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Harm Reduction International Conference 2013, June 9 - 12, Vilnius, Lithuania

Workshops and Dialogue Space


The full programme for the dialogue space and workshops can be found by clicking on the image below or clicking here

Dialogue space cover

Workshop trainings track

A full programme of training sessions will take place in the Epsilon room in the afternoons of Monday 10th and Tuesday 11th, and in the following rooms Eta, Gamma, and Zeta during the evenings of Monday 10th and Tuesday 11th. For full details of these workshops please see below:

Monday 10th June 14.00 - 15.30 - WHO/UNODC/UNAIDS technical guide

Objective: The WHO/UNODC/UNAIDS Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention Treatment and Care for Injecting Drug Users and the Comprehensive Package of interventions presented within it, has been widely endorsed and is now used by countries in the developing and evaluating the response to HIV and injecting drug use, and in application and reporting processes to major funding bodies.

The Guide has recently been revised in light of experiences from its application in the field, from systematic reviews assessing the availability of relevant data, and through consultation with a broad range of stakeholders and experts from around the world.

The session aims to provide an introduction to the framework and indicators presented in the guide and to familiarise participants with the important recent revisions and to give an understanding of how to embark on the process of measuring indicators and setting targets on the availability, coverage, quality and impact of interventions in the Comprehensive Package.

Format: The session will involve a brief presentation by those involved in the development and revision of the guide to provide a background and introduction of key concepts followed by an interactive session where participants will be guided through the process of measuring and interpreting indicators. There will be a particular focus on the newly developed framework for assessing the quality of interventions.

Learning outcomes: Participants will: - Gain a clear understanding of the basic framework for assessing progress in the implementation of targeted interventions; - Be able to apply the framework for assessing the availability, coverage, quality and impact of interventions in their country; - Be able to identify which indicators are most useful for their own epidemics and response.

Monday 10th June 17.30 - 19.00 - “Difficult Decisions"- a toolkit for care workers on managing ethical dilemmas

Carers working with children and families in highly-stigmatized groups such as people who use drugs and sex workers face difficult decisions. In the absence of proper guidance, they can make decisions that are unethical, and often based on bias or influenced by stigma about who has the ability or right to parent. These decisions can do more harm than good.

An international working group is filling a major programmatic gap by developing guidance to help carers in community-based organizations to make better decisions when they are faced with competing choices or when the rights or interests of two people (perhaps a parent and a child) are in conflict. The working group developing this guidance comprises groups representing people who use drugs, sex workers, transgender people, people living with HIV, men who have sex with men and other gay men, care worker organizations, ethicists, major NGOs and funders.

This workshop - geared to anyone working in a care or support role as well as their managers - will lead participants in understanding the ethical decision-making framework. Facilitators will share results from a global survey of care workers and their clients on ethical dilemmas and their impact. Building on real-life ethical dilemmas highlighted in the guidance or drawn from participants, facilitators will then guide participants in the use of the draft guidance, including the four step tool that is at its heart to develop understanding how ethical decision-making differs from following the law, organizational policy, religion, culture or societal norm. A discussion on orientating staff in an organization to the tool, and on policy and other program support will follow. Feedback will be sought on the guidance at the current stage of development and participants will learn about the process for piloting and completing the guidance in at least five languages by March 2014.

Learning outcomes:
• Results from a global survey of care workers on ethical dilemmas and their impact on their work - understanding how ethical decision-making differs from following the law, organizational policy, religion, culture or societal norms.
• Understanding of the impact on care workers of not properly managing ethical dilemmas in terms of moral distress & moral residue
• Orientation to "Difficult Decisions: A Toolkit for Care Workers - Managing Ethical Dilemmas When Caring for Children and Families in Especially-Stigmatized Populations"

Monday 10th June 17.30 - 19.00 - Hepatitis C and drug use - bringing theory to practice

Viral hepatitis affects more than half a billion people worldwide and is a major public health problem in Europe, where it disproportionately affects people who inject drugs. On average, 60% of people who inject drugs are estimated to have hepatitis C, and in several countries the vast majority, over 90% of people who inject drugs, are believed to be living with hepatitis C. While research on the biomedical aspects of hepatitis is extensive, the public health and health systems aspects remain insufficiently addressed. At the scientific level, there is comprehensive knowledge about effective interventions to prevent hepatitis C infections. At the practical level, however, it appears that (drug) services for different reasons do not succeed to implement these potentially effective interventions sufficiently and in an appropriate way.

