Public Health Approaches to Overdose Prevention and Harm Reduction

2019 ◽  
pp. 23-32
Author(s):  
Mark Lysyshyn ◽  
Mark Tyndall
Keyword(s):  
Harm Reduction ◽  
Negative Consequences ◽  
Problematic Substance Use ◽  
Reduction Strategies ◽  
Drug Checking ◽  
Problematic Substance ◽  
Peer Engagement ◽  
Supervised Injection ◽  
Using Data ◽  
Treat All

Harm reduction aims to reduce the negative consequences of drug use in people unable or unwilling to stop. This chapter focus on harm reduction policies, programs, and practices that have been employed in Vancouver, British Columbia, including the controversial introduction of supervised injection sites. Using data from the Vancouver experience, the authors describe successful harm reduction efforts that have resulted in no overdose deaths in Vancouver’s supervised injection facilities. The authors stress that harm reduction approaches are meant to be complementary to prevention and treatment approaches, acknowledging that it is not currently possible to prevent or treat all cases of problematic substance use and also that addiction is a relapsing chronic condition. Other harm reduction strategies include drug checking and alerting, take-home naloxone, injectable therapies, hydromorphone distribution, and peer engagement.

scholarly journals Problematic substance use or problematic substance use policies?

2020 ◽  
Vol 40 (5/6) ◽  
pp. 135-142
Author(s):  
Tim Stockwell ◽  
Cecilia Benoit ◽  
Kiffer Card ◽  
Adam Sherk
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Critical Time ◽  
Policy Makers ◽  
Alcohol Control ◽  
Multiple Data ◽  
Problematic Substance Use ◽  
Reduction Strategies ◽  
Canadian Health ◽  
Problematic Substance

This special issue on substance use issues comes at a critical time for Canadian health policy makers and researchers. Most attention is currently focussed on the opioid crisis and the potential impacts of cannabis legalization. However, our most widely used and harmful substances continue to be alcohol and nicotine. Our policies to reduce harms from these substances are failing. While alcohol control policies are being gradually abandoned, opportunities to maximize the harm reduction potential of new, alternative and safer nicotine delivery devices are not being grasped. More generally, a greater focus is needed on harm reduction strategies that are informed by the experience of marginalized people with severe substance use-related problems so as to not exacerbate health inequities. In order to better inform policy responses, we recommend innovative approaches to monitoring and surveillance that maximize the use of multiple data sources, such as those used in the Canadian Substance Use Costs and Harms (CSUCH) project. Greater attention to precision in defining patterns of risky use and harms is also needed to support policies that more accurately reflect and respond to actual levels of substance use-related harm in Canadian society.

Harm Reduction Strategies and Drug-Related Negative Consequences in the Dance Music Scene: The Moderating Role of Polysubstance Use

2021 ◽  
Vol 56 (6) ◽  
pp. 777-781
Author(s):  
Belén del Valle Vera ◽  
José Carmona-Marquez ◽  
Claudio Vidal-Giné ◽  
Fermín Fernández-Calderón
Keyword(s):  
Harm Reduction ◽  
Dance Music ◽  
Negative Consequences ◽  
Polysubstance Use ◽  
Music Scene ◽  
Reduction Strategies ◽  
Moderating Role

scholarly journals Specific harm reduction strategies employed by 3,4-methylenedioxymethamphetmine/ ecstasy users in the United States and the United Kingdom

2017 ◽  
Vol 3 ◽  
pp. 205032451771106 ◽  
Author(s):  
Alan K Davis ◽  
Harold Rosenberg
Keyword(s):  
United States ◽  
United Kingdom ◽  
Harm Reduction ◽  
The United States ◽  
Negative Consequences ◽  
Web Based ◽  
The United Kingdom ◽  
Assessment Period ◽  
Reduction Strategies

