Applied ethical reflections on the operation of a Geneva drug consumption room: Opportunities for enhanced harm reduction practice

2006 ◽  
Vol 17 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Craig L. Fry
Keyword(s):  
Harm Reduction ◽  
Drug Consumption ◽  
Ethical Reflections ◽  
Drug Consumption Room

scholarly journals The Complexity of Drug Consumption Room Policy and Progress in Finland

2021 ◽  
pp. 009145092110025
Author(s):  
Ali Unlu ◽  
Fatih Demiroz ◽  
Tuukka Tammi ◽  
Pekka Hakkarainen
Keyword(s):  
Complexity Theory ◽  
Government Policy ◽  
Policy Process ◽  
Central Government ◽  
Drug Consumption ◽  
People Who Use Drugs ◽  
Local Response ◽  
Local Actors ◽  
Moral Frameworks ◽  
Drug Consumption Room

Drug consumption rooms (DCRs) have been established to reach high-risk people who use drugs (PWUDs) and reduce drug-associated harm. Despite effectiveness, their establishment requires strong advocacy and efforts since moral perspectives tend to prevail over health outcomes in many countries. DCRs have generally emerged as a local response to inadequate central government policy. Likewise, the initiative of the Municipality of Helsinki in 2018 opened up a discussion between central government, society, and local actors in Finland. This would be the first DCR in Finland, which makes the policy process and the progress of the initiative interesting for analysis. In this article, the identification of agents, structures of interactions, environmental challenges, and policy opportunities are analyzed within the framework of complexity theory. Our results show that the initiative faces policy barriers that have mainly arisen from the conceptualization of DCRs in moral frameworks that result in the prolongation of political and professional actors to take a position on DCRs.

scholarly journals Harm reduction in primary healthcare: an integrative review of care strategies

2020 ◽  
Vol 54 ◽  
Author(s):  
Nayana Santos Arêa Soares ◽  
Márcia Astrês Fernandes ◽  
Hellany Karolliny Pinho Ribeiro ◽  
Daniel de Macêdo Rocha ◽  
Ítalo Arão Pereira Ribeiro
Keyword(s):  
Literature Review ◽  
Harm Reduction ◽  
Primary Healthcare ◽  
Health Professionals ◽  
Maintenance Treatment ◽  
Drug Consumption ◽  
Integrative Review ◽  
Safe Practice ◽  
Opioid Agonists ◽  
Free Care

Abstract Objective: To analyze the evidence available in the literature on harm reduction actions developed by primary healthcare. Method: Integrative literature review carried out in the databases MEDLINE, CINAHL, SCOPUS, Web of ScienceTM and LILACS. Results: Seventeen (17) primary studies published from 2008 to 2017 were included in this review. Care strategies for harm reduction included maintenance treatment with methadone, therapy with opioid agonists, needle and syringe distribution programs and the creation of rooms for supervised drug consumption. Health professionals were essential for consolidating inclusion strategies, possessing skills to listen without judgment and prejudice. Conclusion: Harm reduction care strategies have been disseminated in different countries and healthcare levels, aiming toward safe practice and quality, effective and risk-free care actions.

Mapping the spatial and affective composition of care in a drug consumption room in Germany

2019 ◽  
pp. 1-20 ◽  
Author(s):  
Tristan Duncan ◽  
Bernadette Sebar ◽  
Jessica Lee ◽  
Cameron Duff
Keyword(s):  
Drug Consumption ◽  
Drug Consumption Room

scholarly journals Factors concerning access to a potential drug consumption room in Dublin, Ireland

2017 ◽  
Vol 3 (1) ◽  
pp. 1398207 ◽  
Author(s):  
Emma Atkin-Brenninkmeyer ◽  
Fiona Larkan ◽  
Catherine Comiskey ◽  
Kar-wai Tong
Keyword(s):  
Drug Consumption ◽  
Potential Drug ◽  
Drug Consumption Room

scholarly journals Drug consumption among elderly and harm reduction: a reflection from the complexity

2016 ◽  
Vol 20 ◽  
Author(s):  
Vânia Dias Cruz ◽  
Silvana Sidney Costa Santos ◽  
Daiane Porto Gautério-Abreu ◽  
Bárbara Tarouco da Silva ◽  
Silomar Ilha
Keyword(s):  
Harm Reduction ◽  
Drug Consumption

scholarly journals Of Rats And Men: Peer Presence And Familiarity Are Key Factors Which Reduce Drug Intake

