Harm reduction in Finnish drug policy: conceptual problems and contradictions

2002 ◽  
Vol 19 (4) ◽  
pp. 239-248
Author(s):  
Toivo Hurme
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Harm Reduction ◽  
Drug Policy ◽  
Drug Users ◽  
Social Research ◽  
Policy Research ◽  
General Strategy ◽  
Public Health Perspective ◽  
Wide Range

The article discusses the use of the term “harm reduction” in Finland's contemporary drug policy. The focus is not on the meaning of the term, but rather on its actual use, on how “harm reduction” has been put into play in the governing of the drug question and what is done and has been claimed in the name of “harm reduction”. This brings to light the problems and contradictions that arise if “harm reduction” is taken as a standpoint for policy making or as an analytical tool for drug policy research. The paper reviews different connections and situations where “harm reduction” has been defined or used as an argument for general or specific goals and interventions. Harm reduction is often seen as a general strategy for national drug policy, as opposed to the traditional repressive and punitive strategy. On the other hand, it is also represented as pragmatic, reactive and situational work without general ideals or principles challenging repressive politics. Two main perspectives can be distinguished in the discussion on harm reduction: the human rights perspective and the public health perspective. From a human rights perspective harm reduction is advocated by stressing the rights and equality of drug users. The focus is on the harms that the strict policy of control is causing to abusers. Harm reduction from a public health perspective stresses the harms that drug abuse causes to the nation's population, such as HIV, accidents etc. On the side of these main trends, there are however a wide range of practices which are represented in the name of “harm reduction”, among these tighter police control and surveillance to efface the nuisance problems. The article concludes that in Finland, “harm reduction” is neither a coherent political approach to the drug question nor an exact concept for analytical social research. It is rather a slogan that is used in very different occasions by various political agents as an argument for different interventions, aiming for ideals and goals that might easily contradict each other.

The neoliberal governance of heroin and opioid users in Philadelphia city

2021 ◽  
pp. 174165902199119
Author(s):  
Philip R Kavanaugh ◽  
Jennifer L Schally
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Drug Users ◽  
Policy Documents ◽  
Media Portrayals ◽  
Neoliberal Governance ◽  
Public Nuisance ◽  
Fiscal Austerity ◽  
Opioid Users ◽  
Governmental Response

Drawing on 147 news accounts and five policy documents on the heroin and opioid crisis in Philadelphia, Pennsylvania published between 2016 and 2018, our analysis highlights how media portrayals of opioid users as both tragic victims and public nuisance prompted a schizoid governmental response that draws on rhetorics of treatment and harm reduction to legitimate more punitive interventions. By describing how the state’s quasi-medical responsibilization strategy devolved to fold criminalization into its broader response, we argue the effort to wage a kinder/gentler war on overdose invests in familiar tropes of a recalcitrant drug user class that is a threat to public health. In doing so we provide a basis to critique how drug users are governed in this time of fiscal austerity, resource hoarding, and perpetual, continually evolving drug crises.

Narcan as biomedical panic: The war on overdose and the harms of harm reduction

2020 ◽  
pp. 136248062096477
Author(s):  
Philip R Kavanaugh
Keyword(s):  
Public Health ◽  
Drug Treatment ◽  
Harm Reduction ◽  
Drug Users ◽  
Opioid Addiction ◽  
The State ◽  
Opioid Overdose ◽  
State Response ◽  
Drug Companies ◽  
The Us

As the opioid overdose crisis in the US persists, governments have coordinated with drug companies to propagate the overdose reversal drug naloxone (Narcan) as a ‘kinder/gentler’ state response, deriving from a supposedly progressive harm reduction ethos. Drawing on Derrida’s deconstruction of pharmakon, I show how Narcan is rendered paradoxical and terminal, diverting attention from the structural antecedents of opioid addiction and resources for drug treatment while reproducing corporeal suffering in those revived. I further highlight how Narcan is positioned in a wider array of regressive governing practices that legitimate the state’s punitive drug war and demonization of drug users. Narcan thus provides a useful opening between the state and contemporary biomedicine to theorize how harm reduction and public health unfurl in insidious and corrosive ways.

Harm reduction, human rights and public health

2009 ◽  
pp. 499-523
Author(s):  
Chris Beyrer ◽  
Susan G. Sherman ◽  
Stefan Baral
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Harm Reduction

scholarly journals Slipping through: mobility’s influence on infectious disease risks for justice-involved women in Canada

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Susie Taylor ◽  
Margaret Haworth-Brockman ◽  
Yoav Keynan
Keyword(s):  
Public Health ◽  
Substance Use ◽  
Harm Reduction ◽  
Partner Violence ◽  
Disease Risk ◽  
Health Planning ◽  
Incarcerated Women ◽  
Public Health Perspective ◽  
Sexually Transmitted ◽  
Gender Based

