Out Of Your Mind

 

 

Last week saw the latest reports on the risks of ‘chemsex’, the sexualised use of some drugs by gay, bisexual and other men who have sex with men. The European Monitoring Centre for Drugs and Drug Addiction cites increasing evidence of drug use at sex parties in London and other European cities. It’s a trend we’ve seen for some time here in Antidote, our specialist LGBT drug and alcohol service.

 

The report adds to the growing body of evidence surrounding chemsex and its related harms. Earlier this year Sigma Research published the Chemsex Study which confirmed what people had been telling us in our service: drug use has changed, and whilst the use of the three main chemsex drugs – crystal methamphetamine, GHB/GBL and mephedrone – is still less widespread than the use of say alcohol or cannabis, use is much higher amongst gay and bisexual men, and these three drugs are causing a disproportionate amount of harm.

 

The risk posed by use of these drugs has not gone unnoticed. Last week Public Health England (PHE) published their draft strategic framework to improve the health and wellbeing of gay, bi and other MSM. The strategy has three broad focuses: sexual health, mental health and the use of drugs, alcohol and tobacco. I’m really pleased to see the issues we’ve worked with and raised with officials over the past few years given such prominence on the public health agenda and hope this is the start of a new approach to wellbeing for this group of men. I hope too that we can work to widen the remit to include lesbian and bisexual women and trans people.

 

Supporting LGBT clients when their drug use or drinking has begun to cause them problems is a complex skill. So often the three strands identified by PHE are interconnected, and need time and trust to unpick. Just as the Chemsex Study found, many of the people we support experience anxiety around their identity as LGBT people, or struggle with aspects of ‘how to be’ an LGB or trans person. When exploring in treatment or counselling how this relates to problematic drug or alcohol use our clients need to feel safe to disclose and confident that the person listening to them understands the environments and contexts in which they use or drink. Feeling unsafe or misunderstood are the most common reasons people tell us they avoid mainstream health services.

 

Improving drug and alcohol treatment services

 

We’ve provided training to mainstream health and care services for many years on how to better support their LGBT service users. Sessions are usually lively, with great discussion, and an opportunity to ask the questions people have never been able to ask before. After 15 years I’m still struck by just how many people tell me they’ve never had the opportunity to discuss LGBT issues in a professional setting before, so it’s no wonder staff and volunteers sometimes feel out of their depth, or fearful of ‘saying the wrong thing’.

 

Training days are useful to introduce topics, but they’re just part of the picture. Real improvements in the experiences of LGBT service users will only come if all parts of the system are working in accord. Approaches have to start at the top, with inclusive policy and strategy, combined with a systematic approach to planning and delivering services locally. Commissioners and local Public Health Teams play a vital role in ensuring the services they procure can demonstrate how they’ll meet the needs of their LGBT clients, and that successful outcomes for LGBT people can be measured. Front line staff can take responsibility for developing their own ability to understand and support the LGBT clients and patients they work with. Finally researchers can cover the topics we know less about, helping to fill the gaps in our evidence base.

 

We’ve examined this approach in our new report Out Of Your Mind, a scoping study looking at how drug and alcohol treatment can be improved for LGBT people. Too often it feels like the treatment needs of LGBT service users are literally out of people’s minds when planning and delivering drug and alcohol services. We hope this report will encourage those involved in providing drug and alcohol treatment to be more mindful of LGBT people in their work. The report looks at these key players and makes a series of recommendations for change. I’m pleased to see that actions already being proposed by PHE in their draft MSM strategy are in line with the recommendations we have made.

 

Out Of Your Mind also includes a set of practical toolkits to assist commissioners, drug and alcohol service providers, and substance misuse practitioners to examine their own understanding and practice relating to LGBT people, and develop simple action plans to work on those areas that require more thought.

 

Monty

 

For more information about our Antidote service and the drug and alcohol support available to LGBT people see here. For more information about London Friend’s training and professional services see here.

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Now and Chem

 

Just a bit of fun? or a slow death by irresponsible hedonism? Few subjects divide opinion or create greater controversy than that of recreational drug use. Like it or not, our desire to alter our mental/emotional state has been around for a hell of a long time and doesn’t show any signs of abating anytime in the near future.

 

In more (comparatively) recent times we’ve seen the rise of the “club drug” phenomenon which seems to be grabbing headlines at the moment. For those of you who think that this is something new, think back to the ecstasy hysteria of the late 1980’s. Tabloid newspapers would have you believe that should you come anywhere within a half mile radius of an ecstasy pill then you would  haemorrhage from all your vital organs, fall writhing to the floor then  live out the rest of your days as a hopelessly insane gibbering wreck. Looking back even further,  the 1960’s saw similarly sensational headlines document the pill popping mods spending their amphetamine fuelled weekends shuttling between clubs & parties (sound familiar?) pausing only now and then to menace a poor unsuspecting deckchair in a seaside town somewhere.

