Harm Reduction for Intravenous Substance Use

2021 ◽  
Vol 21 (1) ◽  
pp. 69-84
Author(s):  
Cara L. Connaughton ◽  
Jillian J. Boerstler ◽  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Health Care Organizations ◽  
Roman Catholic ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Reduction Strategies ◽  
Catholic Health Care ◽  
To Receive ◽  
Overdose Deaths

North America is facing an ongoing, persistent opioid epidemic, and Vancouver, British Columbia, continues to be one of its devastating epicenters, with record overdose deaths in 2020. Roman Catholic health care organizations in Vancouver are compelled to pioneer potential solutions to this public health crisis—in solidarity and employing necessary strategies to help the most vulnerable in the communities served. While controversial, harm reduction strategies for intravenous substance use keep people alive until they are able to receive the help that they need to recover. An evaluation of the degree of cooperation involved in some harm reduction strategies indicates that they can be considered morally permissible and compatible with core tenets of Catholic bioethics.

scholarly journals Investigating Community Pharmacy Take Home Naloxone Dispensing during COVID-19: The Impact of One Public Health Crisis on Another

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 129
Author(s):  
George Daskalakis ◽  
Ashley Cid ◽  
Kelly Grindrod ◽  
Michael A. Beazely
Keyword(s):  
Public Health ◽  
Community Pharmacy ◽  
Online Survey ◽  
Comfort Level ◽  
Future Research ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Pharmacy Technicians ◽  
The Impact ◽  
Overdose Deaths

A recent report found that the number of opioid-related deaths in Ontario in the first 15 weeks of the COVID-19 pandemic was 38.2% higher than in the 15 weeks before the pandemic. Our study sought to determine if pharmacy professionals self-reported an increase or decrease in naloxone provision due to the pandemic and to identify adjustments made by pharmacy professionals to dispense naloxone during the pandemic. A total of 231 Ontario community pharmacy professionals completed an online survey. Pharmacy professionals’ barriers, facilitators, and comfort level with dispensing naloxone before and during the pandemic were identified. The sample consisted of mostly pharmacists (99.1%). Over half (51.1%) reported no change in naloxone dispensing, while 22.9% of respondents reported an increase and 24.7% a decrease. The most common adjustments made during the pandemic were training patients how to administer naloxone over video or phone, delivering naloxone kits, and pharmacy technicians offering naloxone at prescription intake. Over half (55%) of participants said the top barrier for dispensing was that patients did not request naloxone. Naloxone distribution through pharmacies could be further optimized to address the increased incidence of overdose deaths during the pandemic. Future research should investigate the reasons for changes in naloxone dispensing.

Community Perceptions of Harm Reduction and Its Implications for Syringe Exchange Policy

2020 ◽  
Vol 50 (4) ◽  
pp. 507-523 ◽  
Author(s):  
Amanda Sharp ◽  
Joshua T. Barnett ◽  
Enya B. Vroom
Keyword(s):  
Harm Reduction ◽  
Community Education ◽  
The United States ◽  
Syringe Exchange ◽  
Policy Integration ◽  
Community Members ◽  
Exchange Program ◽  
Reduction Strategies ◽  
National Public Health ◽  
Overdose Deaths

In the United States, the rising prevalence of opioid addiction has led to an increase in opioid-related overdose deaths and transmission of infectious disease. This resulted in the declaration of a national public health emergency and the need for harm reduction strategies such as syringe exchange. Florida has seen increases in blood-borne diseases and fatal/nonfatal opioid overdoses, yet harm reduction policy integration has been historically limited. To inform policy change, this study explores the perspectives of community members in Manatee County, Florida, on harm reduction services. Six focus groups were conducted with findings centralized around three emergent themes related to the implementation of a syringe exchange program: (a) awareness and acceptability; (b) facilitating factors; and (c) perceived barriers. The results of this qualitative research helped to inform the successful adoption of a local syringe exchange ordinance. Recommendations for community education and engagement regarding harm reduction policy are discussed.

Securitizing Narcotics: The Politics and Prospects of Russian Counterdrug Policies

2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Mark Galeotti
Keyword(s):  
Harm Reduction ◽  
Local Governments ◽  
Moral Problem ◽  
Security Threat ◽  
Comprehensive Strategy ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Transit Country ◽  
Reduction Methods ◽  
Turf Wars