Both recreational and problematic 3,4-methylenedioxymethamphetamine (MDMA)/ecstasy users could benefit from employing harm reduction interventions intended to preserve health and prevent negative consequences. To evaluate whether use of such interventions varied by country of residence and frequency of ecstasy use, we used web-based surveys to assess how often 104 lower-frequency and higher-frequency American ecstasy users and 80 lower-frequency and higher-frequency British ecstasy users employed each of 19 self-initiated harm reduction strategies when they used ecstasy during a 2-month period. Several significant differences notwithstanding, at least 75% of participants had used 11 of the 19 strategies one or more times during the 2-month assessment period, regardless of whether they lived in the United States or United Kingdom and whether they were lower-frequency or higher-frequency ecstasy users. When proportions of American and British participants using a strategy differed significantly, it was typically larger proportions of Americans using those strategies. Many of the less frequently employed strategies are not applicable on every occasion of ecstasy use. However, because ecstasy is not a diverted pharmaceutical of known quality/potency, testing for the presence of MDMA, other stimulants, and adulterants is a strategy that everyone should employ, regardless of country of residence or how frequently one consumes ecstasy.

scholarly journals Peer engagement in harm reduction strategies and services: a critical case study and evaluation framework from British Columbia, Canada

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Alissa M. Greer ◽  
Serena A. Luchenski ◽  
Ashraf A. Amlani ◽  
Katie Lacroix ◽  
Charlene Burmeister ◽  
...  
Keyword(s):  
British Columbia ◽  
Harm Reduction ◽  
Critical Case ◽  
Evaluation Framework ◽  
Reduction Strategies ◽  
Peer Engagement ◽  
Critical Case Study

scholarly journals Combining Trait Models of Impulsivity to Improve Explanation of Substance Use Behaviour

2017 ◽  
Vol 31 (1) ◽  
pp. 118-132 ◽  
Author(s):  
Kaidy Stautz ◽  
Linda Dinc ◽  
Andrew J. Cooper
Keyword(s):  
Substance Use ◽  
Sensation Seeking ◽  
Cannabis Use ◽  
Eysenck Personality Questionnaire ◽  
Negative Urgency ◽  
The Novel ◽  
Negative Consequences ◽  
Total N ◽  
Problematic Substance Use ◽  
Problematic Substance

The UPPS–P model of impulsivity is gaining popularity among personality and substance use researchers, but questions remain as to whether its five facets have incremental validity in explaining substance use over a more parsimonious model specifying only two facets: reward drive and rash impulsiveness. In three cross–sectional studies (total N = 486), we investigated whether the novel components of the UPPS–P model (negative Urgency, Premeditation, Perseverance, Sensation seeking, Positive urgency) predicted typical and problematic alcohol and cannabis use after accounting for reward drive, rash impulsiveness and trait neuroticism (assessed with the Eysenck Personality Questionnaire). Reward drive and rash impulsiveness scores were calculated using principal components analysis of multiple scales, including UPPS–P premeditation and sensation seeking. Results showed that rash impulsiveness was a robust predictor of typical and problematic substance use. The novel facets of the UPPS–P did not improve prediction of typical substance use. The urgency scales inconsistently predicted problematic use. Specifically, negative urgency predicted one of three measures of negative consequences from alcohol use, and positive urgency only predicted negative consequences from cannabis use. Results suggest that the three novel facets of the UPPS–P model add little over a two component model in explaining substance use, although may provide preliminary evidence for the utility of a revised global urgency construct in explaining problematic substance use. Copyright © 2017 European Association of Personality Psychology

scholarly journals Prevention and Harm Reduction Interventions for Adult Gambling at the Local Level: An Umbrella Review of Empirical Evidence

2021 ◽  
Vol 18 (18) ◽  
pp. 9484
Author(s):  
Veronica Velasco ◽  
Paola Scattola ◽  
Laura Gavazzeni ◽  
Lara Marchesi ◽  
Ioana Elena Nita ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Local Level ◽  
Negative Consequences ◽  
Umbrella Review ◽  
Contextual Risk ◽  
Effective Strategies ◽  
Prisma Statement ◽  
Reduction Strategies ◽  
Meta Analyses ◽  
Risk Reduction Strategies

