scholarly journals Harm Reduction, Stigma and the Problem of Low Compassion Satisfaction:

2019 ◽  
Vol 3 (1) ◽  
pp. e8-e21 ◽  
Author(s):  
Stephanie Knaak ◽  
Romie Christie ◽  
Sue Mercer ◽  
Heather Stuart

Background & Objective: Canada is in the midst of an opioid crisis. Given the sheer magnitude of the crisis and escalating death toll, the mobilization of harm reduction interventions is an important priority. Currently, little is known about the role played by stigmatization, particularly in terms of how this may impact the endorsement and uptake of harm reduction strategies and initiatives among front-line providers. Materials & Methods: Opening Minds, the anti-stigma initiative of the Mental Health Commission of Canada, undertook a one-and-a-half-year research project to understand the qualities, characteristics, sources, consequences, and solutions to the problem of stigmatization on the front-lines of the opioid crisis. A qualitative key informant design was selected. Participants included various first responder and health provider groups, people with lived experience of opioid or other drug use, and people in key policy or programming roles. Eight focus groups were held across Canada, and 15 one-on-one key informant interviews were completed. Results: Analysis of focus group and key informant interviews revealed three main ways in which stigma shows up on the front lines of the opioid crisis among providers. These themes coalesced around a central main problem, that of low compassion satisfaction. Suggestions for how these concerns can be addressed were also identified. Conclusion: The findings from this research revealed several key ways that stigma ‘shows up’ in the experiences and perceptions of front-line providers and provide several promising avenues for combatting stigmatization related to opioid use and harm reduction. An important avenue for future research is to develop and elaborate on the theoretical connections between the concepts of stigmatization and compassion satisfaction as a way to better understanding the problem of stigmatization in helping environments.

2018 ◽  
Vol 15 (3) ◽  
pp. 255-258 ◽  
Author(s):  
Lauren Brinkley-Rubinstein ◽  
David Cloud ◽  
Ernest Drucker ◽  
Nickolas Zaller

Author(s):  
Sophie Favre ◽  
Hélène Richard-Lepouriel ◽  
Sophie Favre

Introduction: Bipolar disorder is characterized by recurrent episodes of depression and hypomania and is often associated with functional impairment even between mood episodes. A substantial proportion of patients experience inter-episode mood swings, making bipolar disorder a complex psychiatric disorder to manage. Patients’ perspectives can enhance clinical practice and research. The present study aimed to explore the impact of the bipolar disorder experience from a patient’s perspective to facilitate better understanding in clinical practice and future research. Method: We conducted a single case study with a key informant living with bipolar disorder (type I) for more than 20 years. The key informant constructed a chart of his mood disorder experiences. Subsequently, he commented on the chart and these comments were noted down by his therapist. Results: We present a chart of lived experience perception by a person living with bipolar disorder. The main axis was reality perception and it was related with mood, identity, and functioning. The comments on the chart provided a detailed and accurate description of a lived experience of functioning of bipolar disorder and its impact on a person’s life. Discussion: Globally, the experiences described by the key informant are consistent with previous literature. The principal finding was the meaning of the subjective experiences of reality perception, their relation with mood change, and impact on the person’s life. The perception of reality seems to be a key factor in the experience of bipolar mood swings. Not only did the disorder affect the self and the functioning, but at its extreme, reality “either did not matter or did not exist.” This feeling enhanced the sense of being disconnected from the world and the surroundings and led to the experience of extreme loneliness. Conclusion: The description in this study cannot be generalized, since it was conducted with only one subject. However, it provided a better insight into the detailed real-life experience that can be useful for clinicians treating persons living with bipolar disorder. Such descriptions obtained from a qualitative procedure can also be combined with quantitative data in patients' assessments and research. This study suggests that the experience of “disconnection” should be investigated further.


2019 ◽  
Vol 47 (1) ◽  
pp. 63-77
Author(s):  
Janine Chapman ◽  
Ann M. Roche ◽  
Victoria Kostadinov ◽  
Vinita Duraisingam ◽  
Sianne Hodge

Background: Workers with lived experience of problematic alcohol and other drug (AOD) use are increasingly recognized as integral to the AOD field. However, little is known about the prevalence or characteristics of AOD workers with lived experience across the general AOD workforce, in Australia or internationally. This study aimed to (1) investigate the prevalence of lived experience in AOD workers, (2) build an initial profile of workers with lived experience, (3) identify areas where appropriate support mechanisms may be warranted, and (4) generate recommendations for future work. Method: Nongovernment organization AOD workers from New South Wales, Australia, were invited to participate in a purpose-designed, online survey. Measures included demographic and workforce characteristics, work-related psychosocial factors, and health, quality of life, and AOD use. Descriptive analyses compared responses from workers with and without lived experience on key variables. Results: Two hundred and sixty-eight workers responded. Workers with lived experience comprised 43% of the sample; were more likely to be older; male; identify as lesbian, gay, homosexual, or queer; have lower salary; report discrimination in the workplace; abstain from alcohol; report opioid use; and experience less support outside work. Conclusion: This is the first Australian study to examine the profile of AOD workers with lived experience. Workers with lived experience constituted a substantial proportion of the AOD workforce. Analogous to other countries, comprehensive, appropriately tailored workforce development and support policies are required. Future research should build on these findings by extending to a broader population base, including government workers.


Author(s):  
Patrycja Michalska ◽  
Anne Chatton ◽  
Louise Penzenstadler ◽  
Paweł Izdebski ◽  
Emilien Jeannot ◽  
...  