Abstract Background The relationship between incarceration and women’s vulnerability to sexually transmitted and blood-borne infections (STBBI) is understudied in Canada, despite numerous studies showing that justice-involved women experience very high rates of infection. Justice-involved women in Canada are highly mobile, as a result of high rates of incarceration and extremely short sentences. From a public health perspective, it is productive to understand how the mobility of justice-involved women shapes their vulnerability to STBBI. Results This narrative review demonstrates that mobility between incarceration facilities and communities drives sexually transmitted and blood-borne disease risk for justice-involved women in Canada. Associations and interactions between epidemics of gender-based and intimate partner violence, substance use, and STBBIs shape the experiences of justice-involved women in Canada. In correctional facilities, the pre-existing vulnerability of justice-involved women is compounded by a lack of comprehensive STBBI care and limited harm reduction services. On release, unstable housing, disruptions to social support networks, interruptions in medical care, and relapse to or continuation of substance use, significantly increase individual disease risk and the likelihood of community transmission. High rates of incarceration for short periods perpetuate this cycle and complicate the delivery of healthcare. Conclusions The review provides evidence of the need for stronger gender-transformative public health planning and responses for incarcerated women, in both federal and provincial corrections settings in Canada. A supportive, evidence-based approach to STBBI identification and treatment for incarcerated women - one that that removes stigma, maintains privacy and improves access, combined with structural policies to prevent incarceration - could decrease STBBI incidence and interrupt the cycle of incarceration and poor health outcomes. A coordinated and accountable program of reintegration that facilitates continuity of public health interventions for STBBI, as well as safe housing, harm reduction and other supports, can improve outcomes as well. Lastly, metrics to measure performance of STBBI management during incarceration and upon release would help to identify gaps and improve outcomes for justice-involved women in the Canadian context.

A tale of two epidemics: drugs harm reduction and tobacco harm reduction in the United Kingdom

2016 ◽  
Vol 16 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Gerry V. Stimson
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Tobacco Harm Reduction ◽  
Public Health Response ◽  
Content Type ◽  
Drug Of Choice ◽  
The United Kingdom ◽  
Health Response ◽  
Wide Range ◽  
Hiv Aids

Purpose The purpose of this paper is to compare the response to HIV/AIDS and drug use (drugs harm reduction) with tobacco harm reduction. Design/methodology/approach Analysis of historical and contemporary sources, combined with personal knowledge of key stakeholders in the history and development of both fields. Findings Both drugs harm reduction and tobacco harm reduction share a similar objective – to reduce health risks for people who are unwilling or unable to stop using their drug of choice. Both also share a broader public health aim of helping people to make healthier decisions. Drugs harm reduction – as a response to HIV/AIDS – included the adoption of a wide range of radical harm reduction interventions and was a public health success. It became an established part of the professional Public Health agenda. In contrast the Public Health response to e-cigarettes and tobacco harm reduction has ranged from the negative to the cautious. A recent Public Health England report is exceptional for its endorsement of e-cigarettes. Originality/value Highlights contradictions in Public Health responses to drugs and tobacco; and that public health interventions can be implemented without and despite the contribution of professional Public Health.

Social Media Use in Emergency Response to Natural Disasters: A Systematic Review With a Public Health Perspective

2020 ◽  
Vol 14 (1) ◽  
pp. 139-149 ◽  
Author(s):  
Kamalich Muniz-Rodriguez ◽  
Sylvia K. Ofori ◽  
Lauren C. Bayliss ◽  
Jessica S. Schwind ◽  
Kadiatou Diallo ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Social Media ◽  
Natural Disasters ◽  
Natural Disaster ◽  
Media Use ◽  
Media Analysis ◽  
Social Media Use ◽  
Public Health Perspective ◽  
Wide Range

ABSTRACTSocial media research during natural disasters has been presented as a tool to guide response and relief efforts in the disciplines of geography and computer sciences. This systematic review highlights the public health implications of social media use in the response phase of the emergency, assessing (1) how social media can improve the dissemination of emergency warning and response information during and after a natural disaster, and (2) how social media can help identify physical, medical, functional, and emotional needs after a natural disaster. We surveyed the literature using 3 databases and included 44 research articles. We found that analyses of social media data were performed using a wide range of spatiotemporal scales. Social media platforms were identified as broadcasting tools presenting an opportunity for public health agencies to share emergency warnings. Social media was used as a tool to identify areas in need of relief operations or medical assistance by using self-reported location, with map development as a common method to visualize data. In retrospective analyses, social media analysis showed promise as an opportunity to reduce the time of response and to identify the individuals’ location. Further research for misinformation and rumor control using social media is needed.

scholarly journals Heterosexual Transmission of Hepatitis B virus: A Public Health Perspective

1991 ◽  
Vol 2 (suppl a) ◽  
pp. 23-26
Author(s):  
Jean Robert
Keyword(s):  
Public Health ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Disease Transmission ◽  
Drug Users ◽  
Cost Effective ◽  
Heterosexual Transmission ◽  
Public Health Perspective ◽  
Modes Of Transmission ◽  
B Virus

Given the objectives of the medical aspects of public health, the 'heterosexual transmission' approach may be restrictive and too conventional as it considers transmission only through two individuals of different sexes and only by peno-vaginal penetration, to the exclusion of all other sexual activities. Bloodborne disease transmission in intravenous drug users must be considered as well as anal transmission of this disease. Three sine qua non conditions must be met before public health interventions are initiated: the disease agent must be known or presumed; a causal relationship must exist between the agent and disease; and the proposed intervention must be both pertinent and effective. The first two conditions have been established in the case of hepatitis B virus infection. The latter condition, however, has proven difficult to fulfill. It must be determined whether the approach of immunizing all infants, drug addicts and prostitutes is cost effective and accepted by a moral society. Consideration must be given to all possible modes of transmission in order to develop an effective public health strategy to combat hepatitis B.

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