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Harm Reduction Journal

Mohammad Karamouzian, Carolyn Dohoo, Sara Forsting, Ryan McNeil, Thomas Kerr, Mark Lysyshyn
BACKGROUND: British Columbia, Canada, is experiencing a public health emergency related to opioid overdoses driven by consumption of street drugs contaminated with illicitly manufactured fentanyl. This cross-sectional study evaluates a drug checking intervention for the clients of a supervised injection facility (SIF) in Vancouver. METHODS: Insite is a facility offering supervised injection services in Vancouver's Downtown East Side, a community with high levels of injection drug use and associated harms, including overdose deaths...
September 10, 2018: Harm Reduction Journal
Atte Oksanen, Iina Savolainen, Anu Sirola, Markus Kaakinen
BACKGROUND: Severe economic difficulties are common among younger generations who currently have an easy access to consumer credit and payday loans in many Western countries. These accessible yet expensive short-term loans may lead to more severe financial difficulties, including default and debt enforcement, both which are defined as debt problems within this study. This study hypothesized that consumer debt and debt problems mediate the relationship between problematic gambling and psychological distress...
September 3, 2018: Harm Reduction Journal
William A Zule, Alisher Latypov, David Otiashvili, Steffani Bangel, Georgiy V Bobashev
BACKGROUND: In 2012, the World Health Organization recommended that needle and syringe programs offer their clients low dead space insulin syringes with permanently attached needles. However, in many countries, these syringes are not acceptable to a majority of people who inject drugs. This study assessed the feasibility of working with needle and syringe programs to implement the WHO recommendation using low dead space detachable needles. The study also assessed the acceptability of the needles...
August 31, 2018: Harm Reduction Journal
David M Barnes, Don C Des Jarlais, Margaret Wolff, Jonathan Feelemyer, Susan Tross
BACKGROUND: Transitioning from non-injection to injection drug use dramatically escalates health risks. Evidence suggests that people who inject drugs (PWID) help in a majority of others' first injections, yet these helpers represent only a minority of experienced PWID. Recent research has provided insight into this helping process, as reported by helpers. PWID who have never helped, although the majority of PWID, have not previously been the focus of study. To address this gap, we give primary voice to non-helpers' perspectives on the helping process, while also comparing their views with persons in our sample who have helped with first injections...
August 28, 2018: Harm Reduction Journal
Annie Madden, Max Hopwood, Joanne Neale, Carla Treloar
BACKGROUND: Recent advances in the treatment of hepatitis C virus (HCV) infection provide the possibility of eliminating HCV as a public health threat. This focus on HCV elimination through treatment, however, is also driving a concomitant focus on 'achieving cure' as the primary outcome of treatment. The aim of this paper is to explore what people who inject drugs consider to be important in relation to outcomes of HCV treatment, and whether there are outcomes 'beyond cure' that might be important to understand as part of improving engagement in treatment...
August 15, 2018: Harm Reduction Journal
Paula Tookey, Kate Mason, Jennifer Broad, Marty Behm, Lise Bondy, Jeff Powis
BACKGROUND: Despite the integration of peer workers into harm reduction services, there is little documentation regarding the experience of this integration or of models in which peers are fully integrated as members of health care teams. The purpose of this study was to gain an in-depth understanding of the transition from client to support worker from the perspective of two individuals who received treatment for hepatitis C at a multi-disciplinary, community-based program, grounded in a harm reduction approach to substance use...
August 14, 2018: Harm Reduction Journal
Natasha Elms, Kendra Link, Adam Newman, Susan B Brogly
BACKGROUND: There are few women-centered treatment programs for substance use disorder. We therefore undertook an exploratory study to better understand the treatment experience, barriers, and facilitators of mothers with substance use disorder. METHODS: We conducted two focus groups with a total of ten women with a history of substance use disorder in Kingston (Canada). Women were recruited from a community program for mothers with substance use disorder. The focus groups were recorded, and the resulting data were transcribed, coded, and thematically analyzed...
August 6, 2018: Harm Reduction Journal
Lise Lafferty, T Cameron Wild, Jake Rance, Carla Treloar
BACKGROUND: Hepatitis C (HCV) is a global public health concern. There is a global prevalence of 15% among the world's prisoner population, suggesting the need for priority HCV treatment among this population group. New highly efficacious therapies with low side effects, known as directing-acting antivirals, became available under Australia's universal healthcare scheme on 1 March 2016. This creates an opportune time to trial treatment as prevention as an elimination strategy for HCV in prison settings...
August 3, 2018: Harm Reduction Journal
Hannah Farrimond, Charles Abraham
BACKGROUND: Public health leadership in England has taken a distinctive international stance by identifying the potential public health benefit of e-cigarettes for smoking cessation. This includes the development of a ground-breaking set of national guidelines for developing e-cigarette friendly stop smoking services. However, little is known about the views of staff engaged within these services and whether or how such services are becoming e-cigarette friendly. This study aimed to investigate the uptake and usage of e-cigarette guidance, from the perspective of those enacting tobacco cessation interventions 'on the ground'...
August 3, 2018: Harm Reduction Journal
Sharon Cox, Lynne Dawkins
After publication of the original article [1], the authors noticed an error in the Competing interests section.
July 16, 2018: Harm Reduction Journal
Kirsten M A Trayner, Amanda Weir, Andrew McAuley, Gauri Godbole, Corinne Amar, Kathie Grant, Gillian Penrice, Kirsty Roy
BACKGROUND: People who inject drugs (PWID) are at an increased risk of wound botulism, a potentially fatal acute paralytic illness. During the first 6 months of 2015, a large outbreak of wound botulism was confirmed among PWID in Scotland, which resulted in the largest outbreak in Europe to date. METHODS: A multidisciplinary Incident Management Team (IMT) was convened to conduct an outbreak investigation, which consisted of enhanced surveillance of cases in order to characterise risk factors and identify potential sources of infection...
