Atg_1’s story

Back in the mid-1990s I was working in the music industry. A huge surge in worldwide heroin production combined with musicians’ unfortunate tendency to glorify drug use as an aid to creativity and hipster coolness. In only three or four years, I lost a raft of good friends. I saw a lot of good people and musical potential cut off in their prime by overdoses (and, in one case, post-overdose brain damage from loss of oxygen to the brain). Our community was grieving. 

Outside the music industry, though, the stigma was enormous. Public antagonism to drug use was huge and drug users had access to very little up-to-date health information or treatment — remember, the internet was barely available to most people in the late ‘90s.  
At a national level, the concept of ‘harm minimisation’ hardly existed as a government policy. Politicians of all stripes were worried that they may be seen as ‘promoting drug use’. (Recent debates around Medically Supervised Injecting Rooms show we haven’t progressed in that realm as much as we might like to think).

In that hostile environment, people who used drugs lacked access to the basic harm minimisation information and initiatives we take for granted today. On the ground, there were virtually no needle exchanges and clean syringes were used and re-used until they became blunted vectors of Blood Born Viruses (BBVs). Hepatitis C ran rampant and started years’ long journey of compromised health for many before a cure in Ribavrin became available. 

Heroin overdoses reached such a level that OD numbers were reported daily, just inside the cover page next to the road death figures. Letters to the editor opining that it was ‘their own bloody fault’ were far too frequent. Naloxone was strictly the province of the ambos and ED departments but there was a fear that if you involved emergency services the police would also become involved. Many ODs that should have been reversible, became fatal instead. 

In the year 2000, I moved from music into welfare work in the Windana detox. With heroin overdoses on the increase and so starkly presented in the press, many people noticed that the so-called ‘war on drugs’ was an expensive failure. Public debate started shifting from demonising drug users as criminals towards a better understanding and acceptance of harm minimisation in both principle and practice. 

Communities organised to protect themselves, their loved ones and the people in their neighbourhoods. They demanded attention and resources to combat the problem.

In 1998, the federal government responded to pressure from community members and health professionals and declared a new National Drug Strategy using a harm minimisation approach. 

As a result, government money began to flow into the harm minimisation sector. Support networks began to increase. It was encouraging to witness an increase in street-level support via increased needle and syringe exchange programs (NSPs/NSEPs), after-hours mobile outreach NSEPS, overdose response teams, more Methadone (and eventually Suboxone) programs, Hep C and AIDS treatment options, Naloxone (also known as Narcan) distribution programs, detoxes, rehabs and counselling centres. New funding streams meant the increasing professionalisation of an industry that had been relying on the incredible dedication and energy of volunteers and ex-users.

At the government and public education levels there was a noticeable improvement in calm, factual education programs/resources around the nature and dangers of drug use and information on overdose prevention. The internet was becoming more of a public utility and grew exponentially as a vital education tool. Health budgets significantly increased the slice allocated to drug and alcohol treatment (although they still feel inadequate and waiting lists to access services remain a massive roadblock for many people). There's no question, however, that compared to my first days at the Windana detox in 1998, the difference today is huge.

Another important part of the change has been the shift in negative stigma directed towards drug users. As the ‘war on drugs’ wound down and harm minimisation became better accepted, many began to realise that drug users were first and foremost human beings with a health issue and not inherently flawed or criminal. Particularly with the huge rise in meth use, we have seen families of all types ravaged. People are better able to recognise that class, education or economic status has no bearing on who can slide into problematic drug use. 

I don’t want to go overboard on optimism, though. New challenges keep arriving. There has been a huge rise in access to methamphetamines. Benzodiazepines, fentanyl and new psychoactive substances like NBOMBs and synthetic cannabis all pose significant risk. Nitazenes, a class of synthetic opioids, have been associated with dozens of overdoses through 2024. Some psychoactive drugs change so rapidly in chemical composition that it can be hard for legislators and treatment providers alike to keep up. 

We should not forget that continuity of government strategy, attention and investment is never a guaranteed thing. For example, creating a safe injecting room in Melbourne was a positive step, but the political will for a second room in Melbourne seemed to wane as public pressure became more noticeable.

When there is noisy public pressure against harm minimisation, we need to be equally noisy in support of it. We can never take harm minimisation programs for granted or expect the government of the day to believe that they are a right. Let’s be thankful for every initiative that promotes safety and reduces stigma.

On that note, I’d like to highlight an initiative we can be thankful. It’s the International Overdose Awareness Day (IOAD) on 31st of August:

“It’s the world’s largest annual campaign to end overdose, remember without stigma those who have died and acknowledge the grief of family and friends left behind. Our theme for 2024 is “Together we can”, highlighting the power of our community when we all stand together.”

Their website explains how YOU can participate in making this a fantastic campaign. IOAD has created events across Australia to commemorate the day. There are community get-togethers where the public and community services organisations come together to pay our respects to those lost from overdose and to promote local drug education and services. There are light show events where large and well-known buildings are lit up in the purple colour that is associated with the day and there’s a Tribute Page where you commemorate and mourn someone you’ve lost. 

If you’d like to participate, the IOAD Event Support Kit outlines in detail ways you and your community can plan, host and promote a wide range of events — like educational and awareness-raising, memorials, faith-based, community or workplace vigils, parties, or fundraisers. 

If the idea of creating an event feels a bit overwhelming, you can donate or download a range of resources to give to your workplace or family and friends. Advocacy Toolkits, Media Support Kits, and Educational Material kits are free to download. 

Any contribution you make helps. Even checking out the resources will help to arm you with important evidence-based strategies and initiatives for overdose prevention. This practical info will be vital if you’re ever faced with managing an overdose. Please head on over there now. I’m sure you can find a level that works for your needs and circumstances and I encourage everyone reading this blog to check them out and get involved.