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Harm Reduction Journal

Mark Goodhew, Allison M Salmon, Christina Marel, Katherine L Mills, Marianne Jauncey
The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm...
October 12, 2016: Harm Reduction Journal
Gen Sander, Alessio Scandurra, Anhelita Kamenska, Catherine MacNamara, Christina Kalpaki, Cristina Fernandez Bessa, Gemma Nicolás Laso, Grazia Parisi, Lorraine Varley, Marcin Wolny, Maria Moudatsou, Nuno Henrique Pontes, Patricia Mannix-McNamara, Sandro Libianchi, Tzanetos Antypas
While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners...
October 7, 2016: Harm Reduction Journal
Eva Charlotte Toth, Jette Tegner, Sigurd Lauridsen, Nanna Kappel
BACKGROUND: Drug consumption rooms (DCRs) have been implemented worldwide as a harm-reducing strategy. In 2012, Denmark passed legislation allowing establishment of DCRs. The aim of this study was to identify characteristics and gain knowledge of the way service users use the DCRs including bridge building to specialized health care. Associations between nationality, opioid substitution treatment (OST), drug intake method, and response to staff advice on harm-reducing education was investigated, as well as service user's reasons for using the DCRs, and their perceptions of safety and trust in the DCRs...
October 7, 2016: Harm Reduction Journal
K Closson, R McNeil, P McDougall, S Fernando, A B Collins, R Baltzer Turje, T Howard, S Parashar
BACKGROUND: Community-based HIV, harm reduction, and addiction research increasingly involve members of affected communities as Peer Research Associates (PRAs)-individuals with common experiences to the participant population (e.g. people who use drugs, people living with HIV [PLHIV]). However, there is a paucity of literature detailing the operationalization of PRA hiring and thus limited understanding regarding how affected communities can be meaningfully involved through low-barrier engagement in paid positions within community-based participatory research (CBPR) projects...
October 7, 2016: Harm Reduction Journal
Andrew Deonarine, Ashraf Amlani, Graham Ambrose, Jane A Buxton
BACKGROUND: The British Columbia take-home naloxone (BCTHN) program has been in operation since 2012 and has resulted in the successful reversal of over 581 opioid overdoses. The study aims to explore BCTHN program participant perspectives about the program, barriers to participants contacting emergency services (calling "911") during an overdose, and perspectives of law enforcement officials on naloxone administration by police officers. METHODS: Two focus groups and four individual interviews were conducted with BCTHN program participants; interviews with two law enforcement officials were also conducted...
May 21, 2016: Harm Reduction Journal
Daniel Werb, Richard Garfein, Thomas Kerr, Peter Davidson, Perrine Roux, Marie Jauffret-Roustide, Marc Auriacombe, Will Small, Steffanie A Strathdee
BACKGROUND: Injection drug use remains a primary driver of HIV and HCV-related harms globally. However, there is a gap in efforts to prevent individuals from transitioning into injecting. People who inject drugs (PWID) play a key role in the transition of others into injecting, and while behavioral interventions have been developed to address this phenomenon, socio-structural approaches remain unexplored. To that end, we hypothesize that certain interventions designed to reduce injecting-related risk behaviors may also reduce the risk that PWID expose and introduce others into injecting...
2016: Harm Reduction Journal
Tristan I Evans, Scott E Hadland, Melissa A Clark, Traci C Green, Brandon D L Marshall
BACKGROUND: To date, no studies have examined the extent of knowledge and perceptions of Good Samaritan Laws (GSLs) among young adults who engage in non-medical prescription opioid (NMPO) use. We sought to determine awareness of and factors associated with knowledge of Rhode Island's Good Samaritan Law (RIGSL) among young adult NMPO users. FINDINGS: We compared the sociodemographic and overdose-related characteristics of participants who were aware and unaware of the RIGSL and determined independent correlates of knowledge of the RIGSL via modified stepwise logistic regression...