July 11, 2018: Harm Reduction Journal
Pauline Voon, Alissa M Greer, Ashraf Amlani, Cheri Newman, Charlene Burmeister, Jane A Buxton
BACKGROUND: People who use drugs have a significantly higher prevalence of chronic non-cancer pain compared to the general population, yet little is known about how various policy, economic, physical, and social environments may serve as risk or protective factors in the context of concurrent pain and substance use. Therefore, this study sought to explore perspectives, risks, and harms associated with pain among people who use drugs. METHODS: Thirteen focus group interviews were held across British Columbia, Canada, from July to September 2015...
July 5, 2018: Harm Reduction Journal
Ju Nyeong Park, Brian W Weir, Sean T Allen, Patrick Chaulk, Susan G Sherman
BACKGROUND: The opioid crisis remains a major public health issue in the US and beyond. Despite rapid rises in fentanyl-related mortality nationally, little is known about the role of fentanyl in the occurrence of non-fatal overdose among people who use drugs. We examined the prevalence of non-fatal overdose and perceived fentanyl exposure among syringe services program (SSP) clients and modeled the correlates of non-fatal overdose. METHODS: Data were drawn from a cross-sectional survey of 203 SSP clients in Baltimore, MD recruited in 2016...
July 5, 2018: Harm Reduction Journal
Christopher Russell, Neil McKeganey, Tiffany Dickson, Mitchell Nides
BACKGROUND: Understanding the role that flavors play in the population's use of e-cigarettes and the impact that flavored e-cigarette products have on the population's use of more harmful tobacco products, like conventional cigarettes, has been identified by the US Food and Drug Administration (FDA) as a public health research priority. The purpose of the study was to assess the first e-cigarette flavor and current e-cigarette flavors used by a large non-probabilistic sample of adult frequent users of e-cigarettes in the USA and assess how flavor preferences vary by cigarette smoking status and time since first e-cigarette purchase...
June 28, 2018: Harm Reduction Journal
Sharon Cox, Lynne Dawkins
No abstract text is available yet for this article.
June 22, 2018: Harm Reduction Journal
Caitlin Notley, Emma Ward, Lynne Dawkins, Richard Holland
BACKGROUND: We have little understanding of how vapers use e-cigarettes beyond cessation. E-cigarettes may have a role to play in reducing the health-related harms of tobacco smoking, through not only assisting smoking cessation attempts but also supporting long-term abstinence from smoking. However, there are fears that vaping may lead to the 'renormalisation' of smoking type behaviours. This study aimed to explore patterns of use and reported experiences of vapers quitting smoking using an e-cigarette in relation to long-term smoking status (abstinence or relapse)...
June 20, 2018: Harm Reduction Journal
Tamar M J Antin, Geoffrey Hunt, Emile Sanders
BACKGROUND: The mainstream tobacco field in the USA tends to situate youth as passive, particularly in terms of their susceptibility to industry manipulation and peer pressure. However, failing to acknowledge youths' agency overlooks important meanings youth ascribe to their tobacco use and how those meanings are shaped by the circumstances and structures of their everyday lives. METHODS: This article is based on analysis of 58 in-depth qualitative interviews conducted with sexual and gender minority youth living in the San Francisco Bay area in California...
May 31, 2018: Harm Reduction Journal
Gitau Mburu, Sylvia Ayon, Alexander C Tsai, James Ndimbii, Bangyuan Wang, Steffanie Strathdee, Janet Seeley
BACKGROUND: A tenth of all people who inject drugs in Kenya are women, yet their social contexts and experiences remain poorly understood. This paper reports how multiple forms of stigma are experienced by women who inject drugs in coastal Kenya and the impact that they have on their ability to access essential health services. METHODS: In 2015, in-depth interviews and focus group discussions were held with 45 women who inject drugs in two coastal towns. These data were supplemented with in-depth interviews with five individual stakeholders involved in service provision to this population...
May 25, 2018: Harm Reduction Journal
Jose Luis Burgos, Javier A Cepeda, James G Kahn, Maria Luisa Mittal, Emilio Meza, Raúl Rafael Palacios Lazos, Psyché Calderón Vargas, Peter Vickerman, Steffanie A Strathdee, Natasha K Martin
BACKGROUND: Mexico recently enacted drug policy reform to decriminalize possession of small amounts of illicit drugs and mandated that police refer identified substance users to drug treatment. However, the economic implications of drug treatment expansion are uncertain. We estimated the costs of opioid substitution therapy (OST) provision in Tijuana, Mexico, where opioid use and HIV are major public health concerns. METHODS: We adopted an economic health care provider perspective and applied an ingredients-based micro-costing approach to quantify the average monthly cost of OST (methadone maintenance) provision at two providers (one private and one public) in Tijuana, Mexico...
May 23, 2018: Harm Reduction Journal
Angelica Ospina-Escobar, Carlos Magis-Rodríguez, Fatima Juárez, Dan Werb, Sergio Bautista Arredondo, Rubén Carreón, María Elena Ramos, Steffanie Strathdee
BACKGROUND: A large body of research has investigated the rise of injection drug use and HIV transmission in Tijuana and Ciudad Juarez (CJ). However, little is known about the dynamics of injecting in Hermosillo. This study compares drug-related behaviors and risk environment for HIV of people who inject drugs (PWID) across Tijuana, CJ, and Hermosillo to identify factors that could explain differences in HIV prevalence. METHODS: Data from Tijuana belong to a prospective study (El Cuete IV)...
May 18, 2018: Harm Reduction Journal
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