HARM REDUCTION

Mainline's mission is to promote health and fulfil the human rights of people who use drugs without a primary focus on the reduction of drug use and with respect for the individual drug user's freedom of choice and capabilities.

International

Bridging the Gaps 2 (2016-2020)

Mainline is part of the Bridging the Gaps programme. With partners across the whole world, this programme is committed to the health and rights of drug users, sex workers and the LGBT community. Our goal: a world free of AIDS. 

The programme receives support from the Ministry of Foreign Affairs. After a first phase between 2011 and 2015, Bridging the Gaps launched a second round in 2016 which will continue until 2020.

Several outstanding results are highlighted in this annual review. Within Bridging the Gaps, Mainline is the expert in the area of drug use. Mainline finances and establishes harm reduction projects. In 2017, this was done with partners in Indonesia, Kenya, Nepal, Pakistan and South Africa.


Uppers and harm reduction

In 2017, Mainline launched an ambitious study into harm reduction for individuals using uppers. 'Uppers' include drugs such as crystal meth, speed and cocaine. The study examines 7 drug interventions from around the world. 

Following a literature review and research amongst colleagues from the field of harm reduction, we discovered seven highly varied and inspiring good practices.

Which type of harm reduction interventions exist, for example, for crack users in Brazil – or meth users in Indonesia? We also observe a pipe exchange in Canada, support groups in South Africa and, of course, drug consumption rooms in our own country.

The study will continue until mid-2018. This project is supported by the 'Global Partnership on Drug Policies and Development (GPDPD) – a component of the German 'Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH'.

Women in action in the Middle East

MENAHRA commissioned Mainline to prepare an advocacy plan. The objective: to enable people in the Middle East to lobby for better access to services for female drug users. Crucial efforts – women are often forgotten, but still face significant health risks due to their drug use. 


The result: a practical document which utilises international guidelines.

Are you working with an organisation providing harm reduction services in the Middle East? Are you part of a local human rights organisation? Are you someone who is simply drawn to the fate of this vulnerable group? Read our practical guide!

Georgia: Life after prison

In Georgia, Mainline works on the theme of 'transition management' with organisations such as Tanadgoma. Simply put, transition management means support during the transition between a life in prison and a life of freedom.

The question arises: does an individual imprisoned for drug use actually belong there? Or is there an alternative?  



Shabu in Indonesia

In Indonesia we reinforced our efforts for meth users. When the price of heroin suddenly increased several years ago, many individuals in Indonesia switched to using crystal meth. The needle was exchanged for homemade pipes. 

This requires a different approach to health risk prevention with less of a focus on opiates and the provision of clean needles and a greater focus on mental health and instilling peace and calm. The motto: eat, drink, sleep.
Karisma foundation in Jakarta provided more and improved services in 2017 to individuals using meth (shabu). An expansion of the pilot to Makassar in Sulawesi is currently in the pipeline.  

Groundbreaking research

Groundbreaking research was conducted in 2017 by the Atma Jaya Catholic University and with the support of Mainline. They researched the prevalence of HIV amongst 1500 meth users. An increased risk of HIV and hepatitis C was documented – even for those who never injected drugs. This indicates that high-risk sexual behaviour under the influence of crystal meth plays a key role in HIV transmission.

Together with Mainline, LBH Masyarakat supported a study of drug treatment in Indonesia. In the maze of options, they show the way and provide recommendations.

Harm reduction in Nepal

1639

users in Kathmandu, Nepal were tested for HIV, sexually transmitted infections and Hepatitis C.

2944

individuals received methadone or buprenorphine as a replacement for street heroin or received clean needles and syringes for safe injections. 


Mainline: Custom advice & expertise

In 2017, Mainline developed a business plan with the help of a small grant from the Aidsfonds.
Mainline now extends advice regarding the purchase of harm reduction materials such as syringes and needles, Stericups, and other paraphernalia.

Our range of consultancy offerings has expanded.

View our expertise here

Women's project in Kenya

The heroin business is flourishing in Mombasa, Kenya. In collaboration with MEWA, Mainline launched a new project specifically targeted at female users.  

The organisation of support groups for women, breaking the silence on sensitive issues and providing access to testing services, clean syringes and condoms are a few examples of the services offered to women. MEWA is, however, also dedicated to providing specialised care surrounding pregnancy and children.

