We drive innovation in drug user health
At NUAA’s recent Peers and Consumers Forum, NUAA’s Deputy Chief Executive Officer Charles Henderson gave the keynote address: Driving innovation: the role of NUAA in drug user health in NSW. This is a taste of his awesome presentation.
In order for both organisations and individuals to be innovative, you need to know who you are, what you are and why you do what you do. That’s not always easy. Drug user community-controlled organisations like NUAA have a great handle on what makes us special, what drives us and what we are trying to achieve — our vision, purpose and objectives. It can be trickier to work out how we fit in the wider community. What are the government structures that support us? What is our role in health policy and NSW’s economic priorities?
If innovation is change and the process of changing, then NUAA must keep measuring ourselves against other services in the Australian drug policy arena. We have to focus on connecting with other organisations and find ways to work together. That means being flexible and adaptable.
If innovation is about making ideas work in the real world and getting new and improved services out there, then NUAA is way ahead. One standout example is the way we reacted to the changed conditions caused by the COVID epidemic.
We pivoted into action fast. We talked with our community members to find out what they needed, then we quickly connected to our organisational partners and funders. As COVID conditions changed, so did NUAA. The first priority was getting fits and other injecting supplies out to our people, when most health services had shut down and there were limitations around travel. We responded with a postal NSP service across NSW, which at first was internally funded by NUAA because we saw the need. We understood illicit drug markets and what drug using ‘on the ground’ meant — regardless of the rules around things like social distancing.
Resources were developed quick smart. We focused on messaging around using safely in COVID. We held podcasts with health professionals and peers talking about COVID itself and the changes to services, so we could keep people informed. We raised overdose awareness and distributed Naloxone. We provided tips to reduce the risk of COVID for people in drug sales. We set up a 1800 PeerLine number. We made changes at our NSP at 345 Crown St, Surry Hills, including providing vaccines and boosters to community members. We distributed a card to remind police that OTP clinics and NSPs were essential services.
The harm reduction festival space was turned upside down but we provided online interactions, drug alerts, education and events in the digital world, keeping our connection to the festival community intact.
COVID-19 is the new normal and NUAA maintains community connection because our purpose is simple and because humans — including drug users — are great at coping, even when things are uncertain. In all this, we stayed focused on how we want people to think about NUAA. What is our truth? What do we want to be known for?
I believe NUAA holds at its heart the desire to serve. We uphold the health and human rights of drug users. Just because it is law does not make it right — our current situation is unworkable. We want our community to get health care without stigma and discrimination — whatever we need and whenever we need it.
Innovation is crucial to the continuing success of any organisation. NUAA’s role in driving innovation starts with the way we communicate and connect with the people we serve — the community of people who use/inject drugs in NSW. Community engagement is NUAA’s beginning, middle and end. We acknowledge the needs, the achievements and the strength of our community because these things define NUAA’s place in the world.
We must always keep that connection and understand who we are and where we have come from, because that is what keeps us focused and true to our purpose. We understand that drug use is part of the human condition, that drug use is neither good nor bad, that the first cut, the jagged edge, the ultimate trauma, is criminalisation itself. We also know that others do not hold this view. Drug user health to many in society means not doing drugs.
We acknowledge the peers that came before us. The HIV epidemic landed in Australia in 1981 out of the blue. It was very real and confronting to people who inject drugs. If it weren’t for the deliberate and concerted efforts of people who injected drugs and the forming of NUAA then, we would not have met the challenges so well. HIV would have ripped through our community with many more lives lost.
NUAA continues to innovate around the HCV (hep C) epidemic, which primarily affects people who inject drugs. Although we have always advocated for access to HCV treatment, it wasn’t always a priority for decision-makers. We innovated, we worked with research institutions to provide treatment access, all the while building an evidence base while our community were treated all too slowly. When DAAs, the medication that cures HCV, became available in 2016, our community was finally able to get sorted. Yet again NUAA was at the forefront with education, advice and expertise. We made sure that treatment was available to everyone. It didn’t matter if you were using, or were on the street, or in jail, or in rural areas.
We worked to gain our state-wide Dry Blood Spot (DBS) site code for getting our people tested, and our peer workers have since tested hundreds of injecting drug users. We provide a peer-led nurse-based clinic at our NSP and walk with our community from testing to cure. Our current efforts in the HCV space include our Peers-On-Wheels (POW) Project, a totally peer-led pilot mobile service that travels all over NSW with a 1-hour testing service.
We acknowledge that what we do today matters. It matters now and it will always matter. We are providing a legacy that will endure. We have a duty to all those who have dedicated themselves to harm reduction and ending criminalisation. We have a duty to end the senseless loss of life.
We do these things because we care. We build a connection because no-one else does. We know who we are and will continue to reaffirm the reasons for doing what we do. NUAA continues to raise our profile and work where we can affect change, realising the vision shared by our community all around the world. We move ever forward with passion. Advancing the health, human rights and dignity of people who use drugs is what drives us — now and always.