Harm Reduction

 

Drug use behavior and harm reduction

Aksion Plus is implementing an outreach intervention in some of the hot spots of Tirana. Two outreach workers (a former IDU and a former sex worker and drug users) are providing clean needless, leaflets, condoms, multivitamins for some of the Roma IDUs in a poor health and referral to other services. Most of the drug users report their strong need to enroll in opiate substitution treatment or any other type of treatment.

The Harm Reduction records show high-risk behavior among drug users, mainly sharing of used needles and syringes. There are no reliable data related to the morbidity and mortality in Albania pertaining to the drug use.

According to our findings there is still a strong need to continue with the provision of services of the Harm Reduction Center.

Aksion Plus is implementing the following services and activities:

  • Methadone Maintenance Program for nearly 900 clients. This program is supported by Soros (IHRD) and currently by GFATM
  • Improving the sexual and reproductive health of drug users, creation of friendly spaces for them (in collaboration with UNFPA).
  • Surveys, questionnaires, assessment of the situation with respect to drug use (Aksion Plus was involved actively during the latest Behavioral/Biological Surveillance conducted by Family Health International – August 2005)
  • Outreach (contacts with DU s, providing information and life skills, collecting used syringes, condom distribution etc)
  • Raise the awareness of the general population
  • Training with students of Social Work, DU s, peer educators, and other youth
  • Formal and non formal education with the staff and volunteers
  • Publication of brochures, posters and other material
  • Medical assistance and simple medical training, referral to other services.
  • Training with the police forces with the Anti-drug Dept regarding drug use, harm reduction, protection of human rights of DUs.
  • series of seminars and lectures in high schools of Tirana. Another very useful service that is now available on the center is counseling, one to one or group counseling.
  • Lectures at the Faculty of Social Work and Psychology to present the center’s activities and have their input in the Center.

Project Goal

In Tirana (Albania) there is a substantial number of drug users that are not in contact with helping facilities and they should be traced and motivated to enter treatment.

They need also practical assistance in social, medical and health problems, AIDS prevention etc.

Project objectives

  • A lot of drug users (maybe 500 including other towns) will be contacted with a certain ratio between drug users who were never in touch with existing facilities and those who had previous contacts. Specific subgroups of drug users will be contacted (women, young drug users, certain ethnic groups, migrants and emigrants etc).
  • Certain interventions will be carried out (such as: distributing needles, condoms, information materials, referral addresses, providing counseling and training, social support and other advises to handle their situation)
  • To conduct simple questionnaires with drug users.
  • Maintain contacts and improve collaboration with other NGOs, agencies and Governmental structures.
  • We will fight against any discrimination and stigmatization toward drug users and will protect their human rights.

Main priorities/activities for this project

  • A strong need to continue with the Harm Reduction activities among drug users as the only and the safest way to reduce harms related to drug use.
  • Put more efforts in reaching out more drug users that do not make use of the services delivered in the Center. Outreach workers will have to be more active and “aggressive” in identifying drug users in the drug scene. It is true that they were having problems with the police during their needle exchange but we think we can improve things in this level.
  • Strengthen newly introduced elements that improve the quality of services and enhance the impact of the center (Drop-in Center and Counseling)
  • Establish the network with governmental and non-governmental structures to respond to the phenomenon of drug use. We are contacting the Minister of Social Affairs, head of the Drugs and AIDS Committee, Minister of Public Health and the Director of Institute of Public Health to co-ordinate our efforts and activities.
  • One of the main interventions will be to set up contacts with drug users in other towns. They suffer manifold consequences because the high level of stigma, and the total lack of services for them.

Aksion Plus is aware that drug users have more needs and problems that the Center could afford. Anyway we have been trying to address some of them taking into consideration the limited financial sources. After a long experience with drug users and interviews with them we can deduce that DU s are exposed to the following adverse factors:

  • HIV/STIs (Hepatitis) transmission
  • Basic rules of hygiene are not respected during heroine injection
  • Involvement in criminal activities
  • Overdose risk
  • Negative model for other youth
  • Stigma and prejudices from friends, state social/health services and from their families
  • Abandonment and denial

We provide a warm and friendly space where they can share some time with non-using people, namely peer educators, volunteer students from the Faculty of Social Sciences, trainers etc. This is the most important element that other services have been missing so far. They want to get mingled with other people in order to find their motivation to quit drugs because, they say, it is quite impossible to quit drugs in the company of drug users.

Methadone Maintenance Therapy in Albania – run by Aksion Plus

The first community based methadone center for nearly 110 veterans users of heroin started in 2005. At the moment Aksion Plus offers services for nearly 900 heroin users. This program was financed by IHRD and the Ministry of Health. At present GFATM is supporting this project. In cooperation with state structures Aksion Plus is striving to extend the methadone program in other towns of Albania where the drug use phenomenon is reaching dramatic levels. In Albania there are altogether 30-40000 drug users, 8000-10000 out of them are intravenous drug users.

The methadone treatment and other harm reduction activities are extended to drug users who are in prisons and in pre-trial settings.