of society. They can CHOSE to keep not complying, but then no free drugs for them. Obviously, this will be a big motivation and eventually these people will become productive members of society just like in NL. That's the goal anyway.

Decriminalization is a small piece of the pie here.

 

[Jnowhere]

I live in the Bay Area and have a very middle class income and find it quite liveable. I love it here

Your are old and probably live in a home you own and the area, I am speaking more of actual cities. Hell, I remember seeing Sonoma, Napa and those areas, are quite beautiful and their are OK areas in Northern Part of California but for the young and so many others it is not, in the cities of California and rent.
Also everything is expensive and I am talking about the future and the stupid paths of destruction and paycheck robbery by the government, I had no roots and was very nomadic as a young person, and I saw the differences in areas and politics played a huge part.

 

[Shinji Ikari]

Crack and heroin will still be quite expensive even if legalised. Maybe they'd be a bit cheaper, but you need huge fields to grow that stuff

Maybe I dunno. I'm just talking about decrim not legalising. I don't think you can do harm reduction effectively in a landscape where you can be arrested just for being a drug user but that doesn't meant crack and heroin should be available in stores for anyone to buy.

In the UK, you can get generous amounts of methadone for free. People still do H, because they prefer H

I'm not an opioid user but I don't think you can really go cold turkey when you're on methadone because of the long half life so it's kind of a commitment.

When you're on H you always have the option of locking yourself in a room for a few days to get clean so I can see why a lot of users might prefer the flexibility.

I don't know what withdrawing from nits is like though. Apparently fent is harder to get off than H, and from what I'm hearing lately even in the UK real heroin is getting hard to find.