Tracing a path for opium gum from Mexico as a safe supply harm reduction measure for Canada

2021 ◽  
pp. 103066
Author(s):  
Zara Snapp ◽  
Jorge Herrera Valderrábano
Keyword(s):  
Harm Reduction ◽  
Reduction Measure

scholarly journals Peer-Assisted Injection as a Harm Reduction Measure in a Supervised Consumption Service: A Qualitative Study of Client Experiences

2020 ◽  
Author(s):  
Em M. Pijl ◽  
Tracy Oosterbroek ◽  
Takara Motz ◽  
Erin Mason ◽  
Keltie Hamilton
Keyword(s):  
Qualitative Study ◽  
Harm Reduction ◽  
Interpersonal Relationships ◽  
Safe Place ◽  
Client Experiences ◽  
Controlled Drugs ◽  
Reduction Measure ◽  
Significant Burden ◽  
And Gender ◽  
Health Canada

Abstract Background: Peer assistance is an emerging area of study in injection drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, BC, clients were prohibited from injecting their peers; only recently has this practice been introduced as a harm reduction measure at these sites. In 2018, Health Canada granted federal exemption to allow peer-assisted injection at certain SCS sites, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection addresses several topics: interpersonal relationships between the injection provider and recipient; the role of pragmatism; trust and expertise; and gender relations. Methods: In this qualitative study, participants (n=16) were recruited to be interviewed about their experiences in a peer-assisted injection program (PAIP) at one SCS regulated by Health Canada. Interview data were transcribed and thematically analyzed. Quantitative administrative data was used to provide context and to describe the study population, comprised of people in the PAIP (n=248) Results: PAIP clients made up 17.4% of all SCS clients. PAIP clients were more likely to be female and Indigenous. Injection providers expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors related to the injection provider-recipient relationship were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the PAIP which included adding more inhalation rooms so that if someone was unable to inject they could smoke in a safe place instead. Additionally, being required by law to divide drugs outside of the SCS, prior to preparing and using in the site, created unsafe conditions for clients. Conclusions: Regular use of the SCS, and access to its resources, enabled participants to lower their risk through smoking and to practise lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.

Insights on Prison Needle and Syringe Programs: Research With Former Prisoners in Canada

2017 ◽  
Vol 97 (5) ◽  
pp. 628-643 ◽  
Author(s):  
Emily van der Meulen ◽  
Tara Marie Watson ◽  
Ann De Shalit
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Injection Drug Use ◽  
Qualitative Data ◽  
Injection Drug ◽  
Injection Equipment ◽  
Federal Prisons ◽  
Former Prisoners ◽  
Reduction Measure ◽  
Needle And Syringe Programs

Although injection drug use occurs inside Canadian federal prisons, the correctional service does not allow prisoners access to sterile injection equipment as a harm reduction measure. International evaluations have shown that prison-based needle and syringe programs (PNSPs) lead to many beneficial health and other outcomes, and contribute to safer environments for prisoners and staff. This article presents qualitative data from a community-driven study with 30 former prisoners in Ontario, Canada. Participants shared insights that are highly valuable for understanding the prison context in relation to the need for PNSPs, both in Canada and in other jurisdictions.

scholarly journals Peer-assisted injection as a harm reduction measure in a supervised consumption service: a qualitative study of client experiences

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Em Pijl ◽  
Tracy Oosterbroek ◽  
Takara Motz ◽  
Erin Mason ◽  
Keltie Hamilton
Keyword(s):  
Qualitative Study ◽  
Harm Reduction ◽  
Interpersonal Relationships ◽  
Safe Place ◽  
Client Experiences ◽  
Controlled Drugs ◽  
Reduction Measure ◽  
Significant Burden ◽  
And Gender ◽  
Health Canada

