dc.description.abstract | Nye lokaler
Oslo kommune åpnet sprøyterom i Tollbugata 3 i januar 2005. Etter en tids drift ble det tydelig at lokalene var lite egnet til formålet, og 1. juli 2007 flyttet sprøyterommet til en brakkerigg i Prindsenkvartalet i Storgata 36.
Ny evaluering
Den oppfølgende evalueringen er gjort på samme måte som den som ble levert i 2007 og gir en vurdering av om sprøyterommet, slik det fungerer i dag, innfrir formålene som ble satt i lov og forskrift. Oslo kommune ba også om en ”kost-nytte” vurdering av tilbudet.
Forbedringer
De ansattes situasjon er blitt langt bedre i nye lokaler, og brukerne gir også uttrykk for at de synes tilbudet har blitt bedre. Dette har ført til bedre trivsel for både ansatte og brukere. Det har vært en økning i helse- og sosialfaglig oppfølging av brukerne. Sårbehandling og samtaler er det som oftest går igjen.
Dilemmaer
Flere av dilemmaene som ble vurdert i den foregående evalueringen, er imidlertid fortsatt aktuelle. Ordningen omfatter fremdeles bare injisering av heroin, selv om røyking av stoffet er langt mindre helseskadelig. Omfanget av injisering i hals og lyske har økt, da dette medfører økt risiko for helseskade er det et dilemma hvorvidt sprøyterommet skal tillate slik injisering.
Når det gjelder de ansattes meldeplikt til barnevern og sosialtjeneste, ser det nå ut til å være avklart at denne skal overholdes slik det fremkommer i helsepersonelloven. Tidligere ble det også opplevd som et dilemma at psykisk syke brukere ikke alltid kunne bruke sprøyterommet fordi de ikke greide å innordne seg reglene. Dette problemet er langt på vei løst med nye og større lokaler som bedre ivaretar de ansattes sikkerhet, samtidig som det gir brukerne mer armslag.
”Kost-nytte”
Kost-nyttevurderingen av sprøyteromstilbudet blir i evalueringen vurdert ut fra om de oppsatte formålene med ordningen kan sies å være nådd, selv om disse ikke alltid er målbare. Det må kunne sies at tilbudet bidrar til økt verdighet for den aktuelle målgruppen, både på et individuelt og på et overordnet nivå. Sprøyterommet har også bidratt til økt mulighet for helse- og sosialfaglig oppfølging, og trolig også til bedre sprøytehygiene. | |
dc.description.abstract | he new premises are satisfactory. Staff security is well attended to. Operating costs
have virtually doubled since the injecting room moved to a new home, however.
Higher outlays must be seen in light of the depreciation of the new premises.
Consistent with the findings of the former evaluation, frequency of use by
registered clients varies widely. The ‘frequently’ percentage (on average 6 or more
visits per month) rose slightly, but so did the ‘rarely’ category (0
−
2 visits per month
on average). A detailed examination of the ten clients with the highest visiting
frequency reveals, all the same, large fluctuations from month to month.
The amount of heroin the users report to inject shows more or less the same
distribution as at the former evaluation. Percentage of injections in the groin was
slightly higher compared the first two years of operations.
Again compared with that period, the move to new premises has not caused
problems in the sense of the police «chasing» injecting room clients away or
making it difficult to run the Oslo-injecting facility in any way.
As was said in connection with the last evaluation, the supervised drug injection
scheme can be said to have promoted the dignity of the group in question, both
generally and for the individual. Although it is impossible to operationalise dignity
as a concept in a measurable way, one can say that the injecting room communicates
an acknowledgement of injecting drug users’ basic human value and need of help.
For the clients, the services and contact with staff doubtless go some way to
underpinning a sense of dignity. Working conditions at the new premises are better,
increasing staff and client satisfaction, which again can be said to help clients feel
more valued than was the case in the old facility.
After the move to the new premises, somatic and psycho-social health matters were
raised in 14 per cent of all visits, while the corresponding percentage during the
first two operating years was 8 per cent. Treatment of wounds and consultations with staff are the most frequent forms of assistance. Although the rise can be put
down to an improved registration procedure, there is reason to believe that
increased focus and better staffing have played a not inconsiderable role.
There was a rise in the number of visits during which the clients receive advice
about injecting the drug, from 13 per cent in the first two years to 17 per cent in
the new injecting room. At the same time, advice was given to a smaller percentage
of clients, from 81 to 76 per cent.
Following the move, 0.68 per cent of injections have resulted in overdose incidents,
compared with 0.61 per cent during the first two years. There was, however, a fall
in the percentage of clients suffering from an overdose, from 18 per cent in the first
two years to 11 per cent after the move.
Staff sick leave fell significantly and reports attest to a good working environment.
Staff express great satisfaction with their immediate superior, but feel dogged by
the senior management at the Alcohol and Drug Addiction Service. Training of
new staff and support meetings appear to work in a satisfactory way. While staff are
generally happy with the working environment, they would like more space, longer
opening hours and more staff.
Harm reduction programmes such as the injecting room will raise numerous
dilemmas/problems for staff and decision makers. Having said that, opinions on
what exactly constitutes a dilemma and how seriously it should be taken will vary.
Some dilemmas/problems are largely similar to the challenges, choices and
constraints in other services for drug users. Others are issues addressed under
general drug and alcohol policy, but seen here through the lens of a public injecting
room facility. Most of the dilemmas and choices discussed in the last evaluation
report still apply; some, however, appear to have been eliminated. | |