Canberra Alliance for Harm Minimisation and Advocacy
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| Naloxone Program | Campaigns | Workshops & Education |
Campaigns
CAHMA has been involved in numerous campaigns and projects over the years, and many of these have proved hugely successful.
Current campaigns which CAHMA is involved in include :
The Alexander Maconchie Center Needle & Syringe Program
The Peer Distributed Naloxone Program
The Foot Patroll Needle & Syringe Program
One initiative, which CAHMA has backed since its inception, is the campaign for a heroin trial in Canberra. This project is run down by some as being merely a pipe dream, but over the years it has gained considerable support and CAHMA believes that it is now a real possibility. Heroin trials have been successfully run in many countries around the world and have shown that this humane, pragmatic approach is indeed a sensible, cost-effective approach to dealing with our "drug problem". But have a read of the following article and see what you think...
A Heroin Trial for Canberra? A heroin trial is an initiative where long-term users of opiate drugs are provided pharmaceutical grade diacetylmorphine (heroin) by health authorities to scientifically evaluate whether it is an effective way of improving their health and keeping them from having to obtain heroin illicitly. Since the abandonment of the ACT initiative, heroin trials have taken place in a number of countries such as Germany, the Netherlands and Spain. They have shown clear health and social benefits. Switzerland has over 10 years’ experience in the prescription of heroin and in a November 2008 referendum 68% of voters were in favour of its continuation. The prescription of heroin is now recognised in some European countries as the optimal treatment for patients for whom other treatments have failed. Methadone maintenance does not work for all and the provision of diacetylmorphine (heroin) keeps these users away from street drugs and in contact with health and other services. A major randomized control trial was conducted in Canada in 2008.The North American Opiate Medication Initiative (NAOMI) trial aimed at testing whether heroin assisted treatment offers benefits over and above optimised methadone therapy in the treatment of individuals with chronic addiction who continue to use despite having tried conventional treatments in the past. 251 participants were followed up for 2 years. Entitled “Reaching The Hardest To Reach-Treating the Hardest to Treat” the trial resulted in the following conclusions:
Heroin-assisted therapy proved to be a safe and highly effective treatment for people with chronic, treatment-refractory heroin addiction. Marked improvements were observed including decreased use of illicit “street” heroin, decreased criminal activity,decreased money spent on drugs, and improved physical and psychological health.
- The NAOMI trial attracted the most chronic and marginalized heroin users who were outside the treatment system and continued to use heroin despite numerous previous treatment attempts. Both heroin-assisted therapy and optimized methadone maintenance treatment achieved high retention rates and remarkable response rates in this difficult-to-treat group.
- Contrary to pre-existing concerns, the treatment clinics appeared to have no negative impacts on the surrounding neighbourhoods.
- Participants on hydromorphone did not distinguish this drug from heroin. Moreover, hydromorphone appeared to be equally effective as heroin although the study was not designed to test this conclusively. If this were proven to be true, hydromorphone assisted therapy could offer legal, political and logistical advantages over heroin and could be made more widely available.
What are the benefits?
CAHMA considers that the need for an increase in options and choices for users of opiates in the ACT remains. Heroin remains a significant health, social and crime issue. While all currently available options such as methadone maintenance, suboxone (buprenorphine with added naloxone), residential rehabilitation and counselling are beneficial for some dependant users, none are satisfactory for a further significant proportion. Additional options are needed. There is an emerging consensus that heroin is a viable treatment for a number of opiate users who do not do well on, or never consider, other treatment options. The provision of prescribed heroin to these people is consistent with harm minimisation and human rights principles. Regrettably, the approach to treatment options is more affected by politics than evidence or research. Politicians have championed a “war on drugs” (effectively a war on your own citizens!) and the promotion of abstinence from illicit drugs as effective public policy. The media have perpetuated a negative portrayal which has increased the stigma and discrimination that drug users face. Biased reporting of issues related to illicit drugs makes it harder for there to be informed debate in the community let alone progressive reform. The reality is that huge profits continue to be made by organized crime and enormous harms are inflicted on individuals and society.
How can you get involved?
The provision of prescribed heroin would make an incalculable difference to the health of both the user and their immediate family. It would make sizable inroads into black market profits. The time has come for the war rhetoric to be axed. What is needed is thoughtful debate that leads to positive change. Get informed and get involved. CAHMA is the organisation that advocates for injecting drug users in the ACT. If you are interested you can read up on the evidence or get involved in the campaign to get approval for the heroin trial to go ahead. A heroin trial is in the ACT Drug Strategy so it is realistic to argue the case. You could write to your local MP, write a letter to a newspaper or just talk to your family.
But these are not the only initiatives which CAHMA is involved in. We have been campaigning for a number of other changes which will not only improve the lives of illicit drug users and their families but will also help ease the burden on our health and legal systems.