AbstractRussia is suffering from a serious and worsening challenge from narcotics, with 6% of the population using or addicted to drugs, which is also leading to a growing public health crisis. A particular problem is the growing availability of heroin from Afghanistan, with Russia an increasingly important transit country, as well as market. Efforts to control this have been severely limited by issues of resourcing, political will and turf wars between security agencies. Russia’s growing economic problems have also led to a need for liquidity on the part of many financial institutions that leads them to turn a blind eye to dirty money. However, the fundamental issues are that the Kremlin regards this as a nationalist, securitized and moral problem. The influx of Afghan heroin reflects at best Western failure and at worse a malign attempt to damage Russia. This needs to be considered a security threat and is therefore best addressed through interdiction and punitive measures rather than harm reduction and civil outreach, especially because drug addiction is considered a moral rather than a medical issue. Thus, Russia needs to adopt a more inclusive and comprehensive strategy that balances policing with treatment, prevention and harm reduction methods, in partnership with local governments, communities and NGOs, as well as foreign partners. Not only must law enforcement cooperation not continue to be a hostage to geopolitical rivalries, but policy over Afghanistan needs to be about encouraging productive efforts to reduce production rather than using the issue as a means to asserting regional hegemony.

All Women Are Welcome: Reducing Barriers to Women's Shelters With Harm Reduction

Partner Abuse ◽  
2019 ◽  
Vol 10 (4) ◽  
pp. 409-428
Author(s):  
Angela Hovey ◽  
Susan Scott
Keyword(s):  
Domestic Violence ◽  
Substance Use ◽  
Service Delivery ◽  
Harm Reduction ◽  
Violence Against Women ◽  
Health And Safety ◽  
Service Delivery Model ◽  
Reduction Strategies ◽  
Positive Experiences ◽  
Minimal Research

Women who experience domestic violence are more likely to use or become dependent on substances. Their health and safety are at greater risk when Violence Against Women (VAW) shelters have policies prohibiting admission if noticeably impaired. Harm reduction strategies can help reduce harms caused by substance use. Minimal research was found about impacts of integrating harm reduction in VAW shelters. We examined women's experiences with a harm reduction service delivery model at a Canadian rural VAW shelter. Interviews were conducted with 25 former residents to explore their experiences. Most women preferred to have harm reduction implemented, although most women also wanted changes made to harm reduction practices. These recommended changes would enhance positive experiences and feelings of safety for all women, thereby achieving the goal of all women welcome. Overall, our findings support the integration of harm reduction in VAW shelters that balances harm reduction philosophy and practices with the individualized needs of traumatized women and safety of children.

scholarly journals General recommendations and guidelines for remote assessment of toddlers and children

2020 ◽  
Author(s):  
Carolyn J King ◽  
Kathryn Garrisi ◽  
Lindsay Hillyer ◽  
Nadine Gaab
Keyword(s):  
Age Groups ◽  
Educational Institutions ◽  
Second Grade ◽  
Clinical Settings ◽  
Clinical Services ◽  
Health Crisis ◽  
Public Health Crisis ◽  
The World ◽  
Remote Assessment ◽  
To Receive

High rates of infection and mortality from the COVID-19 pandemic have led to the sudden closures of educational institutions in 191 countries, affecting over 91% of students around the world (Holmes, 2020). Schools, clinics, and research institutions around the world abruptly closed their doors to mitigate a growing public health crisis, postponing critical in-person and research services. With an uncertain date of return to typical in-person schooling or clinical visits, remote assessment offers the best opportunity for children to receive necessary educational and clinical services. Here we offer a practical guide to remote assessment for toddler through second grade age groups that can be applied to educational and clinical settings.

A Study of Drugs and Substance Abuse among Adolescents of Slum Dwellers

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Mridula Sharma ◽  
Moni Chaudhary
Keyword(s):  
Public Health ◽  
Substance Abuse ◽  
Substance Use ◽  
Substance Abusers ◽  
Slum Area ◽  
Health Crisis ◽  
Targeted Interventions ◽  
Public Health Crisis ◽  
Slum Dwellers ◽  
The World

Drugs and substance abuse and dependence has become a worldwide public health crisis. The abuse of drug is an international problem, which affects almost every country in the world, both developed and developing. The present study was carried out with the objective: To study the prevalence and patterns of drugs and substance abuse among adolescents, living in slum of Meerut. A survey was conducted on slum area of Nauchandi compound, Meerut District. Sample was collected from 110 boys of 12 to 16 years old. The survey was based on drug addiction habits. Results shows that 46.36 % adolescents of the slum area used substance like Gutkha, Tobacco, Smoking, Alcohol, Afeem, Ganja, Thinner and Marijuana. 54.91% admitted to using one time, 23.53% admitted rarely, 15.68% admitted occasionally and 5.88%   admitted that they have craving for drugs, so use frequently. The most common substances used were Gutkha 46.36%, tobacco 40.91%, smoking 37.27%, and alcohol 13.63%.  8.18% substance abusers used multiple substances. Synthetic narcotics and LSD were not used by any of the abusers. Our study revealed that prevalence of substance use among adolescents is high and cause significant problem in this population, therefore there is necessity of targeted interventions to reduce this huge burden.

