What Support Don't Punish means to me

By Guest blogger

Peter Kamau is Deputy Executive Director at Alliance Linking Organisation in Kenya: KANCO.

To mark the Support Don't Punish Global Day of Action (26 June), Peter Kamau reflects on what this day means to him and Sabrina Vidot, a former drug user who is now accessing methadone maintenance therapy.

<p>Sabrina Vidot is a former drug user in the Seychelles who is now on methadone therapy.</p>

Sabrina Vidot is a former drug user who is now on methadone therapy. ©Peter Kamau

While the world marks Support Don’t Punish - a Global Day of Action dedicated to championing support for people who use drugs (PWUDs), for many the day may whisk away just like any other.

However, for Sabrina Vidot, a 33 year old Seychellois woman who has been using drugs for 17 years and currently on methadone (a form of opioid substitution therapy), it’s a very personal and definitive day as she observes ‘this is my day’. To her, the call for health and human rights based policies for PWUDs is central to her day-to-day life and to the lives of hundreds of thousands of PWUDs the world over.

My interaction with Sabrina gives a very clear picture on the daily struggles of PWUDs and their families, and why it’s important for policy makers and health programme leaders to fully understand the policy and health challenges affecting PWUDs.

I was lucky I did not get hepatitis C, although most of my friends contracted it along the way because they could not access clean needles and syringes.

Sabrina’s addiction to drugs dates back 16 years ago, to when she was living in Canada with her mum and brother. In 2006, in one of the many attempts to get her off drugs, her mother sent her back home to the Seychelles for a detox programme. The assumption was that with the change of environment and the perceived ‘unavailability’ of hard drugs, she would easily be weaned off and be back home in a years’ time. However, six years later, she was still in a rehabilitation centre, on and off drugs.

Sabrina’s initial drug of choice was cocaine, but soon after landing in the Seychelles, she transitioned to heroin due to the scarcity of cocaine. In 2015, she joined a facility-based methadone detox programme for a year and a half, after which she relapsed, three months after her discharge from the facility. Sabrina’s mother relocated back to the Seychelles, to help take care of Sabrina’s two children, so that she could join the community-based methadone programme at a hospital. Since October 2016, Sabrina has adhered to the methadone programme, taking her dose every day. Despite the constraint associated with the daily visits to the hospital, she highly appreciates remaining integrated in the community as she undergoes the programme.

I am feeling that my life is back, I am able to think of my children and mum.

Sabrina is grateful for the methadone programme, however she observes that one of the major setbacks is the notion that methadone is a quick fix, resulting in Ministry of Health officials wanting to wean clients off methadone rapidly. This has resulted in low titrated doses that often do not meet the clients’ needs, thus forcing them to use other drugs such as heroin and alcohol to manage the cravings. This has resulted in clients being expelled from the programme.

Presently, we have only 19 out of 120 people left who started the programme. With methadone, you need enough time to go through the process.

Sabrina’s present unemployment brings to focus the socio-economic struggles faced by recovering drug users. Challenged by the need to access treatment every day, and coupled with mistrust by potential employers due to her drug use record, she observes that everyone thinks she want to steal from them.

Sabrina joined the Drug User Network Seychelles (DUNS) in January 2017. The network was formed by the HIV AIDS Support Organisation of the Seychelles (HASO) with the support of the HIV and Harm Reduction for Eastern Africa project managed by KANCO, and funded by the Global Fund to Fight AIDS, TB and Malaria. Through the network she believes they could influence some policies and practices such as needles and syringe exchange programmes.

Twice, I have been able to take clients to hospital for Hepatitis C screening and management. Together we can create a world where users can start a new life.

She sees the network as a great avenue to advocate for issues of concern to PWUDs. Through DUNS, Sabrina has been trained as a peer educator and is currently a peer mobiliser. My first meeting with Sabina was at a meeting where she had mobilised 16 PWUDs to participate. Her past experience as a drug user makes her a better peer educator. Sabrina is reaching about 150 drug users who have access to her house, which to her is a great achievement.

My interaction with Sabrina brought to life the real meaning of Support Don’t Punish and the critical role of each stakeholder in making it a reality.

This blog was first published on KANCO's website.