The workshop will present recent tools in regard to Hepatitis C prevention and discuss their potential impact on daily practice at service provider level:
1. The development of a tool to monitor current procedures for hepatitis C related counselling, testing and treatment referral in drug services. (Heike Zurhold, ZIS)
2. The UK based RCGP has developed a unique and accredited two part introductory and advanced Certificate in Detection, Diagnosis and Management of Hepatitis B and C in Primary Care to increase the knowledge skills and competency of health care professionals in supporting patients to overcome barriers and to improve access to and quality of HCV treatment.(Danny Morris, consultant)
3. The pilot study conducted by the Robert Koch Institute on Hep C prevention using respondent driven sampling and the relevance for daily practice of services, working with drug users. (Astrid Leicht, Fixpunkt)
4. Actions to influence the policy debate in Europe and the linkage between policy and practice will be discussed with participants.(Eberhard Schatz, Jose Queiroz, Correlation Hepatitis C Initiative)

Moderator: Jeff Lazarus, CHIP

Learning outcomes: Learning outcomes of the workshop will be - how to assess obstacles and barriers to the implementation of effective strategies in the field of HCV prevention, counseling, testing and treatment; - what can be done to improve Hep C prevention on service provider level - how to influence policies and advocate for the development and implementation of evidence-based HCV strategies at the European and national levels.

Monday 10th June 17.30 - 19.00 - Ketamine: living in dreams; managing the realities
This workshop will look at the emerging health and social challenges surrounding ketamine. A perfect storm has been established in which health risks faced by ketamine users are escalating, against a backdrop of increasing stigma, discrimination and criminalization. 

In a number of settings, successful drug interdiction strategies disrupted the market and changed supply patterns which has further contributed to the risk environment. As a new generation of drug users, use ketamine more widely, frequently and intensively so a new array of health issues are being identified; this requires new harm reduction, practice and peer support strategies.

The workshop will provide a review of:
• Ketamine’s effects and the profiles of some typical users
• Harm reduction and peer education strategies for active ketamine users
• Managing setting issues including the risks arising from public ketamine use
• Strategies for managing ketamine casualties and ‘k-holes’
• Management strategies for chronic health issues such as ketamine bladder syndrome, k-cramps, memory issues etc
• Avoiding and responding to ketamine dependency syndrome
• Introduce K-Check, a primary health care assessment tool for people who use ketamine developed by ketamine users and health professionals 

Biography: Mat Southwell has worked in the drugs and HIV fields as a practitioner, manager and activist for 25 years. He has a particular interest in developing peer, practice and policy responses to new patterns of risk behaviour or emerging drug trends and is a Partner in the peer technical support agency Coact.
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Tuesday 11th June 14.00 - 15.30 - Youth friendly' harm reduction services in practice

Workshop objective: Young people are especially vulnerable to drug related harm due to a number of individual, social, and structural influences. Many harm reduction programs however report difficulties in reaching young people with their services, as well as other ethical, legal and practical issues with responding to drug use amongst youth (particularly with young people under the age of 18). Young people who use drugs require an innovative and ‘youth friendly’ response.
The objective of the workshop is to train service providers on design and implementation of ‘youth friendly’ harm reduction.

Workshop format: The format of the workshop will be a mix of presentations and interactive activities. Four resource persons (young people who use drugs) will be facilitating the sessions.

Topics covered:
• Introduction to unique developmental and situational needs of young people who use drugs;
• What does ‘youth friendly’ harm reduction look like? What issues need to be taken into consideration in harm reduction for children and youth;
• Reaching both injecting and non-injecting youth;
• Developing and supporting youth-led harm reduction programs;
• Case studies

Learning outcomes:
• Gain skills in developing harm reduction services for reaching young people who use drugs;
• Gain skill in addressing some of the practical, ethical, and other issues that arise in servicing youth;
• Understand the importance of youth participation and learn how to effectively support youth participation and leadership in harm reduction programming work.