Abstract Background Peer assistance is an emerging area of study in injection drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, Canada, clients were prohibited from injecting their peers; only recently has this practise been introduced as a harm reduction measure at these sites. In 2018, Health Canada granted federal exemption to allow peer-assisted injection at certain SCS sites, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection addresses several topics: interpersonal relationships between the injection provider and recipient; the role of pragmatism; trust and expertise; and gender relations. Methods In this qualitative study, participants (n = 16) were recruited to be interviewed about their experiences in a peer-assisted injection program (PAIP) at one SCS regulated by Health Canada. Interview data were transcribed and thematically analyzed. Quantitative administrative data were used to provide context and to describe the study population, comprised of people in the PAIP (n = 248). Results PAIP clients made up 17.4% of all SCS clients. PAIP clients were more likely to be female and Indigenous. Injection providers expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors related to the injection provider-recipient relationship were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the PAIP which included adding more inhalation rooms so that if someone was unable to inject they could smoke in a safe place instead. Additionally, being required by law to divide drugs outside of the SCS, prior to preparing and using in the site, created unsafe conditions for clients. Conclusions Regular use of the SCS, and access to its resources, enabled participants to lower their risk through smoking and to practice lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.

scholarly journals Should the Health Community Promote Smokeless Tobacco (Snus) as a Harm Reduction Measure?

PLoS Medicine ◽  
2007 ◽  
Vol 4 (7) ◽  
pp. e185 ◽  
Author(s):  
Coral E Gartner ◽  
Wayne D Hall ◽  
Simon Chapman ◽  
Becky Freeman
Keyword(s):  
Harm Reduction ◽  
Smokeless Tobacco ◽  
Health Community ◽  
Reduction Measure

Amphetamine Prescribing as a Harm Reduction Measure: A Preliminary Study

1997 ◽  
Vol 5 (2) ◽  
pp. 95-112 ◽  
Author(s):  
Andrew J. McBride ◽  
Gary Sullivan ◽  
Andrew E. Blewetp ◽  
Sue Morgan
Keyword(s):  
Harm Reduction ◽  
Reduction Measure ◽  
Preliminary Study

scholarly journals Peer-Assisted Injection as a Harm Reduction Measure in a Supervised Consumption Service: A Qualitative Study of Client Experiences

2020 ◽  
Author(s):  
Em M. Pijl ◽  
Tracy Oosterbroek ◽  
Takara Motz ◽  
Erin Mason ◽  
Keltie Hamilton ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Interpersonal Relationships ◽  
Client Experiences ◽  
Controlled Drugs ◽  
Reduction Measure ◽  
Significant Burden ◽  
Qualitative Descriptive ◽  
And Gender ◽  
Study Participants ◽  
Health Canada

Abstract Background Peer assistance is an emerging area of study in intravenous drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, BC, clients were prohibited from injecting their peers; only recently has this practice been introduced as a harm reduction measure at these sites. In Alberta, a government-sanctioned SCS recently received federal exemption to allow peer-assisted injection in their facility, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection, while scant, addresses several topics: interpersonal relationships between the injector and recipient; the roles of ritual and pragmatism; and gender inequality. Methods In this qualitative, descriptive study, participants were interviewed about their experiences in a peer-assist program at an SCS regulated by Health Canada. Results Participants expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the peer-assist program. Conclusions These findings reveal the humanity within a cohort of at-risk individuals, often dehumanized at the societal level. Relational equity and mutuality were evident, in contrast to other studies. Regular use of the SCS, and access to its resources, enabled participants to make healthier choices and practise lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.

scholarly journals Peer-Assisted Injection as a Harm Reduction Measure in a Supervised Consumption Service: A Mixed Method Study of Client Experiences

2020 ◽  
Author(s):  
Em M. Pijl ◽  
Tracy Oosterbroek ◽  
Takara Motz ◽  
Erin Mason ◽  
Keltie Hamilton
Keyword(s):  
Harm Reduction ◽  
Interpersonal Relationships ◽  
Client Experiences ◽  
Controlled Drugs ◽  
Sequential Mixed Methods ◽  
Reduction Measure ◽  
Significant Burden ◽  
And Gender ◽  
Study Participants ◽  
Health Canada

