scholarly journals HaRePo (Harm Reduction by Post): An innovative and effective harm reduction program for people who use drugs using email, telephone and post-service.

2020 ◽  
Author(s):  
Magally Torres Leguizamon ◽  
Emmanuel G. Reynaud ◽  
Thomas Néfau ◽  
Catherine Duplessy
Keyword(s):  
Harm Reduction ◽  
Customer Service ◽  
Positive Feedback ◽  
Feedback Loop ◽  
Online Communication ◽  
People Who Use Drugs ◽  
Postal Service ◽  
Harm Reduction Program ◽  
Health Authorities ◽  
Overseas Territories

Abstract Background: Despite multiple Harm Reduction (HR) programs worldwide, there are still an important number of people who use drugs (PWUD) who do not access those services. Their difficulties to obtain HR tools are due to their inability to reach such services (remoteness and/or limited customer service hours), costs, quantitative restrictions, fear of judgment, lack of confidentiality in pharmacy and unfamiliarity with HR programs. We tested an innovative approach using the power of remote online communication and the national postal distribution network to improve HR tools access and counselling. Methods: Based on these observations, SAFE association created HaRePo in 2011, a free and confidential program designed for people who have difficulties accessing HR tools and counselling. PWUD can access the program by phone and/or email. An HR professional delivers HR counselling, HR tools and connects PWUD to other HR services, medical, and social workers. HR tools are prepared and sent according to the person’s needs through the French postal service to consumers across Metropolitan France and overseas territories. Results: Since 2011, 1920 PWUD have benefited from HaRePo: 10,450 parcels were sent accounting for more than 1.7 million syringes and 6 million HR related items. HaRePo receives positive feedback from PWUD who have improved their practices through remote but trusted communication. The percentage of people that, after joining the program, never reuse and/or share HR tools have significantly increased. On average 71.5% of beneficiaries never reuse syringes and 81% do not reuse needles. And they are 98.5% consumers who never share syringes and 99% needles any longer. Between 44% and 80% HaRePo beneficiaries have reported that their drug-related practices (injection, inhalation and snorting) are now safer. Finally, between 39% and 53% HaRePo consumers declared that their overall physical state has improved (e.g., venous condition, the appearance of point of injection, swelling of arms, legs, and hands). Conclusion: HaRePo is an innovative HR program efficient for hard-to-reach PWUD. It shows evidence of a positive feedback loop for PWUD in improving their practices. Finally, HaRePo represents a clear benefit for health authorities in France, who decided to expand the program in 2016.

scholarly journals HaRePo (Harm Reduction by Post): An Innovative and Effective Harm Reduction Program for People Who Use Drugs Using Email, Telephone and Post-Service.

2020 ◽  
Author(s):  
Magally Torres Leguizamon ◽  
Emmanuel G. Reynaud ◽  
Thomas Néfau ◽  
Catherine Duplessy
Keyword(s):  
Harm Reduction ◽  
Customer Service ◽  
Positive Feedback ◽  
Feedback Loop ◽  
Online Communication ◽  
People Who Use Drugs ◽  
Postal Service ◽  
Harm Reduction Program ◽  
Health Authorities ◽  
Overseas Territories

Abstract BackgroundDespite multiple Harm Reduction (HR) programs worldwide, there are still an important number of people who use drugs (PWUD) who do not access those services. Their difficulties to obtain HR tools are due to their inability to reach such services (remoteness and/or limited customer service hours), costs, quantitative restrictions, fear of judgment, lack of confidentiality in pharmacy and unfamiliarity with HR programs. We tested an innovative approach using the power of remote online communication and the national postal distribution network to improve HR tools access and counselling.MethodsBased on these observations, SAFE association created HaRePo in 2011, a free and confidential program designed for people who have difficulties accessing HR tools and counselling. PWUD can access the program by phone and/or email. An HR professional answers any questions, delivers HR counselling, and connects the PWUD to other HR services, medical, and social workers. HR tools are prepared and sent according to the person’s needs through the French postal service to users across Metropolitan France and overseas territories.ResultsSince 2011, 1920 PWUD have benefited from HaRePo: 10,450 parcels were sent accounting for more than 1.7 million syringes and 6 million HR related items. HaRePo receives positive feedback from PWUD who have improved their practices through remote but trusted communication. The percentage of people that, after joining the program, never reuse and/or share HR tools have significantly increased. On average 71.5% of beneficiaries never reuse syringes and 81% do not reuse needles. And they are 98.5% users who never share syringes and 99% needles any longer. Between 44% and 80% HaRePo beneficiaries have reported that their drug-related practices (injection, inhalation and snorting) are now safer. Finally, between 39% and 53% HaRePo users declared that their overall physical state has improved (e.g., venous condition, the appearance of point of injection, swelling of arms, legs, and hands).ConclusionHaRePo is an innovative HR program efficient for hard-to-reach PWUD. It shows evidence of a positive feedback loop for PWUD in improving their practices. Finally, HaRePo represents a clear benefit for health authorities in France, who decided to expand the program in 2016.

