What motivates you to work with women who use drugs?
I’m from Mallorca where we have a very serious problem with the use of injectable drugs, especially heroin. I experienced it very closely. At the age of eighteen I lost a friend to an overdose and the number of friends lost as a result has not stopped increasing. The last direct friend I lost because of this died not long ago. This personal part weighs heavily. More than once, I thought that if I needed help with drug problems, if I needed it, I would not find it. Metzineres works with people who identify as womxn who use drugs, survivors of violence and those who have not been able to access or adapt to the requirements of drug treatment services. Participants face multiple barriers in accessing drug treatment services as these spaces are male dominated and do not provide womxn focused services. The services also do not provide or offer referral to allied services addressing gender base violence issues. I am an anthropologist and I did a master’s degree in criminology and legal-criminal sociology and I remember a class with Oriol Romaní in which he said that 80% of the people who are in prison are there for drug-related crimes. And so I realised that if we want to change prisons, if we want to close prisons, we have to change drug policies. Metzineres therefore focuses on providing a full range of women-centred harm reduction services and applies an innovative and pioneering service model based on human rights and gender mainstreaming, underpinned by social ethical and feminist values. Our innovation is underpinned by a shared sense of community and the adoption of reliable, pragmatic and cost-effective financial strategies. In this way, Metzinres ensures a customer-focused approach for every womxn service user.
Please share with us how Metzineres evolved?
When I went to work in Canada, in the only supervised drug consumption room in North America, I discovered a system based on the conception of people who use drugs as protagonists in the design, implementation, monitoring and evaluation of programmes. When I returned to Barcelona I participated in a study on women who inject drugs and for the research, a network of women was created, which later became the embryo of Metzineres. At the beginning, We met every week to have a snack together, then these meals became particularly interesting as a meeting point for women and non-binary people who
use drugs. So Metzineres started in 2017 and in October 2020 was registered as a non-profit cooperative.
Daily accompaniments to access public services are committed to comfort the well-being of the womxn and they have shown extraordinary results after just 4 years of implementation, exceeding the highest expectations. A lack of funding and infrastructure endanger the sustainability of Metzineres itself, despite worldwide admiration and acknowledgement of pace setting good practice evident in the Metzineres approach, not to mention national level media coverage and acknowledgement from various government agencies, here in Spain.
Can you please describe what you mean by ‘holistic’ service provision and why it is important?
Metzineres works with an all-women transdisciplinary team which includes experts in drug policy, gender mainstreaming, and harm reduction; a legal project officer; a women’s harm reduction coordinator; a doctor; a social worker; a social educator; a nursing assistant; a Kundalini Yoga workshop facilitator; a social integration specialist who is also a graphic artist and designer; and workshop facilitators, volunteers, interns, and neighbours. The holistic mission of the Metzineres is complemented by various components or principles aimed to respond to the complex, often overlapping issues experienced by our users. These principles include: ‘The Cover’ -providing a caring and healing environment ‘The Powerful’ – addresses self-protection and empowerment ‘The Ivy’ – focused on community and neighbourhood engagement ‘The Howl’ – advocacy, production and entrepreneurship ‘The Plucky’ – participation and activism ‘The Artisan’ – fostering art and creativity. Metzineres aim to mitigate potential for womxn to feel that they have failed and reduce exposure to traumatic situations. Many womxn who attend Metzineres have previously accessed other services, however these services were unable to adequately engage or link them with wraparound services to support their multifaceted needs. For some women, this is their first encounter with a service. For all, this is the first time they have engaged with a womxn focused service where they are encouraged to actively participate in the service design, implementation and management.
How is collaborative decision-making implemented and encouraged by staff and users at Metzineres?
Metzineres has a horizontal structure. All team members attend weekly meetings to discuss any issues or concerns. Financial and structural decisions are discussed at the weekly staff meeting, however all decisions must take into account the contributions of the entire Metzineres community. These decisions are then channeled through the “Network of Women who use Drugs-(XADUD)” and are also included in the weekly meeting of participants in our local, “La Vida Alegre”.
Can you please describe why Metzineres places importance on the creation of safe places for women who use drugs?
Women and non-binary people who use drugs often find it difficult to enter or adhere to social mainstream healthcare networks. The are often excluded from specialized services, including those focused on drugs or gender-based violence. Metzineres welcomes all those who have experienced marginalisation by creating safe spaces and places for womxn that offer individual-focused, compassionate responses to their complex and ever-changing realities.
Data compiled by Metzineres shows that the issues experienced by our services users include:
- Drug-related problems (72%)
- Homelessness (69%)
- Migratory experiences (37%)
- LGTBIQ+ (20%)
- Sex work (16%) and/or sex for survival (20%)
- Imprisonment (29%)
- Mental health disorders (46%)
- Functional diversity (6%).
This range of experiences and the trauma they engender highlight the critical need to provide safe and nurturing environments for women.
What advice would you give to other organizations hoping to establish safe spaces for women who use drugs?
Trust the expertise of the women who use drugs and include them in the design, implementation, monitoring and evaluation of services. These womxn are experts on their own needs and practices, they know the dynamics, as well as the care networks.
They provide particular information that is essential for the effective delivery of services. WUD must be engaged and incorporated as equal partners in the organization. In this way, bonds are built that reinforce autonomy and utility of the organization.
Be rigorous about collecting data that demonstrates the cost effectiveness and social benefits of the organisation and its services.
Don’t wait for permission, just do it!
How does Metzineres facilitate the active involvement of womxn who use drugs in advocacy actions?
Metzineres is based on specific values that are the foundation of our work:
- genuine creativity
- radical tenderness
- collective resilience
- rogue courage
- activism of care
- complicity
- mutual support,
- anti-prohibitionist commitment
- evidence-based transdisciplinary practice
- transformative passion
- confidence
- adaptability
- flexibility
- love
- joy
- enthusiasm
The Metzineres ‘Howl’ component focuses on activism and fights against exclusion by encouraging awareness, protest and demonstrations emboldened by the motto “Nothing about us, without us”.
We attend conferences and seminars, organize informative talks, and participate in the development of policies that advocate for the human rights of women. We collaborate with local, national, and international organizations, including the Catalan Network of People who Use Drugs (CATNPUD), the Network of Anti-Prohibitionist Women (REMA), the International Network of People who Use Drugs (INPUD), the International Network of Women who Use Drugs (INWUD), and the Women and Harm Reduction International Network (WHRIN).
What do you think is important for other service providers to know about ‘good practice’ in engaging with women who use drugs?
We would suggest to others working with womxn who use drugs to explore approaches drawing from intersectional feminism, harm reduction and human rights. These approaches should be focused on each individual to strengthen their physical, emotional and psychological well-being. It is also necessary to include womxn in all aspects of program design, implementation, and management. Encourage and empower womxn to advocate for gender equality through political, and social actions.
If you had to choose one most important ‘success’ ingredient in the work of Metzineres what would it be and why is it critical? What makes Metzineres’ work successful is our holistic approach. Broadening our focus from the one issue of drug use by also responding to multifaceted forms of violence and trauma experienced by women who use drugs is critical. These issues cannot be separated as they are interwoven and have to be addressed in tandem to heal and grow. When we say harm reduction we mean policies and practices aimed at reducing the harms of substance use. I like to say that it is no longer about fighting drugs but about harm reduction, because perhaps the most serious harm that a person receives does not come directly from the substance, but, for example, from lack of employment, or housing, stigma, criminalization and discrimination.
