Harm Reduction Or Harm Maintenance

In this volume, international contributors discuss the philosophical basis and history of harm reduction policies and examine their outcomes. They also cover controversial topics related to harm reduction especially conflicts between the public health system, where most programs are located, and a worldwide criminal justice system that further marginalizes drug users. The book describes programs from the United States, the United Kingdom, Canada, Brazil, The Netherlands, Switzerland and Australia.

This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.

An estimated 69000 people die each year from opioid overdose. Opioid overdose is easily reversed with the opioid antidote naloxone and with basic life support. Such care is generally only available in medical settings, however. These guidelines recommend that people who are likely to witness an opioid overdose, including people who use opioids, and their family and friends should be given access to naloxone and training in its use so that they can respond to opioid overdose in an emergency if a medical response is not available. Naloxone can be injected or administered intra-nasally and has minimal effects in people who have not used opioids. While naloxone administered by bystanders is a potentially life-saving emergency interim response to opioid overdose, it should not be seen as a replacement for comprehensive medical care.

Harm Reduction is a philosophy of public health intended as a progressive alternative to the prohibition of certain potentially dangerous lifestyle choices. Recognising that certain people always have and always will engage in behaviours which carry risks, the aim of harm reduction is to mitigate the potential dangers and health risks associated with those behaviours. Harm Reduction in Substance Use and High-Risk Behaviour offers a comprehensive exploration of the policy, practice and evidence base of harm reduction. Starting with a history of harm reduction, the book addresses key ethical and legal issues central to the debates and developments in the field. It discusses the full range of psychoactive substances, behaviours and communities with chapters on injecting, dance drugs, stimulant use, tobacco harm reduction, alcohol use and sex work. Written by an international team of contributors, this text provides an essential panorama of harm reduction in the 21st century for educators and researchers in addiction and public health, postgraduate students and policy makers.

The War on Drugs' has traditionally had total abstinence as its target. The contributors to this book take a new and challenging approach to problem drug use, arguing that abstinence is not the only solution. They believe that existing methods of treatment and control have been inadequate in controlling or improving drug problems and they propose a radical alternative: reducing the harm associated with the use of illicit drugs. International in scope, the book covers a broad range of drugs, and of social and individual problems. The spread of HIV infection, which has been described as a greater threat to individual and public health than drug misuse is also considered. The contributors give an overview of the current theories and practices that have helped to minimise the harmful effects of drugs and describe national and city-level strategies towards drug problems. They also cover the drug policies of several agencies and organisations world-wide, including police, doctors, community groups and local authorities. Concentrating on reducing drug-related harm, this in an important contribtuion to the debate on the future shape of drug control systems. It questions the role and function of existing drug laws and discusses how harm reduction will shape day-to-day work with drug users. Provocative and persuasive, it should be read by all policy-makers and practitioners faced with drugs problems, and will do much to help establish new strategies for dealing with drug use, strategies that minimise rather than exacerbate drug-related harm.

In More Harm Than Good, Carter, Boyd and MacPherson take a critical look at the current state of Canadian drug policy and raise key questions about the effects of Canada’s increasing involvement in and commitment to the “war on drugs.” A primer on Canadian drug policy, the analysis in More Harm Than Good is shaped by critical sociology and feminist perspectives on drugs and incorporates insights not only from individuals who are on the front lines of drug policy in Canada — treatment and service workers — but also from those who live with the consequences of that policy on a daily basis — people who use criminalized drugs. Finally, the authors propose realistic alternatives to today’s failed policy approach. “Your book really expanded thinking and understanding and had a big influence on students critical and reflective thought. Readings sparked rich conversations about their own hopes and wishes for the field, broader social and political responses and the impact on youth and families affected by substances.” - Stephanie McCune, University of Victoria Please note: an error occurred with the printing of this book, and one of the sidebars was not printed. It is available to download here. We sincerely apologize for this oversight.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.