There is a current advertising campaign from Burrell Street Clinic for Sexual Health in the pages of this magazine, proclaiming ‘SLAM SAFELY’. Slamming is slang for the injection of drugs – like mephedrone or crystal meth – straight into the bloodstream. Is such a bold campaign right to tackle controversial behaviour in such a direct way, or is it potentially condoning, or even normalizing, the act of injecting drugs? QX speaks to Robert Palmer, Lead Advisor and Specialist Psychotherapist at Burrell Street, to find out why the clinic has decided to adopt this strategy…
What was the thinking behind the current ‘Slam Safely’ campaign?
It comes off the back of a number of things, and the first thing is the number of injectors that we started to see at Burrell Street. We were really surprised, because it kind of came out of nowhere. I think it’s been a very interesting history in the change of the types of drugs that gay people are using, and I recognise that part of that is due to the closure of routes of certain types of drugs being able to get into the country.
But also there has to be something going on around the sex that people are having, and the headspace in which they are in, in order to choose the drugs that they are using. We didn’t expect to see such a rise in crystal meth use. We’re more surprised by the injecting of mephedrone. And what we seem to be seeing, and this is only anecdotal evidence for us, is that it’s an older age group that are injecting crystal, and it’s a much younger age group injecting mephedrone, which is why we’ve been targeting Grindr and yourselves in particular.
Do you think the younger age group inject mephedrone because they see it as more harmless, even though it’s still injecting?
Yes. And because it’s very, very cheap as well, and they’re probably used to snorting it, or mixing it up in water and drinking it, and so will then probably get introduced to the idea of injecting it by a sex partner or at a sex party and will give it a go. The problem I have with mephedrone is it’s a nasty drug.
In what way?
The evidence and research we have around this drug and what it might do to people in the short and long-term is very, very small. This is not ecstasy where we’ve got a huge amount of data done over the years as to what kind of effect this drug will have. It came out and hit a market at a very specific time to do a very specific thing. It’s very, very clever. But it has unpleasant side effects; the anxiety and the comedowns people get from it. They’re also injecting something that they’re buying from a dealer and they don’t know what is in that power or what they have put in their bodies, and that concerns me as well.
“How many years have the government been doing ‘stop taking drugs’ or ‘saying no’? It doesn’t work.”
Do you think the adverts, with the huge words stating ‘SLAM SAFELY’, might seem to condone slamming?
I don’t think so. I think we’re very clear actually about what we’re trying to say, which is: ‘if you must inject, then please do it safely.’ And I think we’re very clear about the wording that we use and being very, very careful on that as well. It’s not something that we want people to do and we’re not trying to advertise this as a service where it’s okay. We’re really concerned about the health of people. But this is a harm minimisation approach, and if I said to you ‘stop using’, that won’t do anything – it’s a typical psychological response, if I tell you to not do something, you’ll want to do it more, so actually that’s not the right route to go down.
How many years have the government been doing ‘stop taking drugs’ or ‘saying no’? It doesn’t work. So what we do is have the ability to build up relationships with people who are using, and we know that gay men prefer to come to sexual health clinics and have a check-up and pick up things like needles rather than they would going to a community drugs team. They feel more comfortable here.
You don’t think there’s a chance of this wording, or the vernacular used, normalising the idea of slamming in a way?
I think that’s a really, really good question. But what we’re trying to do is make it, I suppose, words that people know. It’s like when we talk in the clinic: we start talking about people having sexual intercourse, they often don’t know what we mean. If we talk about fucking, people know exactly what we mean. And I think it’s the same with the vocabulary we use around slamming, people know what slamming is – if we’re talking about injecting, it becomes much more difficult language to start describing, so that’s why we’ve gone for this kind of wording.
“If you have a sex party where there’s a large number of people, there may be people who are HIV positive, HIV negative, Hepatitis C positive, Hepatitis B positive. It becomes a perfect storm of sexually transmitted infections.”
So, if people are doing it, at least they’ve got the message?
Absolutely, which is ‘look after yourself’. And that’s what we want to put forward: if you’re going to do this, if you have to do this, for fuck’s sake, look after yourself in doing it. And what we do is provide [in our free ‘Slam Packs’] syringes that are colour-coded, so if you’re at a party, you are not going to mistake your syringe for somebody else’s syringe. Because this is the perfect storm, if you have a sex party where there’s a large number of people, there may be people who are HIV positive, HIV negative, Hepatitis C positive, Hepatitis B positive. It becomes a perfect storm of sexually transmitted infections, injecting drugs and viruses and bacteria. And so what we want to do is try and limit the possibility of infections spreading.
We asked David Stuart, Drugs Counsellor at Soho sexual health clinic 56 Dean Street, what he thought of the ‘Slam Safely’ campaign:
The steep increase and popularity of slamming may be the greatest public health concern gay men in London face right now; its potential to increase HIV and hepatitis infections in our communities is indisputable; even beyond the injecting ‘community’. In the last 3 months, over 100 gay men who inject drugs have come to 56 Dean Street seeking information on safer injecting, clean needles, information or support; not a single one of them had accessed a statutory drug service for clean needles.
Perhaps one of the greatest ever achievements in public health, was the good relationship that was forged between gay men and sexual health clinics during the HIV/AIDS epidemic; gay men visit their GU clinics more easily than they do their GPs, many have favourite clinics, and relationships with healthcare teams or individuals that no other population can equal. This is definitely something that we should resource, as we seek ways to address the ChemSex/slamming syndemic that threatens the cohesion of our gay communities and the wellbeing of our gay brothers.
The campaign to provide injecting equipment to gay men within sexual health services began over a year ago, with support from Public Health England and the National Aids Trust, amongst others. Heroin and crack services will continue to be an unattractive and unpopular place for many gay men to access needles, and the need to find an accessible alternative is paramount. We’re very pleased to support and promote the Slam Safely campaign from our colleagues at Burrell Street, it is an important and timely initiative.
• To read more about Robert Palmer, slamming and the Burrell Street clinic, visit: qxmagazine.kinsta.cloud/blog-event/in-conversation-with-robert-palmer
• The Burrell Street Clinic is the only sexual health clinic in London open seven days a week, and can be found at 4-6 Burrell Street, SE1 0UN. www.burrellstreet.co.uk