Harm reduction at the crossroads and the rediscovery of drug user abstinence

2012 ◽  
Vol 19 (4) ◽  
pp. 276-283 ◽  
Author(s):  
Neil McKeganey
Keyword(s):  
Harm Reduction ◽  
Drug User

scholarly journals Online drug user-led harm reduction in Hungary: a review of “Daath”

2013 ◽  
Vol 10 (1) ◽  
pp. 18 ◽  
Author(s):  
Levente Móró ◽  
József Rácz
Keyword(s):  
Harm Reduction ◽  
Drug User

Harm reduction in Italy: the experience of an unsanctioned supervised injection facility run by drug users

2019 ◽  
Vol 19 (2) ◽  
pp. 59-71 ◽  
Author(s):  
Sonia Bergamo ◽  
Giuseppe Parisi ◽  
Paolo Jarre
Keyword(s):  
Harm Reduction ◽  
Drug User ◽  
Drug Users ◽  
Legal Status ◽  
Professional Staff ◽  
Point Of View ◽  
Overdose Death ◽  
Content Type ◽  
Direct Support ◽  
Practical Implications

Purpose Efforts to establish harm reduction interventions in Italy have persisted since the mid-1990s. Despite this, no sanctioned SIF has ever been implemented. The purpose of this paper is to provide information about a 10 year unsanctioned drug user-run SIF experience in Italy called Stanzetta. Design/methodology/approach The aim of the paper is to assess how Stanzetta met its objectives. Analysis was conducted compiling narrative accounts from the staff working in the NSP, which is adjacent to the Stanzetta, and conducting a simple frequency analysis of the available statistical data. Findings The Stanzetta unsanctioned SIF has been running for ten years and continues to be vulnerable due to its legal status. Being open 24 h/days has maximised its accessibility, but at the same time, it has encouraged a misuse of the Stanzetta. Although not trained, drug users became self-empowered to run the Stanzetta and to keep it clean, but the hygiene-health aspect is seen as one of the greatest challenges by the NSP professional staff. Over 10 years, not a single overdose death has been recorded. Drug use in the park has shifted from more visible places to the Stanzetta. As a result, the abandoned syringes have diminished in number and those disposed of correctly have increased. Moreover, no complaints from citizens or law enforcement were ever made. The neighbourhood acceptance seems to be the main goal of the peer-run unsanctioned SIF. Research limitations/implications The paper is based on a narrative account from the point of view of the professional staff involved, and results are specific to the context in which the study was conducted. Because of the chosen approach, the research results lack scientific generalisability. A relevant limitation is that no peer was involved in this study. Despite this, the research contributes to the information based on peer-run SIFs and makes a case for the de-medicalisation of SIFs in Europe. Practical implications This paper gives visibility to a long-lasting drug user-run SIF experience that was not made public mostly for an unclear legislative background about SIF in Italy. Social implications Efforts to establish harm reduction interventions in Italy have persisted since the mid-1990s and were undertaken primarily in response to epidemics of HIV infection and overdose (DPA, 2017). Despite this, no sanctioned SIF has ever been implemented. Primarily, this study wants to underline the urgency for an SIF pilot in Italy, and secondly the need to consider de-medicalising these services through direct support for peer-based models. Originality/value The Stanzetta unsanctioned SIF in Italy that has been running for ten years. Despite this, the venue continues to be vulnerable due to its legal status. For this reason, these results were never made public before. The experience showed a good working synergy between NSP professionals and the SIF peers. This model can be considered as a “light” de-medicalisation form to be explored and eventually to be implemented as a pilot SIF in Italy.

scholarly journals Victimless Crime in Indonesia: Should We Punished Them?

