The People in Need (Člověk v tísni) organization has published an interview on its website with Radka Kobližková, the director of the Contact Center of the DRUG-OUT Klub civic association about the Předlice quarter in Ústí nad Labem and its residents’ problem with drugs. News server Romea.cz is publishing the article in full translation below with the kind permission of People in Need.
Předlice is hostage to pervitin (methamphetamine)
People in Need has started collaborating with the DRUG-OUT Klub organization in Ústí nad Labem on a project entitled "Cooperation for Ústí nad Labem-Předlice". A field social work program for the street users of drugs in the Předlice quarter is one of its key activities.
Over the course of the next 30 months we intend to support at least 300 intravenous drug users in the Předlice locality. We asked DRUG-OUT’s director of professional programs, Mgr. Radka Kobližková, for a brief interview about this activity and the situation in Předlice with respect to drug use.
Q: Could you please describe the current situation in Předlice? What is the aim of your work?
A: We have been working intensively in the locality since last November, but we knew of Předlice even before then. The drug situation there has long been constant and unchanging as far as its composition, the ways drugs are used, and the lifestyle of the drug users. The drug most used there continues to be pervitin [methamphetamine].
The aim of our work is primarily harm reduction, reducing or even terminating declines in the health and social situations of intravenous drug users. Naturally, we would love to strengthen their motivation to abstain from drug use, but that aim is hard to achieve for many clients. We primarily do our best, through our activities, to prevent the repetition of unpleasant occurrences like the hepatitis A epidemic that afflicted Předlice in 2002.
We ask the clients about their habits and give them information about where they should not inject themselves – for example, that it’s dangerous to inject in the groin or in the neck – and we let them know that if they give an injection to someone else, it’s a felony. That might horrify professionals who work with addicted people, but working in excluded localities adds various extremes and specifics to our work that we would never encounter elsewhere.
What is specific for Předlice, for example, is the large number of children who are completely used to the presence of drugs. By the age of two they know what an injection needle is, and the presence of drugs in their families is not frightening to them. We can almost certainly expect that such children will start their own drug careers too.
Another eccentricity is a large group of women using drugs who maintain regular contact with us. We know where they live, we have even managed to knock on their windows and exchange information with them by talking to them from the street, as well as through their "enlightened" family members.
Q: What are the other specifics about the work in Předlice?
A: We are concentrating primarily on intravenous drug users there. If we had more finances and staff capacity, we could expand our services to include other groups, such as regular marijuana users. The concentration of drug users in Předlice is very high. It’s more complicated to communicate the crux of our activities there and the consequences – that it’s not just about using a sharp exchange needle, but primarily that the needle also be clean.
The locality also keeps us very busy providing social counseling. We go above and beyond to provide people with clothing, and the distribution of, for example, basic grocery packages would also greatly help drug users and their families. What is very specific is how we build up trust with clients through their family and other networks. It helps us when some knows or recommends us, in short, when we become part of the talk in the locality. Sometimes we have the feeling that we have been almost "adopted" by some families. They have to get used to us, they have to know us, they have to know what they can expect from us.
Q: How do the drug scene and this drug use influence the education and employment of those now living in the locality?
A: Our starting point is that people who get the opportunity to educate themselves or to work have lower tendencies toward engaging in risky behavior. A drug user does not have time to look for employment, to study, or to work, but this is not just a problem in Předlice. This concerns all drug users, irrespective of where they hang out or live. Taking drugs is a full-time job, there’s no time for anything else.
When you are parenting children and using drugs, it’s clear that your care for them will be at a very low level. It seems normal to you that your child would handle an injection needle. It’s also normal that people around you are taking drugs. It doesn’t seem like something menacing or weird to children and young people in such environments. That’s very bad.
Q: How is your work in Předlice going, what are you having success with and what not?
A: It’s good to reach out to clients when they are in a group. There is a guarantee that one person out of the bunch will know one of us. We introduce ourselves, we say who we are, what we do and why we are there. Our work in Předlice is very much about the needle exchange program. It’s a success when the users start changing needles and using condoms, and we are succeeding there. The consumption of condoms in Předlice is several times higher that it has previously been in other localities in the town. That’s a big success. I can recall the days when a condom was simply taboo.
It is difficult for us, for example, to contact all of the drug users so that most of them can access clean needles, so they can start using disinfectant when they inject the drug, so they can maintain basic rules of hygiene. We contact each drug user an average of four times per month, and given the fact that most of them use every day, that’s not enough. There are various reasons for this – for example, the users migrate during the course of the day to other parts of town.
We are not succeeding, when exchanging the injection needles, in getting back all the used materials. There are large troves of used drug materials in Předlice, comparable to parts of the Krásné Březno quarter.
The users also need treatment to a great extent. They have destroyed the parts of their bodies where they inject. Most of them don’t know how to do it either safely or well. If they were to apply a certain form of prescribed ritual, like some long-term drug users do, they wouldn’t need this treatment.
Drug use in Předlice is generally a source of entertainment first and foremost, a way to cast off the general boredom in the locality, its everyday "nothingness", which borders on apathy. If nothing else, pervitin is close to hand, both in terms of production and sale. Its distribution is so easy that users from other parts of town travel to Předlice for it. No one currently knows how to offer them anything else, any better form of entertainment and relaxation, than pervitin. That fact is then impacts what we’ve been discussing, the motivation to become educated and to work.
Q: Do you have any concrete proposals for improving the situation in Předlice with respect to drug use?
A: There need to be more of us. If a nurse were to be a stable part of our rounds, we could perform tests for infectious diseases on a regular basis. It may sound naive or even stupid, but it’s also important that these people change the environment in which they live. The environment they are operating in shapes them in a significant way. The entire Předlice area needs cleaning and repairing. It would be good to spend the whole day in Předlice, to spend more time with the drug users, to have the opportunity to communicate with them more, speak with them. To have the opportunity to spend longer periods of time with them and just have totally normal conversations, to do something together.
For example, a kitchen where everyone could cook together would be an ideal place. Everyone likes eating, the atmosphere becomes different immediately when you eat together. When my tummy is full I am more willing to listen to someone else, to address something more serious, than when I’m hungry and unwashed. At that moment, more things can be resolved, you can interact differently with the clients.
At one point our female clients wanted an iron and a sewing machine at the Contact Center. During shared activities people communicate better, "unofficially".
Q: What are you hoping for from your collaboration with People in Need in the upcoming period?
A: I expect that People in Need staffers will inform us, thanks to their knowledge, of where problems with drugs are, of where we might go and work. Over the course of time it would be good to clarify how we can join forces to work with a particular family as a whole. People in Need does not work with drug users, but it can have an effect on and work in the neighborhood with children, with drug users, with their parents, and with their siblings.
It’s always beneficial and interesting (for the clients and the staffers) to collaborate with someone who shares the same space you do when providing services. The field social workers from our organizations have already tried out joint field visits together. I haven’t received any detailed outputs or reports from that, but we can certainly give one another feedback about our work. We’ll see. We can show others that it is possible to collaborate together on one of the problems in this town. The municipality might see a good return on that.
This interview was conducted by Jakub Michal, manager of People in Need’s Project Cooperation (Projekt KOOPERACE) for Ústí nad Labem-Předlice.
