scholarly journals The impact of the COVID-19 pandemic on harm reduction services in Spain

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Camila A. Picchio ◽  
Jorge Valencia ◽  
Jason Doran ◽  
Tracy Swan ◽  
Marta Pastor ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Harm Reduction ◽  
Social Services ◽  
Methadone Maintenance ◽  
The State ◽  
People Who Use Drugs ◽  
Service Users ◽  
Cross Sectional ◽  
The Impact ◽  
Disease Testing

Abstract Background Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain. Methods This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers. Results All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for 2 months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses, human immunodeficiency virus, and tuberculosis) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm. Conclusion Overall, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment such as methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy.

scholarly journals The impact of the COVID-19 pandemic on harm reduction services in Spain

2020 ◽  
Author(s):  
Camila A Picchio ◽  
Jorge Valencia ◽  
Jason Doran ◽  
Tracy Swan ◽  
Marta Pastor ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Harm Reduction ◽  
Social Services ◽  
Methadone Maintenance ◽  
The State ◽  
People Who Use Drugs ◽  
Service Users ◽  
Cross Sectional ◽  
The Impact ◽  
Disease Testing

Abstract Background: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain.Methods: This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers.Results: All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for two months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses [HBV, HCV], human immunodeficiency virus (HIV), and tuberculosis [TB]) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm.Conclusion: Overall, like other European countries, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment (methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy).

scholarly journals The impact of the COVID-19 pandemic on harm reduction services in Spain

2020 ◽  
Author(s):  
Camila A Picchio ◽  
Jorge Valencia ◽  
Jason Doran ◽  
Tracy Swan ◽  
Marta Pastor ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Harm Reduction ◽  
Social Services ◽  
Methadone Maintenance ◽  
The State ◽  
People Who Use Drugs ◽  
Service Users ◽  
Cross Sectional ◽  
The Impact ◽  
Disease Testing

Abstract Background: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain. Methods: This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers.Results: All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for two months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses [HBV, HCV], human immunodeficiency virus (HIV), and tuberculosis [TB]) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm.Conclusion: Overall, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment such as methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy.

Radical Hope

2020 ◽  
Author(s):  
Michal Krumer-Nevo
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Social Services ◽  
Work Practice ◽  
Social Work Practice ◽  
Service Users ◽  
Critical Social Work ◽  
Close Relationship ◽  
The Rich ◽  
The Impact

This book describes the new Poverty-Aware Paradigm (PAP), which was developed in Israel through intense involvement with the field of social work in various initiatives. The paradigm was adopted in 2014 by the Israeli Ministry of Welfare and Social Services as a leading paradigm for social workers in social services departments. The book draws from the rich experience of the implementation of the PAP in practice and connects examples of practice to theoretical ideas from radical/critical social work, critical poverty knowledge, and psychoanalysis. The PAP addresses poverty as a violation of human rights and emphasizes people’s ongoing efforts to resist poverty. In order to recognize these sometimes minor acts of resistance and advance their impact, social workers should establish close relationship with service users and stand by them. The book proposes combining relationship-based practice and rights-based practice as a means of bridging the gap between the emotional and material needs of service users. In addition to introducing the main concepts of the PAP, the book also contributes to the debate between conservative and cultural theories of poverty and structural theories, emphasizing the impact of a critical framework on this debate. The book consists of four parts. The first, “Transformation”, addresses the transformational nature of the paradigm. The second, “Recognition”, is based on current psychoanalytic developments and “translates” them into social work practice in order to deepen our understanding of relationship-based practice. The third, “Rights”, describes rights-based practice. The fourth, “Solidarity”, presents various ways in which solidarity might shape social workers’ practice. The book seeks to reaffirm social work’s core commitment to combating poverty and furthering social justice and to offer a solid theoretical conceptualization that is also eminently practical.

