Heroin, HIV and harm reduction
In September 1985, Professor John Ashton and Howard Seymour from the Merseyside Regional Health Authority attended a World Health Organization health education conference in Dublin. Also in the Mersey delegation was Allan Parry, an ex-street drug user and community activist in Liverpool.
While in Dublin, the Mersey team met with Glen Margo, Director of Health Promotion for San Francisco. Glen was a key figure fostering AIDS awareness among the gay community, who himself would eventually die of AIDS. Professor Ashton recalls, “We asked him what he would have done back in 1980 that didn’t happen. The answer was needle exchange”. They invited Glen to come to Liverpool for a week of intensive lectures to educate health professionals on the risk of injecting drug users contracting HIV.
As heroin use among young people in Liverpool gathered pace, there was little help and information available other than for those getting treatment, which many didn’t want to do from a general fear and mistrust of authority. With the help of John Ashton and Howard Seymour, Allan Parry set up an informal drug information centre, the Merseyside Drug Training and Information Centre. It provided a user-friendly and non-threatening environment for drug users to get help and advice.
The need for needle exchange
In 1986, the Scottish Committee on HIV and Injecting Drug Misuse published a report, known as the McLelland Report, which stated that the Lothian police’s policy of confiscating needles and syringes from users was encouraging sharing and helping to spread HIV. Furthermore, they controversially recommended establishing needle exchange schemes.
Back in Liverpool, drug workers and public health professionals realised that they needed to get ahead of the virus before it took hold among the city’s drug injectors. Using the toilet conveniently located next to the drug treatment service (in case a nurse was needed), Liverpool saw the launch of one of the first needle exchange schemes in the UK.
On paper, providing injecting equipment to drug users was illegal under the 1971 Misuse of Drugs Act. But Alan Matthews, an ex-youth worker turned drugs worker explains:
“We had a very forward-thinking head of the drugs squad, Peter Deary, who said they wouldn’t arrest people carrying works [needles], and we also got the support of the Liverpool Echo. We asked them not to run ‘needles for junkies’ stories, but to give us six weeks to see what happens and then we would give them the story as an exclusive.
“It was all word of mouth, no advertising, and we saw about 300 people in those first few weeks who had never been near a drug service. We had a guy come down from Glasgow, another from Manchester, and one day this steroid user turned up. We were operating out of this little toilet, so you didn’t even have to go into the information centre. Suddenly everything went dark and there is this big beefy guy filling the doorframe. We never asked questions of anybody: they could give a false name, and we also logged postcode and gender just to collect some basic statistics. But I said to this guy, who looked nothing like a heroin user, “Do you mind me asking what you’re injecting?”. “Steroids” he said. “Oh, does that happen a lot then?”. He said all the guys down the gym were injecting and they all shared. “Have you heard about AIDS?”. “Yes,” he said, “but you only get that from using heroin not steroids”. So I told him about AIDS and injecting, and he became an outreach worker at the gym.
“Another guy ran a shooting gallery [where people would come to inject] and one day he came with a few syringes to exchange. We asked him if he had anymore. “Oh, yes loads”. “’Well, bring ‘em in”. “Oh, I thought it was just for personal use”. Next day he turns up with three bin bags full of works, needles sticking out and everything. We gave him sharps boxes and everything, and he became an unofficial outreach worker too.”