2019 ◽  
Vol 06 (02) ◽  
pp. 216-232
Author(s):  
Erika Chandra
Keyword(s):  
Drug Abuse ◽  
Harm Reduction ◽  
Drug User ◽  
Criminal Law ◽  
Zero Tolerance ◽  
Criminal Policy ◽  
Correctional Institutions ◽  
Tolerance Approach ◽  
Problem Drug

Criminal act deserves punishment because it causes harmful to its victim. However, some criminal acts may be considered as victimless crime since the perpetrator is also the victim. They are, for example, drug abuse, gambling, and abortion. In many states, such as Netherlands, victimless crime like drug abuse are no longer considered to be punishable crime since they use harm reduction approach for drug abuse problem. Drug abuse is seen as a health issue, not a criminal law issue. On the contrary, Indonesia still considers victimless crime to be punishable. The Indonesian Penal Code and Narcotics Law, for example, regulate that drug abuse is punishable. Indonesian criminal policy uses zero tolerance approach. Hence, the criminal policy is to eradicate all narcotics offences, including drug abuse. Nevertheless, it is not a solution for the problem drug abuse. Furthermore, the number of Indonesian drug user is increased. The policy has also caused overcrowd in Indonesian correctional institutions. Considering its unique characteristic and contemplating the purpose of punishment itself, punishment for victimless crime should be reconsidered. This article aims to bring perspectives on this matter by using juridical normative method with regulation, comparative, and case study approaches.

Expanding the reach of harm reduction in Thailand: Experiences with a drug user-run drop-in centre

2010 ◽  
Vol 21 (3) ◽  
pp. 255-258 ◽  
Author(s):  
Thomas Kerr ◽  
Kanna Hayashi ◽  
Nadia Fairbairn ◽  
Karyn Kaplan ◽  
Paisan Suwannawong ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Drug User

Unknown and Under-Researched: The Anatomy of Drinking Under Control Programs

2017 ◽  
Vol 63 (5) ◽  
pp. 277-288
Author(s):  
Harald Klingemann ◽  
Justyna Klingemann
Keyword(s):  
Quality Of Life ◽  
Harm Reduction ◽  
Evaluation Studies ◽  
Mission Statements ◽  
Community Response ◽  
Limited Resources ◽  
Admission Criteria ◽  
Control Programs ◽  
Institutional Order

Abstract. Introduction: While alcohol treatment predominantly focuses on abstinence, drug treatment objectives include a variety of outcomes related to consumption and quality of life. Consequently harm reduction programs tackling psychoactive substances are well documented and accepted by practitioners, whereas harm reduction programs tackling alcohol are under-researched and met with resistance. Method: The paper is mainly based on key-person interviews with eight program providers conducted in Switzerland in 2009 and up-dated in 2015, and the analysis of reports and mission statements to establish an inventory and description of drinking under control programs (DUCPs). A recent twin program in Amsterdam and Essen was included to exemplify conditions impeding their implementation. Firstly, a typology based on the type of alcohol management, the provided support and admission criteria is developed, complemented by a detailed description of their functioning in practice. Secondly, the case studies are analyzed in terms of factors promoting and impeding the implementation of DUCPs and efforts of legitimize them and assess their success. Results: Residential and non-residential DUCPs show high diversity and pursue individualized approaches as the detailed case descriptions exemplify. Different modalities of proactively providing and including alcohol consumption are conceptualized in a wider framework of program objectives, including among others, quality of life and harm reduction. Typically DUCPs represent an effort to achieve public or institutional order. Their implementation and success are contingent upon their location, media response, type of alcohol management and the response of other substance-oriented stake holders in the treatment system. The legitimization of DUCPs is hampered by the lack of evaluation studies. DUCPs rely mostly – also because of limited resources – on rudimentary self-evaluations and attribute little importance to data collection exercises. Conclusions: Challenges for participants are underestimated and standard evaluation methodologies tend to be incompatible with the rationale and operational objectives of DUCPs. Program-sensitive multimethod approaches enabled by sufficient financing for monitoring and accompanying research is needed to improve the practice-oriented implementation of DUCPs. Barriers for these programs include assumptions that ‘alcohol-assisted’ help abandons hope for recovery and community response to DUCPs as locally unwanted institutions (‘not in my backyard’) fuelled by stigmatization.

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