Tuesday 11th June 16.00 - 17.30 - Low threshold digital video storytelling for harm reduction advocacy, activism and education

Sawbuck Productions, a Chicago-based non-profit film company, and the Hungarian Civil Liberties Union propose a two-session, low-threshold workshop that will prepare participants to conceive, produce, distribute, and use digital videos in harm reduction advocacy, practice, and training. The workshop presumes no video production competency on the part of participants and begins on the assumption of limited access to production and editing resources. Workshop activities will involve accessible everyday equipment, including cell phone cameras, inexpensive digital audio recording devices, handheld lighting, and free video editing software.

The first workshop session will present a guided “tour” of effective uses of video in harm reduction over the past decade. Workshop facilitators will provide a basic and practical overview of digital video storytelling approaches and techniques. Participants will share their own experiences with video-making and identify ways in which they would like to use video in their future harm reduction efforts. The second session will entail a dialectical, hands-on “skillshare” modality, wherein facilitators and participants will work together as a collective to develop, produce, and edit a short film using participants’ cell phone cameras and editing freeware.

Participants will understand:
- How to tell a compelling story
- Types of video content
- How to collaborate with video participants (participatory action video-making)
- Pre-production:
- Developing a focus
- Storyboarding (visual planning of a story told through moving images)
- Identifying necessary resources
- Framing the story and selecting modality (interview, observation, etc.)
- Production:
- Video shot composition and video literacy
- Shooting video in anticipation of editing and storytelling
- Guidelines for conducting and filming interviews
- Best practices for observational filming
- Capturing high quality sound
- Post-Production
- Using freeware editing software
- Organizing, tagging, and cataloguing footage
- Creating and arranging clips and sequences
- Shaping a story from arrayed sequences
- Outputting a completed, edited movie to a variety of formats
- Distribution
- Burning to DVD
- Internet distribution

Tuesday 11th June 17.30 - 19.30 - Needle and Syringe Programme in Prisons - 20 Years of Evidence, 20 Years of Advocacy: It's Time to Scale Up!

In prisons, the prevalence of HIV, HBV, and HCV tends to be much higher than in the community. People who inject drugs are overrepresented and some do inject in prisons. Still the access to harm reduction in prisons is very limited and far behind the access in the community.

Needle and syringe programme (NSP) is a key element of the HIV responses in over eighty countries, yet HIV response in prisons lags far behind. Twenty years after the first needle and syringe programme was implemented in the prison of Hindelbank (CH), only a hand full of countries extended this service in prison settings.

The evidence of the effectiveness and feasibility is clear and the time to scale up is now!

A session chaired by Rick Lines, Executive Director, Harm Reduction International

Tuesday 11th June 17.30 - 19.00 - Overdose basics and training of trainers

This workshop will have two sections. The first will be a basic training on risk factors for overdose, recognizing an overdose, and responding properly, including with naloxone and rescue breathing. Participants will have an opportunity to practice what they've learned during role plays.

The trainers will also provide basic information about recognizing and responding to stimulant "overamping."

In the second part of the workshop, the trainers will discuss what to include in a brief (2-3 minute) overdose training (such a brief training can be useful during street outreach or when clients have limited time at a drop-in center). Workshop participants will practice these short minute trainings with partners.

We will then discuss a potential curriculum for a longer overdose training. Trainers will provide insights into how to augment an OD training for various groups, such as parents, police, or treatment providers.

Learning outcomes: Participants will learn how to recognize and respond to opioid and stimulant overdoses. They will also get practical advice for training others on overdose prevention and response.

Tuesday 11th June 17.30 - 19.00 - Strengthening harm reduction workers and values – working towards a European profile of the outreach worker on harm reduction

• To understand the impacts of recognizing the professional profile of the outreach worker and the added value to harm reduction;
• To discuss the main bottlenecks and skills/values of outreach work on harm reduction, through sharing participants experiences of critical job situations;
• To discuss future approaches towards a better recognition of the value of outreach work within harm reduction programming;
• To share best practice.

