‘There were 5,448 drug related deaths in 2023 – that’s 5,448 people who have died.’ As Maddie O’Hare reminded delegates at the HIT Hot Topics conference of this stark statistic, she added that policy and practice were not fit for purpose, and that ‘keeping people alive is the minimum we should do’.
Fortunately, there was ambition among female leaders to support women facing multiple challenges, making sure they not just survived but went on to thrive, and the conference heard from some of them.
Anna Millington, founder of the M2M harm reduction network, showed a video of her daughter Rain talking a few years ago about how her mother’s drug treatment made her feel, the stigma she felt and the difficulties she faced.
There could be overuse of safeguarding by workers ‘covering their backs’ and it was essential that organisations had strong, clear policies that protected the mother and allowed workers to make decisions based on their knowledge and relationship with the individual, said Millington, who followed up discussion through a workshop.
Drug testing was another issue that caused tension between women and their key workers, with scepticism around the accuracy of the tests. They also used up a lot of the valuable time of an appointment – ‘If I have 30 minutes with a client, I don’t want them spending 20 of it in the loo taking a test,’ said one participant.
Paula Kearny from the SAOL Project in Dublin told delegates about their work with disadvantaged women whose addiction might be the primary issue but where it was often a symptom of underlying problems relating to poverty, abuse or mental health.
SAOL did not insist on drug-free recovery but focused on helping women find their strengths and what they wanted from life. ‘When a woman walks through the door they are greeted with tea and chats not judgement and stigma,’ she said. ‘Many of the women accessing SAOL have suffered severe trauma and may have controlling partners – the service tries to wrap around them and support them. We need to stop continually punishing women and making it hard for them.’
This was one of the things that made Stella Kityo tired – tired of working in a system that seemed set up to make people fail, tired of people being re-traumatised, and tired of things not changing. As a women’s specialist who had worked in all kinds of environments, she supported and empowered women in diverse circumstances. ‘Women don’t want reducing, they want options, a voice, a time to heal,’ she said. ‘There needs to be a collective change.’
Sex workers faced multiple stigma – not least from other women, said Grace Sumner from the Women’s Inclusion Health Collective. The criminalisation of sex workers caused problems, with sex workers 12 times more likely to be murdered than women not involved in sex work. ‘But sex workers are well organised and have strong unions and groups – they don’t need to be rescued, she said.
The government’s plans to adopt the ‘Nordic model’ which criminalises clients rather than workers would push workers in the sex trade to take greater risks and engage in more dangerous situations to protect their clients, she said. There needed to be more open and honest discussion about practical harm reduction – such as new sex workers understanding the value of mirrors to know what was happening behind them, and the importance of hiding all ID and ways of being identified.
Julie Smedley shared her experience of visiting sex workers as part of an outreach team, which did not initially go the way she expected. ‘I was naive and thought I would change everything,’ she said. ‘Women asked for a script and laughed when I suggested an appointment in two weeks’ time.’
This doubled her determination to help, and as part of WithYou she set up a service in Liverpool’s red light district that aimed to overcome the barriers of location, waiting times, flexibility, and stigma. Taking the service to the women also removed their concerns about meeting any of the ‘three Ps’ – punters, pimps and perpetrators – who might be attending a mainstream service.
Many of the women who came along wanted a script, and while there was initial scepticism around other support offered this gradually lessened, leading to the IRIS project. Launched in December 2023, it provided holistic wraparound services where most needed.
The devastating global consequences of the war on drugs and lack of safe supply were illustrated by Lynn Jeffreys from EuroNPUD who showed a slide with 47,162 dots representing drug deaths in her native Canada. ‘If I was trying to do this for the USA there wouldn’t be enough space for all the dots,’ she said.