Background: Internet gambling may increase rates of gambling harm. This current study aimed to assess Internet poker players’ views on various harm-reduction (HR) strategies. It also examined differences in these views according to the games played (poker only vs. poker plus other gambling activities), indebtedness, and problem gambling severity. Methods: Internet poker players (n = 311; 94.2% Male) recruited online between 2012 and 2014 were included in the analyses and completed a survey on indebtedness, problem gambling severity index, and ten statements regarding HR features. Results: Among the whole sample, the most frequently endorsed HR strategy was setting money limits, specialized online help, and peer support forums. People who play poker only (70%) are less prone to endorse the utility of information on excessive gambling and specialized healthcare centers. No differences were found between those people with debt versus those without regarding HR assessment. Participants with severe problem gambling were more skeptical about HR strategies based on information on specialized healthcare centers. Conclusion: Setting money limits, online help, and peer support forums are the most commonly endorsed strategies. Future research is needed to evaluate the effectiveness of online harm reduction strategies.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053207
Author(s):  
Nikki Bozinoff ◽  
Charlene Soobiah ◽  
Terri Rodak ◽  
Christine Bucago ◽  
Katie Kingston ◽  
...  

IntroductionBuprenorphine–naloxone is recommended as a first-line agent for the treatment of opioid use disorder. Although initiation of buprenorphine in the emergency department (ED) is evidence based, barriers to implementation persist. A comprehensive review and critical analysis of both facilitators of and barriers to buprenorphine initiation in ED has yet to be published. Our objectives are (1) to map the implementation of buprenorphine induction pathway literature and synthesise what we know about buprenorphine pathways in EDs and (2) to identify gaps in this literature with respect to barriers and facilitators of implementation.Methods and analysisWe will conduct a scoping review to comprehensively search the literature, map the evidence and identify gaps in knowledge. The review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols Extension for Scoping Reviews and guidance from the Joanna Briggs Institution for conduct of scoping reviews. We will search Medline, APA, PsycINFO, CINAHL, Embase and IBSS from 1995 to present and the search will be restricted to English and French language publications. Citations will be screened in Covidence by two trained reviewers. Discrepancies will be mediated by consensus. Data will be synthesised using a hybrid, inductive–deductive approach, informed by the Consolidated Framework for Implementation Research as well as critical theory to guide further interpretation.Ethics and disseminationThis review does not require ethics approval. A group of primary knowledge users, including clinicians and people with lived experience, will be involved in the dissemination of findings including publication in peer-reviewed journals. Results will inform future research, current quality improvement efforts in affiliated hospitals, and aide the creation of a more robust ED response to the escalating overdose crisis.


Author(s):  
Emilie R. Macleod ◽  
Iren Tajbakhsh ◽  
Sarah Hamilton-Wright ◽  
Nancy Laliberte ◽  
Jessica L. Wiese ◽  
...  

Abstract Background Amid increasing opioid overdose deaths in Canada since 2010 and a changing naloxone access landscape, there is a need for up-to-date research on Canadian women’s experiences with opioids. Studies on Canadian take-home naloxone programs are promising, but research beyond these programs is limited. Our study is the first to focus on women’s experiences and perspectives on the opioid crisis in Ontario, Canada’s most populous province, since the opioid crisis began in 2010. Objective Our objective was to address research knowledge gaps involving Canadian women with criminal justice involvement who use opioids, and identify flaws in current policies, responses, and practices. While the opioid overdose crisis persists, this lack of research inhibits our ability to determine whether overdose prevention efforts, especially involving naloxone, are meeting their needs. Methods We conducted semi-structured, qualitative interviews from January to April 2018 with 10 women with experience of opioid use. They were recruited through the study’s community partner in Toronto. Participants provided demographic information, experiences with opioids and naloxone, and their perceptions of the Canadian government’s responses to the opioid crisis. Interviews were transcribed verbatim and inductive thematic analysis was conducted to determine major themes within the data. Results Thematic analysis identified seven major concerns despite significant differences in participant life and opioid use experiences. Participants who had used illicit opioids since naloxone became available over-the-counter in 2016 were much more knowledgeable about naloxone than participants who had only used opioids prior to 2016. The portability, dosage form, and effects of naloxone are important considerations for women who use opioids. Social alienation, violence, and isolation affect the wellbeing of women who use opioids. The Canadian government’s response to the opioid crisis was perceived as inadequate. Participants demonstrated differing needs and views on ideal harm reduction approaches, despite facing similar structural issues surrounding stigma, addiction management, and housing. Conclusions Participants experienced with naloxone use found it to be useful in preventing fatal overdose, however many of their needs with regards to physical, mental, and social health, housing, harm reduction, and access to opioid treatment remained unmet.


2019 ◽  
Vol 32 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Heather Stuart

Substance use stigma makes it difficult to reframe the opioid crisis as a public health issue and has been a barrier to accessing life-saving treatments. Interventions using people that convey recovery stories are promising practices. Groups that may benefit from targeted stigma reduction interventions include opioid users (to combat shame and blame), at-risk youth, first responders, dispensary personal, media, and healthcare professionals. The evidence supporting antistigma interventions is thin, with little Canadian research. Research is needed to establish the effectiveness of substance-related stigma reduction strategies. Health leaders should examine their own responsibilities to lead the public health debate, reduce opioid-related stigma, and actively engage members of the community of those with lived experience to become partners in these activities.


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