2018 ◽  
Author(s):  
E Giorla ◽  
S Nordmann ◽  
Y Pelloux ◽  
P Roux ◽  
S Rosellini ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Social Environment ◽  
Drug Consumption ◽  
Key Factors ◽  
Transdisciplinary Approach ◽  
Reduction Strategies ◽  
Drug Naïve ◽  
Different Characteristics ◽  
The Relationship

ABSTRACTSocial environment influences drug consumption, its persistence and evolution. Little is known regarding the influence of the presence of a peer during drug consumption and especially how the relationship between peers (familiarity and dominance) can influence drug consumption. We used here a translational and transdisciplinary approach to explore the influence of peer presence and peer familiarity in rats and humans that self-administer stimulants. In rats, cocaine intake was compared when rats were alone with intake when peers with different characteristics (familiar or not, cocaine naive or not, dominant or subordinate) were present. In humans, 77 cocaine and/or methylphenidate users were asked to detail their most recent drug use episodes and their relationship with peers present at consumption. The results show that in both humans and rats, the risk of cocaine/stimulant consumption was significantly reduced by 37% and 32%, respectively, when a peer was present. Moreover, the lowest risk of consumption was consistently observed when the peer was unfamiliar (vs familiar) with a further 38% and 17% risk reduction, respectively. In rats, a decreased risk of consumption was greater when the peer was cocaine naive (vs non-cocaine naive).The presence of a non-familiar and possibly drug-naive peer is the most efficient condition to diminish stimulant intake. Our results indirectly support the use of harm reduction strategies, in particular supervised consumption rooms for stimulant users.

scholarly journals Impact of drug consumption rooms on risk practices and access to care in people who inject drugs in France: the COSINUS prospective cohort study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023683
Author(s):  
Marc Auriacombe ◽  
Perrine Roux ◽  
Laélia Briand Madrid ◽  
Sébastien Kirchherr ◽  
Charlotte Kervran ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Drug Use ◽  
Harm Reduction ◽  
Access To Care ◽  
Social Services ◽  
People Who Inject Drugs ◽  
Drug Consumption ◽  
Risk Practices ◽  
The Impact

IntroductionThe high prevalence of hepatitis C and the persistence of HIV and hepatitis C virus (HCV) risk practices in people who inject drugs (PWID) in France underlines the need for innovative prevention interventions. The main objective of this article is to describe the design of the COSINUS cohort study and outline the issues it will explore to evaluate the impact of drug consumption rooms (DCR) on PWID outcomes. Secondary objectives are to assess how DCR (a) influence other drug-related practices, such as the transition from intravenous to less risky modes of use, (b) reduce drug use frequency/quantity, (c) increase access to treatment for addiction and comorbidities (infectious, psychiatric and other), (d) improve social conditions and (e) reduce levels of violence experienced and drug-related offences. COSINUS will also give us the opportunity to investigate the impact of other harm reduction tools in France and their combined effect with DCR on reducing HIV-HCV risk practices. Furthermore, we will be better able to identify PWID needs.Methods and analysisEnrollment in this prospective multi-site cohort study started in June 2016. Overall, 680 PWID in four different cities (Bordeaux, Marseilles, Paris and Strasbourg) will be enrolled and followed up for 12 months through face-to-face structured interviews administered by trained staff to all eligible participants at baseline (M0), 3 month (M3), 6 month (M6) and 12 month (M12) follow-up visits. These interviews gather data on socio-demographic characteristics, past and current drug and alcohol consumption, drug-use related practices, access to care and social services, experience of violence (as victims), offences, other psychosocial issues and perception and needs about harm reduction interventions and services. Longitudinal data analysis will use a mixed logistic model to assess the impact of individual and structural factors, including DCR attendance and exposure to other harm reduction services, on the main outcome (HIV-HCV risk practices).Ethics and disseminationThis study was reviewed and approved by the institutional review board of the French Institute of Medical Research and Health (opinion number: 14–166). The findings of this cohort study will help to assess the impact of DCR on HIV-HCV risk practices and other psycho-social outcomes and trajectories. Moreover, they will enable health authorities to shape health and harm reduction policies according to PWID needs. Finally, they will also help to improve current harm reduction and therapeutic interventions and to create novel ones.

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