At the recent Injecting Conference (NCIDU) there was a lot of discussion around peer distribution of equipment and peer led services.

It's clear that engaging networks of injecting drug users to help with self distribuition of equipment is a great way to increase the numbers of sterile equipment available. However for some people (it seemed mainly to be some service managers) the concepts seemed full of problems. Hopefully this article might help with at least one of them.

Peer supply

For some people the whole idea of injecting drug users giving new equipment to their peers seemed to be a new idea, and one that would need to be micro managed. One person even talked about the possible audit trail that would come from a drug death resulting from a needle that they had knowingly allowed to be peer supplied.

Peer supply of equipment has always happened; often it'll be something that organically develops between people, one week Jon will need some needles, the next week it's his friend Julie that needs some. People have always sorted each other out. The real issue is what happens when there are no clean needles to help out a friend, as people will still be tempted to give them a needle only now it may be a used one.

Social capital

Another question which came up was about what happens if people sell on needles we supply, and yes, this sometimes happens. (I'd just like to quickly point out that the thing that gives any item cash value is scarcity, so if we do increase supply this problem becomes a non-issue.)

But for me the bigger issue is one of social capital. If someone you know needs a few fresh needles and you choose to sell them then yes, you'll get a small amount of cash which will be gone in no time. But the friend will probably resent you for it.

However if you give the person some of your spares willingly then you earn a 'favour' and good will. This is social capital, and it's far more valuable than any cash you'd earn from the equipment. It's social capital that makes you the person people answer the phone to after midnight, and social capital that gets your friends to support you when things are going wrong.

Think about it - who would you go out of your way to help? The friend/dealer that sells you needles? Or the one that sorts you with equipment for free? We need to start thinking about the things we do in terms of social capital, everyone is in this together and we need to help each other out.

Social capital for drugs workers

Don't think that this doesn't apply to you, every time you give good advice, every time you treat your clients well, and every time you take time to understand the issues, you increase your social capital with your clients. I personally think that high social capital is something that will make more people come to a service/worker.

But remember that it works both ways, the attitude that you approach people with can also lose you social capital and in turn lose you and your service any of the good reputation that you may have built up in the community.

Related Links 

Wikipedia entry on Social Capital.
There is a great site called the Social Capital Gateway that collects together articles relating to social capital concepts.