 

The Gay thing

 

Us LGBT’ers have been right there in the thick of it ever since we got it together to open our own bars & clubs and to show the rest of the world that when it come to partying we’re taking no prisoners, unless of course it’s by mutual consent and the handcuffs are fur lined! We’ve revelled in giving a perfectly manicured one finger salute to a mainstream society that has by and large rejected us, reviled us and has on many occasions actively persecuted us.  The bottom line is, LGBT culture has traditionally been synonymous with counter culture we’ve made our own kind of music, sang our own kind of song, we’ve banged our own drum and shouted out “ I am what I am”. All very rousing & affirming however the rain on our parade seems to be questionable confetti of pills, powders and liquids with terrifyingly long names. More recently that rain seems to have become a deluge and appears to have become ever more destructive. So what has happened? Climate change perhaps? Well, in a sense, yes.

 

At Antidote, as the only LGBT specific drug & alcohol service in the UK, we’ve witnessed first hand the changes in patterns of drug use amongst LGBT people. In the early noughties most people seeking support were those of us who had perhaps lost some control over our pill popping or cocaine use. Heroin and crack use which has so beleaguered our heterosexual counterparts seemed to have largely passed us by. Speak to most LGBT people about these substances and the general attitude seems largely to be one of indifference and even contempt for those who partake of these “dirty” drugs. Flash forward to roughly about 2010 and you start to see a significant change, Crystal meth starts to make its presence felt, people start to experience more and more problems with G. then even more recently the new kid on the block, mephedrone, makes its debut. Injecting or “Slamming” once the preserve of the “hardcore junkies” of the trainspotting generation, starts to become more common place and the term “chemsex” starts to enter our vocabulary. People who may have been using drugs for years with a relative degree of control suddenly find that they are completely out of control and pushing boundaries far further than they ever imagined or wanted to. Some people who ordinarily wouldn’t have taken drugs at all find themselves in situations, often sexual, where the temptation is too much and they succumb to the allure of apparent porn star style sex marathons.

 

The issues over why this has happened and what should be done to address it are complex and are the subject of much heated discussion, sensational media reports, research and beard stroking ponderings over a flat white.  Generic, mainstream drug and alcohol services have been fairly slow on the uptake but before we start levelling accusations of institutional homophobia or heterosexism  or simply not giving a dam it’s worth bearing in mind that the recent development in club drug/legal high use have caught almost everybody on the hop. To be fair even if they had wanted to respond, and I know from many conversations with colleagues in the field that they do, their funding criteria dictates that they focus mainly on crack, heroin and alcohol with abstinence based approaches being the norm.

 

Taking Steps

 

Here at Antidote through the dedication of our committed volunteers, the feedback from the many clients who have come to us seeking support and through some great partnerships with some of healthcares finest, we’ve been able to fine tune our approach. We strongly believe in the ability of our clients to make informed choices about their drug or alcohol use. For some this may mean giving up altogether and for others this might mean gaining more control over their use or ensuring that it doesn’t get out of control in the first place. One of the common misconceptions about accessing a service such as ours is that you need to have a “drug problem” and therefore require “treatment”.  This immediately throws up the question what is a drug problem? And how do you define it? For sure some people have experienced catastrophic consequences but for others just recognising that drugs and/or alcohol may be playing a bigger part in their life than they would wish could be enough to prompt some action. We get that, and we also understand that traditional approaches and attitudes aren’t always going to be helpful for the people that come to us looking for advice and/or support.

 

Over the next few weeks I’m going to be sharing some thoughts and reflections based on our experiences here at Antidote as well as some “harm reduction” tips & advice designed to help you if you’re looking for ways to play safer.  Of course if you would like to speak to somebody, if you’re worried about your drug or alcohol use or you just have some questions, there are always our drop in’s. You’re very welcome to come in and have a chat with one of the Antidote keyworkers, you don’t need to book an appointment, it’s a safe space, it’s confidential and you won’t be judged.

 

For details of Antidote services or any other services at London Friend please check our website at http://londonfriend.org.uk/2012/2012/ or call us on 020 7833 1674

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Welcome to our new Antidote Training & Outreach Manager

 

We're pleased to welcome a new member to our team today. Jamie Willis is our new Training & Outreach Manager, working on our Antidote drug & alcohol service. Jamie joins us with a background working in drug and alcohol services, and with LGBT organisations.

 

Jamie will lead on managing our successful partnership services with the Club Drug Clinic, Code Clinic at 56 Dean Street, and the PEP Clinic at Mortimer Market Centre. He'll also lead on managing our training and education work with colleagues in substance misuse, sexual health and other heath & care settings. In addition he will be supporting our great team of volunteers delivering drug and alcohol treatment across our Antidote services.

 

See more information about London Friend's training here. To access support around your drug & alcohol use see our Antidote service information here.

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