An additional training session will be organised in early 2018 by Mainline and a female doctor from the Pakistani organisation Nai Zindagi. The objective is to provide outreach workers and aid workers with the knowledge and skills required to help these women.

Needle Exchange and methadone in South-Africa

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Individuals had access to clean syringes, condoms, overdose information and health thanks to Mainline’s support to OUT Wellbeing. OUT offers drug users efficient, yet compassionate, assistance: something which is desperately needed on the rough streets of Pretoria, South Africa

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new locations in South Africa began offering methadone in 2017. This provision benefited several hundred individuals. The objective is to increase the accessibility to methadone for a wider range of people. Mainline supports the TB/HIV Care Association in this important work.



Innovation in Pakistan

Nai Zindagi in Pakistan consistently discovers new avenues for the improvement of HIV treatment. In a new pilot, the organisation is bringing anti-retroviral treatment to the people. In 2017, this resulted in an immense improvement: in a large country such as Pakistan – with limited HIV healthcare – people no longer need to travel for days to collect their medication.


Read more about the innovations of this unique partner Nai Zindagi here.

National

Mainline scans the region

Mainline developed the Mainline Quickscan in 2016 and 2017 whereby Mainline outreach workers map a region’s drugs situation over a relatively short period. 

Mainline gathered information from users on the street, local experts, drugs forums, outreach workers, venue owners and police, across the various sections of society.
Alkmaar, Zwolle and the municipality of Hof van Twente utilised the Mainline Quickscan in 2016; Haarlem and Kampen did so in 2017.

Alcohol and nitrous oxide

The Quickscan in Kampen consisted of field studies, interviews with local youth and extensive input from professionals. The scan indicated that alcohol, including binge drinking, is relatively accepted – also among underage youth. Laughing gas also proved popular in Kampen. This is sold at various nightlife venues. Alcohol and laughing gas are openly discussed. Within the community, a greater taboo is attached to other drugs which are used to a lesser extent, in certain sub-scenes.

5X Mainline Magazine

The Mainline magazine – a household term in the drugs world – was issued five times in 2017. The year was rounded off with a snort-special. 

The Mainline magazine was established in 1991, specially for people who use drugs. Initially for heroin and crack users, the magazine has since expanded its scope to include users of ketamine, GHB, new psychoactive substances (NPS) or other drugs. With interviews, health tips and news articles, impartial information is provided addressing drugs, health and the street.

The magazine is distributed on a national level in shelters, addiction centres, social pensions and streetwalking zones. The magazine forms a crucial starting point for outreach workers and counsellors in discussions concerning substance abuse.

Want to register for an annual subscription or order an individual edition?

Take a look in our webshop.

No two training programs are alike!

In 2017, Mainline provided dozens of workshops, trainings and presentations addressing drugs and health throughout the Netherlands.  

Participants are drawn from mental health care services, addiction care, social aid and shelters.

Popular training programmes are ‘Complex Contacts’ – about substance abuse and psychiatry – and ‘Coffee and Contact’ – about making contact in an approachable manner.

The chemsex team provided trainings concerning drug use and sexual risk behaviour amongst men who have sex with men (MSM).

Most organisations prefer to draw particular elements from our training selection and receive a custom workshop or training session.

For more information about our training programmes, check out our training page








126

days of outreach conducted in
the Dutch drug scene

2142

were reached by the Mainline outreach team in 2017

15

cities were visited by Mainline to raise chemsex awareness





Sex on GHB

Mainline held a survey amongst 61 individuals who use GHB or GBL. Questions addressed usage, need for help and how they maintain control. 

Sex was the primary motivation for using GHB. Users also indicated use during parties and after-parties. Most notable was the fact that all respondents combined GHB with other drugs.

Survey results can be viewed on our website.


Website about crystal meth & sex

Together with Soa Aids, Mainline developed the website sexntina.nl. A unique website for men who have sex with men (MSM) fully focused on crystal meth (methamphetamine) and sex.  

The objective is to inform MSM (men who have sex with men) of the health risks of certain drugs (‘chems’) during sex. Research conducted by Mainline indicated a lack of knowledge amongst MSM regarding the health risks and care provisions which didn’t align with their needs. 