2016: Harm Reduction Journal
Ting Lin, Chang-Hsun Chen, Pesus Chou
BACKGROUND: In 2003, a major epidemic of human immunodeficiency virus emerged among injection drug users in Taiwan. In response to the twin epidemics of HIV and intravenous drug addiction, the government implemented comprehensive harm reduction programs beginning in 2005. Collected data from relevant agencies were used to explore the impact of the harm reduction programs on HIV and illicit drug use. METHODS: This study divided 2002-2015 into three intervention phases and used the surveillance data and statistics on the HIV epidemic, drug abuse, and the intervention from relevant agencies to explore the correlations between different variables in different intervention periods and the combination effects of interventions on the HIV epidemic...
2016: Harm Reduction Journal
Dinska Van Gucht, Frank Baeyens
BACKGROUND: Many misperceptions of both risks and opportunities of e-cigarettes (e-cigs) exist among the general population and among physicians, although e-cigs could be a valuable harm reduction tool for current smokers. METHODS: Two groups in Flanders, namely general practitioners (GPs; family doctors) and tobacco counselors filled out an online questionnaire with regard to their attitudes and risk perceptions concerning e-cigs. Statements included were on the safety and the addictive properties of e-cigs in absolute terms, whereas other items compared e-cigs with regular tobacco cigarettes...
2016: Harm Reduction Journal
Deepika Ganju, Sowmya Ramesh, Niranjan Saggurti
BACKGROUND: Although targeted interventions in India require all high-risk groups, including injecting drug users (IDUs), to test for HIV every 6 months, testing uptake among IDUs remains far from universal. Our study estimates the proportion of IDUs who have taken an HIV test and identifies the factors associated with HIV testing uptake in Nagaland and Manipur, two high HIV prevalence states in India where the epidemic is driven by injecting drug use. METHODS: Data are drawn from the cross-sectional Integrated Behavioural and Biological Assessment (2009) of 1650 male IDUs from two districts each of Manipur and Nagaland...
2016: Harm Reduction Journal
Nanna Kappel, Eva Toth, Jette Tegner, Sigurd Lauridsen
BACKGROUND: Drug use contributes to higher rates of morbidity and mortality among people who use drugs compared to the general population. In 2012, Danish politicians passed a law that allowed drug consumption rooms (DCRs) to operate; among the objectives were to improve the well-being of vulnerable citizens and to reduce the number of overdoses. Five Danish DCRs are currently being operated. This article presents results from a national investigation focused on assessing the impact of Danish drug consumption rooms on the health and well-being of DCR clients and factors facilitating the acceptance of DCR clients in order to improve their health and refer them onward to social and health service providers...
2016: Harm Reduction Journal
Ehsan Jozaghi, Hugh Lampkin, Martin A Andresen
BACKGROUND: The role of peers (former or current drug users) in reducing risky behavior within methamphetamine and crack smokers has not been well described or researched. The current study not only explores the role of peers in reducing risk factors for morbidity within the illicit drug smoking population in the Downtown Eastside (DTES) community of Vancouver but it also investigates the changes in the nature of drug use after the closure of an unsanctioned smoking facility. METHODS: The data pertain to qualitative interviews with 10 peers and 10 illicit drug smokers...
2016: Harm Reduction Journal
Carla Treloar, Limin Mao, Hannah Wilson
BACKGROUND: Despite high levels of equipment distribution through Needle and Syringe Programmes (NSPs) in Australia, the levels of reuse of equipment among people who inject drugs remain concerning. This paper used an exploratory analysis to examine the needs of NSP client that could be addressed by NSPs to enhance service impact and blood-borne virus risk practices. METHODS: People who inject drugs were recruited from six NSP sites in Sydney, Australia, to undertake a self-completed survey...
2016: Harm Reduction Journal
Kate Vallance, Tim Stockwell, Bernie Pauly, Clifton Chow, Erin Gray, Bonnie Krysowaty, Kathleen Perkin, Jinhui Zhao
BACKGROUND: Managed alcohol programs (MAPs) are a harm reduction strategy for people with severe alcohol dependence and unstable housing. MAPs provide controlled access to alcohol usually alongside accommodation, meals, and other supports. Patterns of alcohol consumption and related harms among MAP participants and controls from a homeless shelter in Thunder Bay, Ontario, were investigated in 2013. METHODS: Structured interviews were conducted with 18 MAP and 20 control participants assessed as alcohol dependent with most using non-beverage alcohol (NBA)...
