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As a harm reduction worker at the Cairn Centre, the main needle exchange in the centre of Dundee, I wondered if any of your readers could answer a question.
We have noticed lately that our clients are asking for lots of citric – much more than they need. We asked them why and it turns out that the IDUs in this area have changed the order in which they prepare their hits.
They put the heroin in first, then put in the citric, and then the water – instead of putting the water in before the citric.
So we have been reminding clients of the correct order. However, a few of them are now telling us that the reason they need much more citric is to dissolve the adulterants in their heroin. They are telling us that the mixture is very white.
Is there a new adulterant around, which is dissolved by acid, or is the heroin simply being adulterated even more, with the usual stuff?
It would be great to hear what other NX workers, or others, think.
George Donald, Cairn Centre, Dundee
Supporting real localism
Marcus Roberts talked about localism (DDN, May, page 11), pointing out that while Public Health England (PHE) is the ‘expert national public health agency’ how effective it is will depend on its ability to persuade those with power at a local level to listen to its ‘evidence-based’ recommendations.
PHE will be presenting ‘evidence-based’ recommendations not just for drugs and alcohol, but for all areas of public health, which is a massive cause for concern for ongoing funding of drug treatment. Drug dependency, despite the terrible consequences for individuals involved, is a minority sport. The scale of the harm caused pales in comparison to that of alcohol, smoking, and poor diet. On top of that we all know how far down the list of priorities it is for most members of the public and therefore their elected representatives. If we are relying on PHE alone to make the case and ensure the continued investment in drug treatment, I think we have scant chance.
However the one thing that I think provides a faint glimmer of hope is the continued rise of the service user and recovery groups. As a regular attendee of the DDN user involvement conference, I have witnessed the changes and growth of different user-led organisations over the past few years. These groups operate on a local level and are increasingly becoming more established and providing a wide-reaching range of services that benefit the whole community.
You cannot underestimate the positive message this sends out of the value to the whole of society gained by helping those with drug problems. In order to capitalise on the positive PR this creates, these groups need to be supported and given the tools to help them continue to make their case and lobby for ongoing funding. If PHE works in partnership with them, and uses the resources and networks available locally, then maybe there is a chance to both make the case and most importantly have it listened to.
John Walton, by email