scholarly journals A Critical Narrative Inquiry to Understand the Impacts of an Overdose Prevention Site on the Lives of Site Users

2020 ◽  
Author(s):  
Abe Oudshoorn ◽  
Michelle Sangster Bouck ◽  
Melissa McCann ◽  
Shamiram Zendo ◽  
Helene Berman ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Sense Of Self ◽  
People Who Use Drugs ◽  
Transformative Change ◽  
Overdose Prevention ◽  
Caring Relationships ◽  
Starting Point ◽  
Reduction Strategies ◽  
The Impact

Abstract Background Globally, communities are struggling to gain support for harm reduction strategies being implemented to address the impacts of substance use. A key part of this discussion is understanding and engaging with people who use drugs to help shape community harm reduction strategies. This study focused on how an overdose prevention site has influenced the lives of people who use drugs.MethodsA critical narrative method was utilized, centred on photo-narratives. Twenty-seven individuals accessing an overdose prevention site were recruited to participate in preliminary interviews. 16 participants subsequently took photographs to describe the impact of the site and participated in a second round of interviews. Through independent coding and several rounds of team analysis, four themes were proposed to constitute a core narrative encompassing the diverse experiences of participants. ResultsA key message shared by participants was the sense that their lives have improved since accessing the site. The core narrative proposed is presented in a series of four themes or ‘chapters’: Enduring, Accessing Safety, Connecting and Belonging, and Transforming. The chapters follow a series of transitions, revealing a journey that participants presented through their own eyes; one of moving from utter despair to hope, opportunity, and inclusion. Where at the outset participants were simply trying to survive the challenges of chaotic substance use, through the relationships and services provided at the site they moved towards small or large life transformations.ConclusionsThis study contributes to an enhanced understanding of how caring relationships with staff at the overdose prevention site impacted site users’ sense of self. We propose that caring relationships are an intervention in and of themselves, and that these relationships contribute to transformation that extends far beyond the public health outcomes of disease reduction. The caring relationships at the site can be a starting point for significant social changes. However, the micro-environment that existed within the site needs to extend beyond its walls for true transformative change to take place. The marginalization and stigmatization that people who use drugs experience outside these sites remains a constant barrier to achieving stability in their lives.

scholarly journals A critical narrative inquiry to understand the impacts of an overdose prevention site on the lives of site users

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Abe Oudshoorn ◽  
Michelle Sangster Bouck ◽  
Melissa McCann ◽  
Shamiram Zendo ◽  
Helene Berman ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Sense Of Self ◽  
People Who Use Drugs ◽  
Transformative Change ◽  
Overdose Prevention ◽  
Caring Relationships ◽  
Starting Point ◽  
Reduction Strategies ◽  
The Impact

Abstract Background Globally, communities are struggling to gain support for harm reduction strategies being implemented to address the impacts of substance use. A key part of this discussion is understanding and engaging with people who use drugs to help shape community harm reduction strategies. This study focused on how an overdose prevention site has influenced the lives of people who use drugs. Methods A critical narrative method was utilized, centred on photo-narratives. Twenty-seven individuals accessing an overdose prevention site were recruited to participate in preliminary interviews. Sixteen participants subsequently took photographs to describe the impact of the site and participated in a second round of interviews. Through independent coding and several rounds of team analysis, four themes were proposed to constitute a core narrative encompassing the diverse experiences of participants. Results A key message shared by participants was the sense that their lives have improved since accessing the site. The core narrative proposed is presented in a series of four themes or “chapters”: Enduring, Accessing Safety, Connecting and Belonging, and Transforming. The chapters follow a series of transitions, revealing a journey that participants presented through their own eyes: one of moving from utter despair to hope, opportunity, and inclusion. Where at the outset participants were simply trying to survive the challenges of chaotic substance use, through the relationships and services provided at the site they moved towards small or large life transformations. Conclusions This study contributes to an enhanced understanding of how caring relationships with staff at the overdose prevention site impacted site users’ sense of self. We propose that caring relationships are an intervention in and of themselves, and that these relationships contribute to transformation that extends far beyond the public health outcomes of disease reduction. The caring relationships at the site can be a starting point for significant social changes. However, the micro-environment that existed within the site needs to extend beyond its walls for true transformative change to take place. The marginalization and stigmatization that people who use drugs experience outside these sites remains a constant barrier to achieving stability in their lives.

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
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Critical Time ◽  
Policy Makers ◽  
Alcohol Control ◽  
Multiple Data ◽  
Problematic Substance Use ◽  
Reduction Strategies ◽  
Canadian Health ◽  
Problematic Substance

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.

Sign in / Sign up

Export Citation Format

Share Document