Responding to Blue Lights

Written by Dr. Stephen Parkin on . Posted in HR Practice

Blue Light
 At the 2010 National Conference on Injecting Drug Use (NCIDU) I organised a workshop session that was concerned with the issue of fluorescent blue lights in public conveniences. In an earlier article on Injecting Advice, I previously outlined the way in which such environments can amplify particular injecting harms and behaviours (such as groin/neck/peer injecting) and emphasised that injecting under these conditions is based almost entirely upon 'touch' rather than 'vision' (i.e. because injectors, literally, cannot see what they are doing in blue light environments). These conclusions were drawn from empirical research that was conducted in the city of Plymouth (UK) during 2006-2009 (Parkin and Coomber 2010).
 
In addition to these injecting-related harms and hazards are the seemingly arbitrary decisions made by local authorities and other agencies to have such lights installed on a national and local level; in which choices to install blue lights are apparently based only on assumptions that they are successful in preventing injecting drug use from occurring in relevant environments. However, there is no known publication, report or research that demonstrates fluorescent blue lights as an effective form of drug prevention, yet they continue to be found in settings throughout the UK on a regular basis.
 
The widespread introduction and popularity of fluorescent blue lights therefore poses particular challenges for harm reduction advocates and practitioners. This challenge relates to:
  • The absence of any 'proof' to demonstrate that blue lights do actually prevent injecting drug use from occurring in affected settings.
  • Findings that conclude they actively establish environments for particular forms of harm and hazard to take place.
It was therefore due to this challenge that I organised the workshop session in order to inform a 'standardised' harm reduction response to any current/planned fluorescent blue lighting in local settings on a national basis.
 
In this article I would like to circulate the outcome of this workshop in order to provide advice, information and a suggested 'action plan' for practitioners who may have concerns about existing/planned blue lights in their particular area/setting. These suggestions were obtained from an interactive discussion/focus-group session with 7 delegates that attended the workshop – and who each approached the issue from their own particular profession. Although the session had been planned to accommodate a greater number of participants (including service-users), I would like to thank each delegate that contributed to this workshop and for their assistance in the development of the following action plan.
 
In short, this action plan aims to challenge decisions to install fluorescent blue lights in any setting – and may be utilised as either a reactive, or proactive response to blue light decisions.

Proactive Response (to any installation planned/proposed by local agencies

  1. Identify the relevant agency responsible for planning blue light installations
  2. Request meeting to discuss proposed installation
  3. At meeting, determine why such lights are to be installed (e.g. increased amounts of drug related litter?) and request detail on how they are to be evaluated
  4. At meeting, also request any evidence to illustrate the efficacy of blue lights in preventing injecting drug use (from any setting)
  5. Also, request data that illustrates blue lights as an example of 'evidence-based' good practice
  6. If there is an evidence base of increased drug use at the proposed site of installation, request consideration for more 'enabling' harm reduction focused intervention (for example: discrete placement of drug related litter bins; outreach work with targeted intervention at site concerned)
  7. Provide a summary of the findings relating to the harms associated with injecting drug use in blue light environments (a copy of the paper outlining these can be obtained This email address is being protected from spambots. You need JavaScript enabled to view it. and/or from the summary on Injecting Advice)
  8. Following any responses to each of the above, refer agency to Department of Environment, Food and Rural Affairs (DEFRA) 2005 report 'Tackling Drug Related Litter: Guidance and Good Practice' Report, that clearly recommends (2005, page 36)
    'due to the increased risks to users and lack of evidence as to its efficiency, blue lighting should not be used in public toilets to deter drug use'.
  9. Ask the relevant agency to consider the annual costs of lighting and if this cost may be used for other more constructive, targeted intervention in the site concerned (e.g. aimed at injecting drug user 'participation' rather than displacement/prevention of injecting drug use)

Reactive Response (to any installation already in place)

  1. Identify the relevant agency responsible for installing blue lights
  2. Request meeting to discuss existing installation
  3. At meeting, determine why such lights were installed (e.g. increased amounts of drug related litter?) and request how the situation may have changed. Request information that may demonstrate a 'prevention effect' and seek information how others (i.e. non-drug users, members of staff, general public) may have been affected by the lighting
  4. At meeting, request evidence to illustrate the efficacy of blue lights in preventing injecting drug use (from any setting)
  5. Also request data that illustrates blue lights as an example of 'evidence-based' good practice
  6. If there is evidence of continued drug use at the site of installation, request consideration for more 'enabling' harm reduction focused intervention (for example: discrete placement of drug related litter bins; outreach work with targeted intervention at site concerned as more appropriate harm reduction intervention)
  7. Engage with members of the public attending sites containing blue light installations; obtain their views and attempt to evaluate from their perspective (also include any relevant employees working in such sites)
  8. Provide a summary of the findings relating to the harms associated with injecting drug use in blue light environments (a copy of the paper outlining these can be obtained This email address is being protected from spambots. You need JavaScript enabled to view it. and/or from the summary on Injecting Advice)
  9. Following any responses to each of the above, refer agency to Department of Environment, Food and Rural Affairs (DEFRA) 2005 report 'Tackling Drug Related Litter: Guidance and Good Practice' Report, that clearly recommends (2005, page 36)
    'due to the increased risks to users and lack of evidence as to its efficiency, blue lighting should not be used in public toilets to deter drug use'.
  10. Consider the annual costs of lighting and if this cost may be used for other more constructive, targeted intervention in the site concerned (e.g. aimed at injecting drug user 'participation' rather than displacement/prevention of injecting drug use)

Advice to injecting drug users

  1. Provide as much information as possible relating to the potentially harmful effect of blue lights upon injecting practice (again, these are described in the above paper available This email address is being protected from spambots. You need JavaScript enabled to view it. and/or from the summary on Injecting Advice)
  2. This could be assisted with an 'in-house' leaflet designed by local harm reduction agencies and circulated with injecting paraphernalia that addresses specific settings (i.e. a locally relevant information sheet)
  3. Alert service-users of all blue lights in area/planned and explain why they may have been installed
  4. Request service users find alternative, safer places to inject and to avoid visiting blue light areas where possible
  5. The best advice here is not to inject under blue lights; regardless of individual injecting ability or length of injecting career
  6. If decisions to install blue lights relate to increased amounts of drug related litter, engage with service users about the issue of safer discarding practice
Finally, I would be very interested in any feedback from any practitioners/ service-users that use this guidance in responding to blue light installations and particularly interested in how harm reduction challenges were received by the relevant agencies.
 
Dr Stephen ParkinDr. Stephen Parkin is a Research Fellow at the University of Huddersfield, UK.  He has been involved in drug-related research since 1995 and has worked extensively throughout the UK on a number of different studies. His previous work has included topics such as ‘black market’ methadone, peer education and recreational drug use. The views expressed in this article are those of the author and do not necessarily reflect those of his employer.
 
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