scholarly journals Helping Behavior among People Who Use Drugs: Altruism and Mutual Aid in a Harm Reduction Program

2021 ◽  
Author(s):  
Geoff Bathje ◽  
Daniel Pillersdorf ◽  
Laura Kacere ◽  
Dan Bigg
Keyword(s):  
Harm Reduction ◽  
Life Experiences ◽  
Helping Behavior ◽  
People Who Use Drugs ◽  
Mutual Aid ◽  
Harm Reduction Program ◽  
Helping Others ◽  
Reduction Program ◽  
Shared Stories ◽  
Helping Behaviour

People who use drugs, and particularly people experiencing addiction, are rarely afforded the opportunity to have their voices heard when it comes to drug treatment or drug policy or even when attempting to define themselves and their life experiences. Of course, there is much more to a person than one area of their behaviour. The current study seeks to capture and understand the lived experiences of people who use drugs, with a focus on their relationships and helping behaviour. We interviewed 32 participants in a harm reduction program seeking to provide understanding beyond stigmatizing and criminalizing drug narratives, by exploring their motivation and context for helping behav- iours. Grounded theory methodology was used to under- stand the patterns of helping behaviour, along with the contexts in which help is or is not given. We particularly focus on participants' distribution of syringes and carrying medicine to reverse overdose (naloxone). Participants shared stories of altruism and mutual aid, along with barriers and disincentives to helping others. We situate these behaviours within contrasting environments of a free harm reduction program and the competitive market system of the U.S. society. Implications for practice and public pol- icy are discussed.

scholarly journals LncRNA MIR17HG promotes colorectal cancer liver metastasis by mediating a glycolysis-associated positive feedback circuit

Oncogene ◽  
2021 ◽  
Author(s):  
Senlin Zhao ◽  
Bingjie Guan ◽  
Yushuai Mi ◽  
Debing Shi ◽  
Ping Wei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Positive Feedback ◽  
Feedback Loop ◽  
Metastatic Tumor ◽  
Feedback Circuit ◽  
Colorectal Cancer Liver Metastasis ◽  
Positive Feedback Circuit

AbstractGlycolysis plays a crucial role in reprogramming the metastatic tumor microenvironment. A series of lncRNAs have been identified to function as oncogenic molecules by regulating glycolysis. However, the roles of glycolysis-related lncRNAs in regulating colorectal cancer liver metastasis (CRLM) remain poorly understood. In the present study, the expression of the glycolysis-related lncRNA MIR17HG gradually increased from adjacent normal to CRC to the paired liver metastatic tissues, and high MIR17HG expression predicted poor survival, especially in patients with liver metastasis. Functionally, MIR17HG promoted glycolysis in CRC cells and enhanced their invasion and liver metastasis in vitro and in vivo. Mechanistically, MIR17HG functioned as a ceRNA to regulate HK1 expression by sponging miR-138-5p, resulting in glycolysis in CRC cells and leading to their invasion and liver metastasis. More interestingly, lactate accumulated via glycolysis activated the p38/Elk-1 signaling pathway to promote the transcriptional expression of MIR17HG in CRC cells, forming a positive feedback loop, which eventually resulted in persistent glycolysis and the invasion and liver metastasis of CRC cells. In conclusion, the present study indicates that the lactate-responsive lncRNA MIR17HG, acting as a ceRNA, promotes CRLM through a glycolysis-mediated positive feedback circuit and might be a novel biomarker and therapeutic target for CRLM.

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