2016: Harm Reduction Journal
Bernadette Bernie Pauly, Erin Gray, Kathleen Perkin, Clifton Chow, Kate Vallance, Bonnie Krysowaty, Timothy Stockwell
BACKGROUND: There is a higher prevalence of alcohol use and severe alcohol dependence among homeless populations. The combination of alcohol use and lack of housing contributes to increased vulnerability to the harms of substance use including stigma, injury, illness, and death. Managed alcohol programs (MAPs) administer prescribed doses of alcohol at regular intervals to people with severe and chronic alcohol dependence and homelessness. As a pilot for a larger national study of MAPs, we conducted an in-depth evaluation of one program in Ontario, Canada...
2016: Harm Reduction Journal
Sean T Allen, Monica S Ruiz, Jeff Jones, Monique M Turner
BACKGROUND: Copious evidence indicates that syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs (PWID). The efficacy of SEPs in supporting the public health needs of PWID populations is partially dependent on their accessibility and consistent utilization among injectors. Research has shown that SEP access is an important predictor of PWID retention at SEPs, yet policies exist that may limit the geographic areas where SEP operations may legally occur...
2016: Harm Reduction Journal
Evelyn Hearne, Jean-Paul Cornelius Grund, Marie Claire Van Hout, Jim McVeigh
Several home-produced substances such as krokodil and boltushka are prevalent in many Eastern European countries. Anecdotal reports of its use have been circulating in Germany and Norway; however, this has not been confirmed. Its use has also been reported by the media in the USA, although only one confirmed report of its use exists. Home-produced drugs are associated with high levels of morbidity and a number of complex health issues such as the spread of blood borne viruses, gangrene, and internal organ damage...
2016: Harm Reduction Journal
Perrine Roux, Caroline Lions, Antoine Vilotitch, Laurent Michel, Marion Mora, Gwenaelle Maradan, Fabienne Marcellin, Bruno Spire, Alain Morel, Patrizia M Carrieri
BACKGROUND: Cocaine use is frequent in patients receiving methadone maintenance treatment (MMT) and can jeopardize their treatment response. Identifying clinical predictors of cocaine use during methadone treatment can potentially improve clinical management. We used longitudinal data from the ANRS Methaville trial both to describe self-reported occasional and regular cocaine use during MMT and to identify clinical predictors. METHODS: We selected 183 patients who had data on cocaine (or crack) use at months 0 (M0), M6, and/or M12, accounting for 483 visits...
2016: Harm Reduction Journal
Jia-Shin Chen
BACKGROUND: In response to the spread of HIV caused by needle sharing among injection drug users (IDUs), the Taiwan Centers for Disease Control implemented a pilot harm reduction program in 2005 that expanded nationwide in 2006. The policy led to a significant reduction in the number of HIV-positive cases among IDUs in 4 years. METHODS: This article aims to provide a critical evaluation of this harm reduction policy in Taiwan. The research leading to this article included a thorough literature review and in-depth interviews with 31 active policy participants, including people working in hospitals, the academia, non-governmental organizations, community pharmacies, the legal system, and health authorities at both the central and local levels...
2016: Harm Reduction Journal
Roberto Abadie, Melissa Welch-Lazoritz, Camila Gelpi-Acosta, Juan Carlos Reyes, Kirk Dombrowski
BACKGROUND: Blood contained in needles and injection equipment has been identified as a vector for HIV and HCV transmission among people who inject drugs (PWID). Yet, there is often a wide discrepancy in prevalence for both viruses. While microbiological differences between viruses influence prevalence, other variables associated with the way drugs are acquired and used, also play a role. METHODS: Respondent-driven sampling (RDS) methods recruited a sample of 315 current intravenous drug users in rural Puerto Rico...
2016: Harm Reduction Journal
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