Concerns about negative consequences of gambling diffusion are increasing. Prevention and harm reduction strategies play a crucial role in reducing gambling supply and harms. This study aims to conduct an umbrella review of the effectiveness of gambling preventive and harm reduction strategies, which can be implemented at a local level and targeted at adults. It was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Sixteen reviews were analyzed, and 20 strategies were selected and classified in 4 areas with different targets and aims. Reducing the supply of gambling is an effective strategy both for the general population and for risky or problematic gamblers. Demand reduction interventions have been found to have limited effects but most of them are mainly focused on knowledge about risks and odds ratios. Risk reduction strategies aim to reduce contextual risk factors of the area where gambling is provided, change the gambling locations’ features, and modify individual behaviors while gambling. Smoking and alcohol bans or restrictions are considered one of the most effective strategies. Finally, harm reduction strategies targeted at problematic gamblers are potentially effective. Some relevant implementation conditions are identified and the results show inconsistent effects across different targets.

scholarly journals Measuring adulterants in street drugs: Implementation of drug residue testing using portable mass spectrometry in a Northeastern U.S. harm reduction program, 2019-2020

2021 ◽  
Author(s):  
Mathieu Boulad ◽  
Atsushi Matsumoto ◽  
Claudia Santelices ◽  
Thomas J. Stopka
Keyword(s):  
Harm Reduction ◽  
Mass Spectrometer ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Portable Devices ◽  
Portable Mass Spectrometer ◽  
Harm Reduction Intervention ◽  
Reduction Strategies ◽  
Drug Checking ◽  
Fentanyl Analogues

Abstract Background: Fatal opioid overdose deaths involving illicitly manufactured fentanyl continue to escalate in the U.S. Drug checking services, as a harm reduction intervention for people who use drugs, has gained support as an effective strategy to reduce fatal overdoses. We examined implementation of drug checking services using portable devices in a syringe services program in the Northeastern U.S. Methods: Trained staff collected trace drug specimens from used paraphernalia provided by participants who requested drug checking services. All the specimens were tested using a portable mass spectrometer and sub-samples were tested for the detection of fentanyl using fentanyl testing strips. We assessed characteristics of participants who used drug checking services, self-reported types of trace specimens of substances that participants reported providing for testing, the actual mass spectrometer test results of these specimens, and agreement of the mass spectrometer and fentanyl testing strips results in detection of fentanyl and fentanyl analogues. Results: Of 155 unique participants who provided demographic information, 59% identified as male and 74.1% as White, with a mean age of 37.7 years. Based on analysis of 396 specimens tested with the portable mass spectrometer, the most common single substance detected was fentanyl (37.7%), without a trace of heroin or other adulterants, followed by methamphetamine (18.2%), and cocaine (13.6%). Fentanyl and fentanyl analogues were detected in specimens provided by participants that were reported as heroin (60.8%), cocaine (11.1%), and methamphetamine (6.7%). We found modest agreement of testing results between the mass spectrometer and fentanyl testing strips. Conclusions: Use of drug checking services within syringe services programs is in its initial test stages. Knowledge about the contents of substances purchased, and conversations between syringe services program participants and staff, have the potential to facilitate informed decisions to decrease overdose risks through engagement in harm reduction strategies. Through analysis of newly implemented drug checking services, we noted participant characteristics and dissonance between participants’ reports of the trace drug specimens submitted for testing and the actual drugs and adulterants detected by mass spectrometer results, which has implications for overdose risk, highlighting opportunities for harm reduction responses.

scholarly journals Drug Checking as Strategy for Harm Reduction in Recreational Contests: Evaluation of Two Different Drug Analysis Methodologies

