[Press release] US needs harm-reduction approach to drug use, researcher says

US needs harm-reduction approach to drug use, researcher says 

From the 14 January 2015 Rice University press release

Neill: Approach minimizes harm associated with drug use for the individual and society    

HOUSTON – (Jan. 14, 2015) – The United States’ law-and-order approach to reducing the supply of drugs and punishing sellers and users has impeded the development of a public health model that views drug addiction as a disease that is preventable and treatable. A new policy paper from Rice University’s Baker Institute for Public Policy advocates that a harm-reduction approach would more effectively reduce the negative individual and societal consequences of drug use.

According to the paper’s author, Katharine Neill, the rate of federal inmates incarcerated for drug offenses hovered at just under 50 percent in 2011, and in 2013 the Obama administration’s budget asked for $25.6 billion to fight the drug war, $15 billion of which was directed toward law enforcement. In addition, by some estimates, state and local governments spend a combined total of $51 billion per year on drug-related law enforcement efforts, which suggests they have a lot to gain by investing in treatment options, Neill said.

“That law enforcement efforts continue to dominate drug policy highlights the need to reframe the discourse on drug use and addiction,” said Neill, the Baker Institute’s Alfred C. Glassell III Postdoctoral Fellow in Drug Policy. “While emphasizing the cost-saving benefits of treatment is important, this should be coupled with more public conversations focusing on drug addiction as a disease requiring medical treatment, not politically based solutions. Reframing the issue in this way should increase the likelihood that a public health approach to drug policy will be adopted for the long term.”

The paper, “Tough on Drugs: Law and Order Dominance and the Neglect of Public Health in U.S. Drug Policy,” is published in the journal World Medical and Health Policy.

Emphasizing harm reduction is a popular public health approach to drugs, Neill said. “A harm-reduction approach recognizes the permanence of drugs in society and, instead of trying to eradicate drug use, focuses on minimizing harm associated with drug use for the individual and society,” she said. “This encompasses a variety of objectives, including preventing individuals from using drugs, treating individuals who want to stop using drugs, preventing drug use where it increases the chances of negative outcomes such as driving while on drugs, and helping individuals who want to continue using drugs do so in a way that does not further compromise their health or the health of others.” This last objective is often achieved through needle-exchange programs intended to prevent the spread of HIV and hepatitis C and is more controversial than other policies, Neill said.

Harm reduction is multidimensional and can include contradictory objectives, she said. For example, some proponents wish to decriminalize drug use and focus on helping drug users get the resources they need for treatment or to continue to use drugs safely, while others accept the illegality of drug use so long as treatment is more available. Others argue that distinctions should be made between drugs according to the risks they pose to the user and society and that policy should be based on these distinctions. “Still, most advocates of harm reduction agree on some basic tenets, including the view that addiction is a disease requiring medical assistance, the desire to minimize risky behavior without requiring abstinence and the need to protect the public from the consequences of drug use, which includes punishing individuals who commit acts that harm others,” Neill said.

– See more at: http://news.rice.edu/2015/01/14/us-needs-harm-reduction-approach-to-drug-use-baker-institute-researcher-says/#sthash.2OCJoKRU.dpuf

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[Reblog] One way to prevent deaths by opiate overdose – Naxolene

From the 6 February 2014 blog item by Mackenzie Fuller at 100 resumes- the perils and victories of starting a public health career

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For opiate users, one option for harm reduction is to provide individuals, their friends, or other people close to them with naloxone (aka Narcan), an antidote to opiate overdose that can be administered intranasally, intramuscularly, or intravenously. Paramedics carry it for responding to potential drug overdoses, but sometimes paramedics aren’t called or arrive too late.

The recent death of actor Philip Seymour Hoffman from a suspected overdose has increased the news coverage of heroin deaths and the importance of naloxone. In my opinion, this news coverage of such an excellent actor highlights that users of heroin and other life-threatening drugs are multi-faceted, complex people, rather than beyond-hope dregs of society. I’m sure to many people this is a no duh statement, yet stereotypes continue to exist.

In July of 2013, Outside In started training their clients to administer naloxone. According one of their Facebook posts, they have trained 600 people and have had 174 overdose reversals reported to them as of February 5th, 2014. That is a lot of lives. While administering naloxone does send a person into withdrawal, withdrawal is better than death. Outside In also runs a needle exchange program, another harm reduction strategy.

In 2013, Oregon passed  SB 384 A, a law allowing persons who have completedtraining (developed by Oregon Health Authority) to possess and administer naloxone for treatment of opiate overdose. The law also gives such individuals immunity from civil liability except for in the case of wanton misconduct. The law became effective June 6th, 2013.

There are naloxone laws expanding access to this antidote in 17 states plus the District of Columbia (though not all the laws are state-wide). See this informative document by the Network for Public Health Law for more information.

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[Reblog] Criminal Law and Public Health – Working at Cross-Purposes?

: Criminal Justice Center (Photo credit: Wikipedia)

 

From the 18th November 2013 post at HealUoS

 

According to recent news reports, the city of Edinburgh is getting tough on those who seek sensual pleasures outside of the confines of their own homes.  The police have asked that condoms be banned from saunas as a way of trying to prevent sexual activity on the premises, and city Councillors have been asked to stop issuing licenses for saunas and massage parlours.

Besides being a naïve and impractical way to prevent people from having sex, there has been, unsurprisingly, a strong condemnation of such a move on the grounds of its potential negative effect on public health.  The charity Scot-pep, for instance, has warned that implementing the police proposal on condoms could lead a HIV epidemic, as well as the proposal to limit establishments where sex workers can meet clients puts them at greater risk from some of the inherent hazards of plying their trade outdoors.

There has been a long history in the United Kingdom of a connection between the criminal justice system and public health.  In some cases, it has been a beneficial relationship in which everything from firearms restrictions, requirements for seat belts, motorcycle helmets and child safety seats and restrictions on intoxicating substances, provide examples where the criminal justice system has been used to mitigate or prevent behaviours that are harmful to individual and population health.  Nevertheless, not all intersections of criminal justice and public health are mutually beneficial.  What is most notable is the distinct progression that has been made from a so-called “policing model of public health”, that often focused on ideas of moral hygiene and legal moralism, which remained influential in Britain into the 19th century, towards more social models of public health that focus on health promotion, harm reduction and social justice.

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Read the entire post here