Impact of Tabletop Exercises on Participants’ Knowledge of and Confidence in Legal Authorities for Infectious Disease Emergencies

2009 ◽  
Vol 3 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Elena Savoia ◽  
Paul D. Biddinger ◽  
Priscilla Fox ◽  
Donna E. Levin ◽  
Lisa Stone ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
The State ◽  
System Level ◽  
Legal Issue ◽  
Fisher Exact Test ◽  
Public Health Preparedness ◽  
Level Of Confidence ◽  
Policies And Procedures ◽  
The Impact

ABSTRACTObjective: Legal preparedness is a critical component of comprehensive public health preparedness for public health emergencies. The scope of this study was to assess the usefulness of combining didactic sessions with a tabletop exercise as educational tools in legal preparedness, to assess the impact of the exercise on the participants’ level of confidence about the legal preparedness of a public health system, and to identify legal issue areas in need of further improvement.Methods: The exercise scenario and the pre- and postexercise evaluation were designed to assess knowledge gained and level of confidence in declaration of emergencies, isolation and quarantine, restrictions (including curfew) on the movement of people, closure of public places, and mass prophylaxis, and to identify legal preparedness areas most in need of further improvement at the system level. Fisher exact test and paired t test were performed to compare pre- and postexercise results.Results: Our analysis shows that a combination of didactic teaching and experiential learning through a tabletop exercise regarding legal preparedness for infectious disease emergencies can be effective in both imparting perceived knowledge to participants and gathering information about sufficiency of authorities and existence of gaps.Conclusions: The exercise provided a valuable forum to judge the adequacy of legal authorities, policies, and procedures for dealing with pandemic influenza at the state and local levels in Massachusetts. In general, participants were more confident about the availability and sufficiency of legal authorities than they were about policies and procedures for implementing them. Participants were also more likely to report the need for improvement in authorities, policies, and procedures in the private sector and at the local level than at the state level. (Disaster Med Public Health Preparedness. 2009;3:104–110)

scholarly journals The Effectiveness of Low-investment Pachinko/pachislot in Reducing Gambling-related Harms: A Cross Sectional Study

2021 ◽  
Author(s):  
Kengo Yokomitsu ◽  
Kazuya Inoue ◽  
Tomonari Irie
Keyword(s):  
Harm Reduction ◽  
Gambling Disorder ◽  
Cross Sectional Study ◽  
Cognitive Distortion ◽  
Normal Amount ◽  
Harm Minimization ◽  
Cross Sectional ◽  
Work Related ◽  
Gambling Severity ◽  
The Impact

Abstract Background: Pachinko and pachislot are popular types of gambling activities in Japan. Prior studies in Japan have reported a concerning prevalence of gambling disorder among university students and adult players. While these studies have identified various gambling-related harms, Japanese research on harm-minimization strategies is scarce. Therefore, the present study aimed to analyze the effectiveness of low-investment pachinko and pachislot as a harm-reduction strategy. Methods: We also called gamblers who played for the normal amount as “normal-pachi players,” those who played pachinko and pachislot for half of the normal amount were called “half-pachi players,” and those who played for a quarter of the normal amount were called “quarter-pachi players.” To assess the effect of harm reduction, a one-way ANCOVA was conducted to compare the impact of the groups (normal-pachi players [n= 101], half-pachi players [n= 104], and quarter-pachi players [n= 100]) on dependent variables, namely the number of days players had gambled during the prior month, the total time and amount of money spent on gambling, debts caused by gambling, gambling severity, cognitive distortion, depressive symptoms, and disability. Results: We demonstrated that the amount of money spent by quarter-pachi players on gambling during the past month was lower than that of normal-pachi players. However, we did not find significant differences with respect to any other gambling-related harms among normal-, half-, and quarter-pachi players. Conclusion: Low-investment pachinko and pachislot can reduce the amount of money spent on gambling. It can thus partly act as a harm-minimization strategy. Moreover, the results of present study indicate that the level of disability at work affects various outcomes for gamblers. Given that 90% of the participants in this study were employed, the results of this study may have important implications for employed gamblers. Interventions should be devised to reduce work-related disabilities among employed adults with a gambling disorder.

The “Drugs-Crime Nexus”

2018 ◽  
Author(s):  
Dominique de Andrade
Keyword(s):  
At Risk ◽  
Drug Use ◽  
Harm Reduction ◽  
Good Evidence ◽  
People Who Use Drugs ◽  
Correctional Institutions ◽  
Reduction Strategies ◽  
At Risk Populations ◽  
Prison Populations ◽  
The Impact

The prioritization of imprisonment as a response to drug use in many countries has led to growing prison populations, with little impact on drug use, drug-related harm, or drug-related crime. There is increased international debate around how to best manage and respond to at-risk populations, with good evidence to suggest that embracing harm reduction strategies in the community and in prison can lead to reduced rates of imprisonment, infectious disease, and other preventable harms. Despite this, evidence-based treatment and harm reduction programs have largely failed to penetrate the walls of correctional institutions in most countries. This chapter provides an overview of major drug groups and explores the impact of drug policy on international imprisonment rates, and the diversity of responses to people who use drugs in the community and prison. The potential for corrections to play a significant therapeutic role in addressing the urgent treatment and harm reduction needs of at-risk, drug-using populations in prison and during their transition back to the community is highlighted.