2021 ◽  
Vol 12 ◽  
Author(s):  
Martina Fregonese ◽  
Andrea Albino ◽  
Claudia Covino ◽  
Alessio Gili ◽  
Mauro Bacci ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Central Italy ◽  
Rapid Identification ◽  
Drug Analysis ◽  
Gas Chromatography Mass Spectrometry ◽  
Infrared Spectrometry ◽  
Colorimetric Test ◽  
Reduction Strategies ◽  
Drug Checking ◽  
Main Component

Introduction: Drug checking as a part of drug harm-reduction strategies represents an essential aspect of public health policies. It focuses on rapid identification of drugs that individuals intend to use during night events, in order to implement health-protective behaviors. Chemical drug analysis techniques vary considerably, from simple colorimetric reagents to advanced forensic methods such as gas chromatography/mass spectrometry (GC/MS).Materials and Methods: In 2019, drug-check services were offered at some night events in Umbria (Central Italy). One hundred and twenty attendees directly delivered unidentified substances to a harm-reduction worker, who collected a few milligrams of the substances on ceramic plates and added a drop of colorimetric reagent. Multiple reagents were used to increase the diagnostic capacity of a substance, which may react with a specific drug or a few drugs. Later, a fraction of the samples was analyzed by GC/MS. The concordance of the results obtained using these two methodologies and the intended behaviors of consumers after being informed of the test result was evaluated.Results: We analyzed 120 samples by colorimetric test: 32 MDMA, 25 ketamine, 10 amphetamine, 11 cocaine, 8 heroin, and 4 LSD samples. The results were inconclusive for 29 samples. The GS/MS analysis confirmed MDMA in 84%, ketamine in 78%, amphetamine in 91%, cocaine in 92%, heroin in 88%, and LSD in 100% of the samples. The results of samples with inconclusive results were as follows: 2, MDMA; 7, ketamine; 2, amphetamine; 2, cocaine; 2, heroin; 2, mephedrone; 6, mixes; 1, debris; and 5, adulterants as the main component. Twenty-one of 29 participants reported that they had no intention of consuming the unidentified substance.Discussion: The high percentage of individuals who claimed no intention of consuming the unidentified drugs indicates that drug checking is viable as a part of drug harm-reduction strategies. Overall, colorimetric reagents showed a good performance with regard to samples being unadulterated (LSD) or minimal in quantity, but failed to identify mixtures of substances and the adulterants present in them. Therefore, the use of more discriminatory on-site methods such as Raman or infrared spectrometry is strongly recommended.

Workplace Ostracism and Its Negative Outcomes

2016 ◽  
Vol 15 (4) ◽  
pp. 143-151 ◽  
Author(s):  
Xiaoming Zheng ◽  
Jun Yang ◽  
Hang-Yue Ngo ◽  
Xiao-Yu Liu ◽  
Wengjuan Jiao
Keyword(s):  
Affective Commitment ◽  
Psychological Capital ◽  
Intention To Leave ◽  
Future Research ◽  
Conservation Of Resources ◽  
Negative Consequences ◽  
Negative Outcomes ◽  
Workplace Ostracism ◽  
Using Data ◽  
The Relationship

Abstract. Workplace ostracism, conceived as to being ignored or excluded by others, has attracted the attention of researchers in recent years. One essential topic in this area is how to reduce or even eliminate the negative consequences of workplace ostracism. Based on conservation of resources (COR) theory, the current study assesses the relationship between workplace ostracism and its negative outcomes, as well as the moderating role played by psychological capital, using data collected from 256 employees in three companies in the northern part of China. The study yields two important findings: (1) workplace ostracism is positively related to intention to leave and (2) psychological capital moderates the effect of workplace ostracism on affective commitment and intention to leave. This paper concludes by discussing the implications of these findings for organizations and employees, along with recommendations for future research.

Sign in / Sign up

Export Citation Format

Share Document