Malta’s harm reduction hiccups: A love story in the making | Karen Mamo

On Sunday 18 August 1996, the news portal The Malta Independent reported that a 17-year-old boy became Malta’s first-recorded ecstasy victim. In the months predating this tragic death, one man by the name of Salvatore decided to kick start Safer Dance Culture, a peer-led movement providing informal harm reduction services for people attending music events. Through the exchange of important harm reduction information obtained via cooperation with the Manchester-based LifeLine Project, Salvatore introduced the first comprehensive harm reduction tools for all people using drugs in Malta.

The advice predominantly focused on educational material on both the benefits and risks of drug use, and ways to mitigate risks, including the availability of free water.

Salvatore’s work attracted mixed reactions, if not direct opposition. An article penned by Dr Francis Saliba, then head of the National Drug Intelligence Unit in the newspaper The Malta Independent on 10 March 1996, denounced Salvatore’s work and definition of harm reduction. Dr Saliba defined Harm Reduction ‘as a means to repair the damage associated with drug abuse, and a way to provide support facilities for drug victims and their families by offering helplines and treatment for the addict’. He underlined that ‘most definitely; harm reduction is not a policy of instructing potential and actual drug abusers on how to use potent psychoactive drugs for recreational use with safety. This would be an illusion and a hopeless task.’

For over two decades, the narrow vision of harm reduction as stuck within the confines of addiction and abuse stifled Malta’s transition towards more humane drug policies and practices. Furthermore, throughout this time and in a somewhat parallel fashion, thousands of law-abiding citizens have been picked up by the police, and in some cases imprisoned with a permanently tainted criminal record, for personal drug use.

In 1997, 75% of people in prison in Malta were recorded as drug abusers and/or drug offences. More recently, and despite the legal amendments introduced in 2015 and 2021, the Council of Europe’s annual SPACE I – 2023 Prison Population report explains that in Malta 24.5% of all inmates had been convicted for drug-related offences [the EU average stands at 18.9%].

Although there is no internationally agreed upon definition of harm reduction, Harm Reduction International defines it as policies, programmes and practices that aim to minimise the negative health, social and legal impacts associated with drug use, drug policies and drug laws. Therefore, harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that they stop using drugs as a precondition of support.

In the past five years, a small team of dedicated professionals have been stepping up the harm reduction message, and in part, rekindling Salvatore’s dream of advancing a safer dance culture in Malta.

Since late 2019, through several collaborations, Harm Reduction Malta has been providing basic educational and risk reduction tools for people attending music festivals and events. In May this year, Harm Reduction Malta cooperated with In.di.go waX collective and Boomerang Festival by developing a festival care guide, providing health and welfare advice before, during and after the event, whilst also providing free basic welfare tools such as hydration sachets, condoms, sanitary towels, water and fresh fruit.

Harm Reduction Malta is proud to observe that similar initiatives are being well received by people attending these festivals and events, and in some instances also prompting a conversation on additional harm reduction services such as access to anonymised drug checking (pill-testing) services, and the establishment of a harm reduction welfare tent on site.

In the same month, Harm Reduction Malta was invited by the Chairperson of the Paceville Town Management Committee Philip Fenech to give a presentation on Promoting Welfare in the Night-Time Economy. The presentation accentuated the relationship between advancing sustainable night-time economies and considerations for public health and welfare of all those visiting the St Julian’s and Paceville area. A number of recommendations emphasised the role of an inclusive approach, thus recognising the needs of various groups and individuals, such as tourists with limited knowledge of the English language, youths, women, and the LGBTIQ community.

It is promising that in recent years, other organisations such as Willingness Team [Chat Bar] and the Richmond Foundation are branching their operations away from the confines of treatment and embarking on a relatively novel initiative of providing mental health support on festival grounds. These initiatives are part and parcel of a newfound way to address the night-time economy, including drug use in society, but are also a strong testament to the core principles of harm reduction, that is, generating positive change without judgement, coercion, discrimination, or requiring that the person stops using drugs as a precondition of support.

When grouped together, these grassroots initiatives are challenging and remodelling in a very tangible manner the decades-old fallacy that educating people about safer night-time experiences, including how to use narcotic and psychotropic drugs in a less risky way, is an illusion and a hopeless task. Most importantly, the renewed ethos of promoting a safer dance culture in Malta is slowly, but surely creating a positive momentum in advancing the human rights and welfare of people on the dancefloor.