Heroin

• The webinar, “Public Health Barriers in Addressing the Opioid Epidemic,” will be held at 11 a.m. Thursday, July 27.
• The speakers will examine addressing the opioid crisis as a public health crisis.
• While this increased focus on public health has produced positive results, there are still many barriers within the system that limit prevention, treatment and recovery, which experts will discuss.
• Since its inception the Partnership has garnered 217 advertising and public relations awards from national, regional and statewide media organizations.

• Like you know transitioning to housing, even help with you know finding work and that, but […] none of those promises were met.
• Like you know transitioning to housing, even help with you know finding work and that, but […] none of those promises were met.
• Getting this kind of pre- and post-release support can drastically reduce the risk of the person re-offending.

System failure

In 2019‑20, 46% of prisoners released in 2017-18 had returned to prison within two years. People who inject drugs are disproportionately more likely to return to prison. This suggests a systemic failure; something is going wrong in the way we provide services to this group of people. For this analysis, “service providers” include actors such as:
• For example, when Jidah got out of prison, he needed crucial medication for his opioid dependence.
• And I was that frustrated that it caused me to relapse and get back on the heroin.
• And I was that frustrated that it caused me to relapse and get back on the heroin.
• Khish told us he was given some support in getting set up for post-prison life but the help was limited.

Trust is key

• Being able to trust a service provider is crucial and can enable a smoother transition to community.
• Ben, however, didn’t find his parole officer “useful”, saying:
  They’re not really there to help you.
• They’re there to watch over you, but they say they can help.

Getting the right support can be ‘life-changing’

• Under this new philosophy, Maine’s prisons focus on rehabilitation and growing respect between correctional officers and people who are incarcerated.
• It can help reduce the chances the prison system is simply reproducing disadvantage and replicating the problems it is ostensibly supposed to solve.
• If you or someone you know needs help with exiting prison, you can find a list of resources here.
• The NSW Users and AIDS Association (NUAA) PeerLine on 1800 644 413 may also be helpful.

• Methadone and buprenorphine prevent intense cravings and other symptoms of withdrawal, while naltrexone works by blocking the effects of opioids.
• We asked what they thought about using medication to treat opioid use disorder.
• Across all four groups, we heard three myths about using medication for opioid use disorder.

Medication isn’t trading one drug for another

• Many of our participants expressed the belief that using medication is the same as using opioids to get high.
• This misperception is likely rooted in the outdated idea that recovery is defined by total abstinence from all substances, except perhaps caffeine and nicotine.

Medication is an important part of long-term recovery

• A community member we spoke with said, “It’s a way of weaning them off everything.
• Guidelines from the U.S. Department of Health and Human Services discourage rapid tapers and affirm that long-term use is the best way to prevent relapse, overdose and death.

Long-term treatment counts as success

• Many of our study participants voiced the belief that long-term use of medication means the treatment did not work.
• Just as those with high blood pressure or diabetes may need to remain on medications for the long term, so might some people with opioid use disorder.
• Keeping people in treatment and alive through use of medications is treatment success, not failure.
• The latest data from the U.S. Centers for Disease Control and Prevention estimates nearly 83,000 deaths in 2022 involved opioids.

• In the 25 years since the Good Friday agreement was signed, paramilitarism in Northern Ireland has remained ever-present in some communities.
• Of the 3,260 instances of paramilitary violence meted out since Northern Ireland achieved peace, 349 have involved children.
• My doctoral research looks at how this coercion follows patterns of what criminologists refer to as “child criminal exploitation”.

Child criminal exploitation

• In the UK, research has found that child criminal exploitation is central to county lines drugs networks.
• To date, most research on child criminal exploitation has been in the context of county lines drugs trafficking.
• My research looks at child criminal exploitation in the context of both drugs trafficking networks in the London Borough of Tower Hamlets and paramilitary groups in Belfast, Northern Ireland.
• Due to the criminality involved in child criminal exploitation, the justice system often fails to recognise that the children affected by this are actually victims.

A modern slavery issue

• The national referral mechanism is the UK’s framework for identifying victims of modern slavery.
• In court proceedings, this mechanism has bolstered legal defences based on modern slavery, particularly in cases related to county lines drug supply.
• In her 2020 review of the Modern Slavery Act 2015, the UK’s Independent Anti-Slavery Commissioner, Dame Sara Thornton, raised concerns about the potential for the modern slavery legal defence to be abused when used in cases of drugs trafficking:
  The operation of the statutory defence is neither adequately protecting victims of trafficking nor adequately protecting the public.
• This is because child criminal exploitation within paramilitary groups is yet to be recognised as a modern slavery issue in Northern Ireland.