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.

scholarly journals Communal latrine utilization and associated factors in Addis Ababa, Ethiopia: a community-based cross-sectional study

2018 ◽  
Vol 8 (2) ◽  
pp. 319-324 ◽  
Author(s):  
Elzabeth Girma Kefeni ◽  
Walelegn Worku Yallew
Keyword(s):  
Population Growth ◽  
Social Services ◽  
Addis Ababa ◽  
Behavioural Change ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
The Impact

Abstract Despite the quick urban population growth increased volume of wastes, including human excreta, which demands an expanded need of infrastructure, solid institutional setup and communities' engagement for management of safe disposal of excreta, arrangement of such basic social services has not developed as per the rate of population growth. Mostly, communal latrines are inclined towards an absence of cleanliness, as they accommodate many people beyond their capacity, filling up septic tanks quickly. A community-based cross-sectional study conducted in 817 randomly selected communal latrine user households, five focus group discussions and four key informant interviews were analysed. Bivariate and multivariate logistic regression analysis was performed to discover the impact of different factors on the use of communal latrines. The findings revealed that the rate of communal latrine use in Addis Ababa was about 79.8%. Unhygienic conditions, latrine emptying challenges, extreme smell, number of family units sharing the same squats, and latrine designs for the aged and children were identified as barriers to latrine utilization. This study suggests that, in parallel with the continued investments to increase access to sanitary facilities in the city, the management and behavioural change part has likewise to be stressed for better use and sustainability.

scholarly journals Non-beverage alcohol consumption among individuals experiencing chronic homelessness in Edmonton, Canada: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jean Nicolas Westenberg ◽  
Mostafa Mamdouh Kamel ◽  
Sindi Addorisio ◽  
Mohammad Abusamak ◽  
James S. H. Wong ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Harm Reduction ◽  
Social Services ◽  
Specific Treatment ◽  
Skills Training ◽  
Cross Sectional Study ◽  
Structural Barriers ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background Among individuals experiencing homelessness, the prevalence of alcohol use disorder is extremely high. Alcohol-related harms are compounded by the use of non-beverage alcohol (NBA; e.g. rubbing alcohol, cooking wine). The dangers of NBA consumption pose significant risks to the individual and to others when consumed in large quantities and when mixed with other substances. The objectives of this paper are to describe the alcohol consumption patterns of individuals experiencing homelessness, identify substance use patterns, psychological stressors, and related harms associated with NBA consumption, and compare NBA consumers to non-NBA consumers in relation to their use of services and perceived barriers to care. Methods Using a cross-sectional survey, 150 individuals experiencing homelessness were recruited from Edmonton’s inner city and adjoining areas. Frequency, quantity, and volume of alcohol consumption were used to assess patterns of alcohol use in the last 6 months. Descriptive statistics and bivariate analyses were used to compare participants reporting NBA consumption and non-NBA consumption (p ≤ 0.05). Results The majority of participants were male (71.3%) and self-identified as Indigenous (74.0%). Overall, 24% (n = 36) reported NBA consumption within the last six months. NBA consumers were older than non-NBA consumers (p = 0.005), reported different perceived living stability (p = 0.022), and had higher psychological distress (p = 0.038). The majority of NBA consumers reported not receiving harm reduction services while also not needing such services (n = 18, 51.4%), which differed from non-NBA consumers (p = 0.003). Structural barriers (e.g. availability, location, cost) were most frequently reported as reasons for unmet harm reduction (60.9%) and hospital care (58.3%) needs, while barriers to skills training (58.5%) and counselling services (53.6%) were mostly motivational (e.g. personal beliefs). Conclusions Within such an already marginalized population experiencing homelessness, individuals who consume NBA represent a vulnerable subpopulation who require adapted and distinct health and social services to stabilize and recover. Current harm reduction services are not prepared to effectively assist this group of individuals, and specific treatment programs are rare. Managed alcohol programs are a feasible approach but must be tailored to the specific needs of those who consume NBA, which is especially important for Indigenous people. More comprehensive assessments of NBA consumption are needed for program development and policy recommendations.

Sign in / Sign up

Export Citation Format

Share Document