Stigma
is a non-profit humanitarian organization working in the field of harm reduction with people who use drugs. We have two day centres in Ljubljana, where users can access free sterile injections, medical supplies and condoms. We provide counselling regarding drug use and practical help to deal with social, health and other personal matters. As a complement to day centres we do outreach work in two ways: 1) we have adapted van that serves as a mobile day centre in certain other cities in Slovenia and 2) by bikes and backpack in the city centre. One of our specific programmes is Safe House for women drug users who are victims of violence. We also provide drug testing as a part of The EU Early Warning System (EMCDDA).
Our mission is to advise people who are unable or unwilling to stop using drugs for various reasons. Without moral judgments and patronage we advise on safer drug use. We are aware that the drug use is a matter of personal decision and the human right. Our work aims to encourage safe drug use so that the drug use causes as little damage as possible to them and to others.
Our programmes:
↘ needle exchange in day centres;
↘ outreach work and needle exchange;
↘ distribution of informative materials about hepatitis B and C, safer drug use and treatment programmes;
↘ distribution of condoms;
↘ counselling and informing on safer, less harmful drug use;
↘ psychosocial help and assistance in getting involved in other therapeutic programmes for those who wish to do so;
↘ informing and advising about hepatitis viruses, HIV and hepatitis virus testing options, tips on safer sex;
↘ counselling in prisons;
↘ drug testing as a part of The EU Early Warning System on the emergence of new psychoactive substances (EMCDDA).
NEEDLE EXCHANGE
Needle exchange is the basic feature and starting point of the harm reduction approach. Free access to sterile needles means a preventive measure. At the same time it provides the access to the largest number of intravenous drug users. It is the basis for the work of the day centre and other programmes and for the social integration of drug users. The programme provides free insulin injections, various syringes and needles, cookers or spoons with a filter, ascorbic acid for the preparation of heroin, alcohol disposable cloth, used needle holders and informative material (safer injection manual, programme leaflets, risky illnesses, substitution medicines and notifications of the emergence of new in/or dangerous drugs as the EU Early Warning System). Condoms are also available. Returning used needles is part of a needle replacement program, but the return of the needle is not a requirement for giving out sterile one.
CONSULTING AND PRACTICAL HELP
Consultation is possible via telephone or internet, in a day centres and outreach work. Personal counselling represents the possibility of continuous monitoring in the process of changing and solving problems. The possibility of our mediation in the case of family treatments is most often in the direction of encouraging constructive communication in the family and in finding appropriate therapeutic programs available in Slovenia.
We also provide practical help in solving day-to-day problems (writing job applications, social security applications, complaints etc.). The services are aimed at motivating drug users to achieve various positive changes: from reducing health risks in drug use to including in health and therapeutic treatment (substitution, detoxification), therapeutic communes, activation in obtaining social assistance, assistance in finding a job (writing applications) and residential accommodation.
We advise on:
↘ addiction problem: the definition of complexity according to pharmacology, age, gender, social status, personality traits, family circumstances;
↘ counselling for drug users, relatives and others – assistance in interpreting and assessing the problem and planning the resolution of this problem;
↘ crisis interventions – first talk, headings of relief services;
↘ harm reduction preventive measures: information on safe drug use and safer sex;
↘ reconstruction of risk behaviour regarding the possibility of infections, information on testing.
DRUG TESTING
Drug testing is a harm reduction service that is aimed at analyzing new psychoactive substances and classic drugs. High risk of health complications not only represents new, unknown and dangerous substances, but also known substances that are supposed to be found in classical drugs such as cocaine, heroin and ecstasy.
With appropriate warnings and notifications through the Early Warning System for the emergence of new psychoactive substances, we reduce the risk of complications that may also be fatal.
Early warning system contains:
↘ a chemical and physical description, including the name under which the new psychoactive substance is known;
↘ frequency, circumstances and/or quantities in which a new psychoactive substance is encountered;
↘ means and methods of manufacture of the new psychoactive substance;
↘ indications of the health and social risks associated with the new psychoactive substance, including the characteristics of users;
↘ chemical precursors, mode and scope of the established or expected use of the new substance and any other use of the new substance.
CONSULTING IN PRISONS
Consulting in prisons is an important service of harm reduction. Our work is carried out in the context of individual and group counselling, Interviews with drug users are not pre-structured and therefore allow the programme’s flexibility to meet the needs of our users.
Our programme in prison is low threshold, which means that abstinence is not a prerequisite for the use of our services. One goal, however, is to motivate users to stop using drugs. Since one of the goals is that convicts are better informed about the risks of drug use, it is all the more necessary for peer-to-peer information in prison. Convicts who are in contact with our outreach workers are therefore encouraged to spread information among other convicts. For many convicts we are the only contact with the outside world. Many people do not have contacts with their family, and many acquaintances and friends use drugs themselves and do not visit them for various reasons. One of the activities that we are carrying out is also to escort our users on out-of-prison exits, which would be very difficult or impossible for them, since the intended exits are possible only with the help of relatives or partners.
SAFE HOUSE FOR FEMALE ILLEGAL DRUG USERS – VICTIMS OF VIOLENCE
Stigma Safe House is intended for female illegal drug users and drug users, members of substitution therapy who have experienced or are experiencing violence in family, relationship or in the streets and who need a safe environment for fulfilling their basic and more complex needs.
Abstinence is not required for entering Safe House. Use of drugs and alcohol in the house is forbidden. We carry out preventive lectures regarding hepatitis and HIV infections. Users that chose to abstain or enter therapy are offered adequate support.
Dealing with users of illegal drugs must be in an unobtrusive way through:
↘ presence (users themselves are contacting staff when needed);
↘ informal conversations (that mostly lead toward concrete conversations/counselling);
↘ organization of everyday life (during the day several different activities are organized that direct users toward different life style).
Project goals:
↘ housing users in safe environment;
↘ decreasing social consequences connected to drug use and violence, improving users quality of life and increasing social integration of users – providing support and helping organizing life (employment; education, housing, establishing social network);
↘ decreasing health consequences connected to drug use and violence;
↘ qualifying users for independent life and empowerment;
↘ developing social skills;
↘ equipping users with information about other forms of professional help;
↘ providing counselling especially with experiences with violence;
↘ qualifying users for recognizing problems, assessment of possible solutions and accepting personal decisions for solving those problems;
↘ reaching so called hidden groups of female drug users in Ljubljana municipality and neighbouring towns, disclosing and recognizing this phenomenon and approaching users life situations.
Stigma Safe House can house eight female users with possibility of housing additional one in crisis situation. Entering the program is voluntary and so is exiting the program. Depending on concrete needs of individual users we work preventive, reducing exposure to street violence and curative, when user has already experienced violence we help her relieving internal distress. Female users can stay in Safe House for 18 months. Even after leaving Safe House we offer users different forms of help and finding suitable solutions. We also offer users the possibility of accommodation in a supportive apartment, which is part of the safe house program.