Abstract Background: Peer assistance is an emerging area of study in injection drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, BC, clients were prohibited from injecting their peers; only recently has this practice been introduced as a harm reduction measure at these sites. In 2018, Health Canada granted federal exemption to allow peer-assisted injection at certain SCS sites, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection addresses several topics: interpersonal relationships between the injector and recipient; the roles of ritual and pragmatism; trust and assessment of expertise; and gender relations.Methods: In this explanatory sequential mixed-methods study, participants were interviewed about their experiences in a peer-assisted injection program (PAIP) at one SCS regulated by Health Canada. Quantitative administrative data was used to provide context and to describe the study sample in comparison to all PAIP participants. Results: PAIP clients made up only 17.4% of all SCS clients; however, 71% of all SCS visits and 83% of all overdoses occurred among PAIP clients indicating their high service utilization. The PAIP program was utilized infrequently (0.4% of all SCS visits) but was a valuable service as expressed by Program participants. Participants expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the PAIP. Conclusions: These findings reveal the humanity within a cohort of at-risk individuals, often dehumanized at the societal level. Relational equity and mutuality were evident, in contrast to other studies. Regular use of the SCS, and access to its resources, enabled participants to make healthier choices and practise lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.

Unknown and Under-Researched: The Anatomy of Drinking Under Control Programs

2017 ◽  
Vol 63 (5) ◽  
pp. 277-288
Author(s):  
Harald Klingemann ◽  
Justyna Klingemann
Keyword(s):  
Quality Of Life ◽  
Harm Reduction ◽  
Evaluation Studies ◽  
Mission Statements ◽  
Community Response ◽  
Limited Resources ◽  
Admission Criteria ◽  
Control Programs ◽  
Institutional Order

Abstract. Introduction: While alcohol treatment predominantly focuses on abstinence, drug treatment objectives include a variety of outcomes related to consumption and quality of life. Consequently harm reduction programs tackling psychoactive substances are well documented and accepted by practitioners, whereas harm reduction programs tackling alcohol are under-researched and met with resistance. Method: The paper is mainly based on key-person interviews with eight program providers conducted in Switzerland in 2009 and up-dated in 2015, and the analysis of reports and mission statements to establish an inventory and description of drinking under control programs (DUCPs). A recent twin program in Amsterdam and Essen was included to exemplify conditions impeding their implementation. Firstly, a typology based on the type of alcohol management, the provided support and admission criteria is developed, complemented by a detailed description of their functioning in practice. Secondly, the case studies are analyzed in terms of factors promoting and impeding the implementation of DUCPs and efforts of legitimize them and assess their success. Results: Residential and non-residential DUCPs show high diversity and pursue individualized approaches as the detailed case descriptions exemplify. Different modalities of proactively providing and including alcohol consumption are conceptualized in a wider framework of program objectives, including among others, quality of life and harm reduction. Typically DUCPs represent an effort to achieve public or institutional order. Their implementation and success are contingent upon their location, media response, type of alcohol management and the response of other substance-oriented stake holders in the treatment system. The legitimization of DUCPs is hampered by the lack of evaluation studies. DUCPs rely mostly – also because of limited resources – on rudimentary self-evaluations and attribute little importance to data collection exercises. Conclusions: Challenges for participants are underestimated and standard evaluation methodologies tend to be incompatible with the rationale and operational objectives of DUCPs. Program-sensitive multimethod approaches enabled by sufficient financing for monitoring and accompanying research is needed to improve the practice-oriented implementation of DUCPs. Barriers for these programs include assumptions that ‘alcohol-assisted’ help abandons hope for recovery and community response to DUCPs as locally unwanted institutions (‘not in my backyard’) fuelled by stigmatization.

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