Factual info

Thanks to this website from Mainline and Soa Aids Nederland, men now have access to factual information surrounding chemsex. This includes tips for safer use and stopping. Useful contact information of healthcare providers specialised in chemsex are compiled in an overview.

The site has been tested by men from within the target group in addition to various professionals. Thanks to the World Health Organisation, an English-language version of the website is also available.

View the website here!

Opinions on crack and opiates

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crack and opiate users in 14 cities completed a survey about drug use, health and self-control. They were also asked whether their quality of life increased or decreased over time. Their opinions differed.

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users indicated that they suffered from psychological issues such as anxiety, depression or confusion. 29 users indicated lung issues, poor legs or stomach and intestinal issues.

Check the full report here (in dutch).

Examining gay dating sites

In 2017, Mainline analysed two online gay dating sites every other month. We now have a better understanding of online drug communication styles in the gay scene. 

In November of 2016, two university students conducted a detailed analysis of two online gay dating sites, commissioned by Mainline: a popular dating site, a private slam group within this site and a hardcore dating site. Mainline then conducted an analysis of these websites every other month.

Drug use proved more prevalent than it initially appeared. Drugs were discussed via code and in closed groups.

On the hardcore dating site with more than 1200 Dutch members, nearly half selected ‘yes’ in their profile regarding drug use.

Following further inspection, of the more than 200 other profiles which selected 'you can do it' or 'no answer', a significant portion proved to be open to drugs.

Moreover, the majority of the 180 men in the ‘private slam group’ – group for men who inject – did not include their preference for drugs or injections in their public profile while they clearly belong to the group of users. More than 120 profiles were found with the search term ‘slam’.

Hepatitis C screening in Amsterdam

In 2017 Mainline, together with de Regenboog Groep and Municipal Health Care Services Amsterdam, went in search of individuals with hepatitis C. Rapid testing was available on location. 

In 12 shelters and 2 support houses in Amsterdam, nurses were on location to conduct rapid testing of clients and visitors.

292 were screened for an increased risk of infection in their past history. 

A staggering 93% of individuals had been exposed to the risk. A saliva swab was taken by the nurse of 284 people; the results were available within 30 minutes. Nearly 5% were carrying hepatitis C. They received extensive blood tests and support, and are now receiving treatment.

The Hepatitis C screening project is coordinated by de Regenboog Groep, who provided advance training to the institutions’ employees. 

Searching for used syringes

Since 2017, Mainline has been collecting used needles throughout the country. The syringes are then evaluated to determine which drugs and adulterants can be detected. This reveals crucial information, such as local variations in drug use.  

The syringe analysis is an element of a European study of the makeup of used needles. As commissioned by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the French Monitoring Centre (OFDT) is coordinating this project. 

300 used syringes

The study was conducted in the Netherlands, Hungary, Scotland, Switzerland, France and Sweden.

Each country collected 300 used syringes for analysis in order to gather information about drug use amongst injection drug users.

The Trimbos Institute is leading the study in the Netherlands. Mainline is responsible for needle collection. This was conducted throughout the country in various drugs scenes and in collaboration with local organisations.

The study results are expected in early 2018.








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Finance 2017

Our Team

Machteld Busz International Programme Manager & Director
Monica Carriere Country Manager Kenya & South Africa
Nick Veldwijk Country Manager Pakistan & Nepal
Hatun Eksen
Country Manager Indonesia
Joost Breeksema Research, Monitoring & Evaluation
Muna Handulle Country Manager
Rafaela de Quadros Rigoni
Researcher
Simon Williams Trainer
Rian Warmoeskerken National Programme Manager
Sara Woods
Project leader for the national department
Guido van Diepen Editor-in-chief of Mainline Magazine
Toon Broeks
Field worker and editor
Annet Vogelaar Fieldworker and editor
Ingrid Bakker Chemsex team
Leon Knoops Chemsex team
Sjef Pelsser Chemsex team & Online veldwerk
Ferry Barendregt Trainer
Herman Kalter Financial manager
Desiree van Dok Office manager
Anca Iliescu Librarian
Mick Jonkman Communications, Marketing & Social Entrepreneurship
Bart Engel
Social Entrepreneurship: Strategy & Advice
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