It is only possible to pick up signals and trends, inform, and refer, by being in direct contact with people who use drugs. Outreach work is therefore are the heart of all Mainline’s activities.
what we do
Mainline’s outreach workers can be found on the streets, in low-threshold social shelters, near sex work and swing venues, in places of use, in correctional facilities, at people who use at home and online on relevant forums. We especially cater to vulnerable groups on the margins of society, such as people without homes, people with serious mental health problems, people without residence permits, sex workers and people with problematic drug use. We reach people who might otherwise not have access to care and information. Through direct contact, our outreach workers also have an important signalling function. They document new drug trends and social and legal issues among people who use drugs.
the importance of outreach work
Our outreach work makes it possible to bring harm reduction to people. We make education and support accessible to people who might otherwise never come into contact with healthcare or education on safe drug use. And that is vital for people who use drugs. By actively walking the streets and being present in places where drug use takes place, we lower the threshold for help and support. From an independent position, we hear what is going on and what people need.
Thanks to the outreach workers’ knowledge of what is going on among people who use drugs, they have a signalling function, including on new drugs and trends in use. Shortcomings in policies for and support of people who use drugs are also quickly spotted through outreach work. We share these findings with local policymakers, politicians and health authorities and sound the alarm if we observe possible new health risks, or a gap in care provision. The outreach work also allows us to put our acquired knowledge to practical use, for instance in training courses.
Instead of taking a moralistic approach, our outreach workers have a practical and effective approach. We can make direct interventions to reduce the risks of drug use. For instance, field workers distribute clean needles, base pipes and other materials. We also distribute educational materials and our informative Mainline magazine. With our outreach work, we offer the following services on-site:
- A listening ear
Mainline has been a familiar face for years. By engaging in the conversation without an underlying agenda, Mainline outreach workers build trusting relationships with the people they meet. This trust is essential to having open and honest conversations about drug use and health. The outreach workers take their time and make sure everyone feels heard and valued.
- Health education
In our information we encourage safer use with the aim of preventing infectious diseases and health damage and improving quality of life. The information we provide is non-binding and unbiased.
- Referral to adequate care
When people who use drugs have a request for help, we are present. Sometimes people want support but are not sure where to turn. This might include medical care, dental care, help in dealing with housing or legal problems, or help in reducing or stopping use. If asked, Mainline outreach workers can think along and refer people to the right agencies.
- Light (recovery) support
Outreach work goes beyond providing physical help. It is also about empowering individuals to take control of their own health and well-being. By providing people with knowledge and tools, we help them make more informed choices and take back control of their lives. Mainline outreach workers also offer individual consultations to people who use drugs or professionals working with them. We do this live, online or by phone. These consultations are conducted based on the presence method and motivational interviewing. They are always harm reduction and/or recovery supportive in nature.
Outreach target groups
Mainline’s history is closely linked to the rise of heroin use in the 1980s and 1990s in The Netherlands. In 1991, three activist men took to the streets of Amsterdam with clean syringes and an informative magazine for and by people who use drugs. And so Mainline was born. Soon, Mainline’s harm reduction work and scope expanded, but its expertise in heroin use remained.
People who inject heroin are also referred to as the ‘classic target group’ of harm reduction. It is an ageing group and the care needs grow along with it. Our outreach workers maintain a strong relationship with this target group and keep a track of care and support needs.
Several risk factors increase the vulnerability of groups of (new) migrants to problematic drug use. These risk factors include traumatic experiences, isolated position in society, unemployment, homelessness and poverty. Health services and municipalities face the urgent question of how to meet the needs of these people.
Mainline’s outreach workers can be found on the streets a lot and map the situation of different groups of migrants. This enables us to develop evidence-based interventions. We work closely with local authorities and communities to create a coordinated response. Mainline advocates for better access to essential services, including for undocumented migrants and those without health insurance.
In recent years, the use of stimulants has increased worldwide. This underlines the urgent need for effective harm reduction strategies. In the Netherlands, there is the “classic target group” of people who use basecoke and are known to social care institutions. In addition, however, we see an increase in the use of basecoke and meth among people who are not known to care agencies. The outreach workers speak to them on the street, at afterparties and online.
Outside the Netherlands, many harm reduction programmes mainly target people who inject heroin, and we see that people who use stimulants and do not inject have more limited access to harm reduction services. This is despite the fact that people who use stimulants often face various health and social problems. Therefore, Mainline has developed several harm reduction interventions aimed at this target group. This group has unique needs and challenges, such as specific attention to mental effects, healthy sleeping habits, nutrition and dental hygiene. By being in close contact with people who use stimulants, Mainline is able to provide effective support and policy advice.
Mainline works with young adults aged between 18 and 35 who use drugs. We focus on young people who often have to deal with many different challenges at the same time, for example: homelessness, debt, conflict and mental health problems. Maintaining a balance in drug use can be complicated in such situations. Mainline offers a listening ear, provides thorough information and identifies gaps in the care.
To reach these young people, we work with young adult peer workers who reach out to their peers with education. This peer-to-peer education is often perceived as more credible by the target group because peer workers know the problems and experiences with drugs. They speak the same language, understand the appeal of substances and the difficulties these young people may face.
Mainline is working hard to improve the status of women who use drugs. Women who use drugs often experience a double stigma – they face prejudice about both their gender and their status as a person who uses drugs. This greatly affects the availability and accessibility of services aimed at them. In addition, women often face additional problems that require specific support, such as with sexual violence, socioeconomic inequality and greater physical risks.
Mainline has years of experience in reaching women who use drugs and has developed several harm reduction interventions aimed at women. Mainline also conducts scans worldwide to identify the care needs of women who use drugs in a particular region.
Female sex workers who use drugs are further marginalised and often have little to no access to care and harm reduction programmes. Mainline’s outreach workers can regularly be found at streetwalking zones in The Netherlands. Internationally, Mainline also works extensively with community-led women’s organisations working to improve harm reduction services for sex workers.
Homeless people face numerous challenges, including mental health problems and social isolation. By no means all homeless people use drugs, but recent research shows that more than half of them do. Often in an attempt to get an emotional grip on their lives. But also to be able to walk on, or be alert at night. Life on the streets and in night shelters is hard and exhausting. Mainline’s outreach workers take to the streets to reach these people, listen to their stories and provide them with the necessary help and resources.
Mainline aims to raise awareness of the complex issues facing homeless people. We advocate for a change in policy and work with other organisations to find sustainable solutions.