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

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.

Author(s):  
Mark Lysyshyn ◽  
Mark Tyndall

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.


2021 ◽  
pp. 145507252098597
Author(s):  
Nina Kavita Heggen Bahl ◽  
Anne Signe Landheim ◽  
Hilde Eileen Nafstad ◽  
Rolv Mikkel Blakar ◽  
Morten A. Brodahl

Aim: The recent nationally implemented clinical pathways for the treatment of substance use problems in Norway require mapping and assessing of patients’ needs, challenges, and resources. However, there is a lack of tools for systematically mapping and assessing patients’ social situations and social networks as part of the national guidelines. The aim of this article is to present a tool developed to map and assess the patient’s social situation, and to propose approaches for promoting multiple psychological senses of community (MPSOC) through clinical pathways for treating substance use problems. Methods: The proposed tool and approaches are developed based on findings in a previous in-depth collaborative study of MPSOC and recovery among people with substance use problems who received help and services from Norwegian municipalities. Findings: The findings suggest that multiple communities (geographical, relational and ideal) and senses of communities (within and outside treatment) simultaneously can influence individual recovery processes from problematic substance use in both positive as well as negative ways. As such, these community dimensions are of central importance to include in mapping and assessing of patients’ social situations, as well as in the promotion of MPSOC through clinical pathways. Conclusions: The suggested tool and approaches can increase the likelihood of achieving key aims of the national clinical pathways. Most important, mapping, assessing and promoting MPSOC through clinical pathways may promote long-term recovery processes and positive recovery capital for persons with substance use problems.


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