The workshop format/structure will consist of:
4-5 focus groups divided by different settings and areas of work (sex work, prison, drug use, party scenes) will discuss topics under the statement 'being an outreach worker on harm reduction':
1) Why recognition is so important and its impact on workers, service users/community and harm reduction;
2) Examples of dilemmas/bottlenecks on performing the job and personal/professional resources (skills/attitudes) used in the situation);
3) Characterization of main competences and values;

Interactive discussion based on the various group statements to elaborate skills, competences and attitudes and values; Summarising ideas and feedback; Presentation of the project profile; European profile of the outreach worker on harm reduction and future approaches as creating an International Group of Outreach Workers on Harm Reduction.

Learning outcomes: Participants of the workshop will understand the importance of creating a ‘standard’ profile of the outreach workers on harm reduction as an essential prerequisite for effective harm reduction. They will learn from group discussions and understand the singularity of this ‘job’ and which barriers are connected to performing it and how to deal with these bottlenecks. At the end, the discussion on future approaches will reinforce outreach workers participants identity and the need to organise themselves to debate professional issues

Tuesday 11th June 17.30 - 19.00 - Shaping international drug policy 

Learning outcomes: By the end of this workshop participants will have learned: 1) About the international drug control system including: history; the treaties and their impact on drug policy; and UN drug control bodies and their functions. 2) How to identify opportunities to impact international drug policy. 3) How to develop strategic collaborations around international drug policy. 4) The significance of harm reductionists and drug users involvement in international drug policy. 5) About the 2016 United Nations General Assembly Special Session on Drugs.

By far, the greatest burden of the global war on drugs falls squarely, and deliberately, on people who use drugs and their communities. It is crucial that communities which experience this destruction firsthand be prepared to organize and participate in debate and decision-making processes at an international level. The objective of Shaping International Drug Policy is to give participants a broad understanding of the international drug control system as well as a distinct set of skills to help them identify opportunities to engage with and shape the global drug policy discourse. While the program will focus on current debates and challenges to the international drug control system, participants will also explore strategies to increase their participation in the debates and decision making processes at the global level. Skilled trainers will stress the importance of engaging in global drug policy and outline the most effective ways to develop strategic collaborations. 

Wednesday 12th June 14:00 – 15:30 A roadmap for overdoes prevention policies: where do you fit?

Objective: To help medical practitioners advocate for opioid overdose prevention policies in localities where opioid use is a significant contributor to mortality, and to use this as a basis for understanding why medical practitioners need to be involved in drug policy.

Format: Participants will learn how to examine their own region’s laws and policies regarding overdose death prevention, and workshop leaders will review relevant strategies for policy changes.

Learning outcomes: In March 2012 the Commission on Narcotic Drugs (CND) passed a resolution promoting measures to prevent drug overdose, in particular opioid overdose. The resolution encourages Member States to include effective drug overdose prevention and treatment elements in national drug policies including the use of naloxone.

Naloxone, an opioid antagonist, rapidly reverses opioid related sedation and respiratory depression. It is on WHO’s list of essential medications and is available in most countries because of its role in surgery, but as yet, many countries have not taken full advantage of it as an opioid overdose prevention tool.
Medical practitioners are seldom leaders in drug policy reform. Promotion of naloxone, a medication and a harm reduction tool, presents a unique opportunity for physicians to be involved in drug policy. Physicians can promote initiation and expansion of naloxone to reverse overdoses across the many nations affected by opioid overdose. The CND resolution shows that naloxone is increasingly accepted as a life-saving intervention, even by those who advocate against harm reduction. Efforts to change naloxone availability policy are likely to be successful.
Participants will learn tools for locally relevant advocacy, including working with stakeholders such as people who use drugs, medical societies and policymakers


We encourage advanced sign up as we expect these workshops to be very popular! Places will be given out on a first come, first save basis. Please email with the workshop you are interested.

Dialogue Space
The dialogue space is an area centred in the heart of the conference venue where we encourage dynamic and interactive discussions to take place in an informal setting. All the details on the dialogue space events can be found here.