The evolution of addiction treatment and harm reduction programs in Iran: a chaotic response or a synergistic diversity?

Addiction ◽  
2019 ◽  
Vol 115 (7) ◽  
pp. 1395-1403 ◽  
Author(s):  
Hamed Ekhtiari ◽  
Alireza Noroozi ◽  
Ali Farhoudian ◽  
Seyed Ramin Radfar ◽  
Ahmad Hajebi ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Addiction Treatment ◽  
Chaotic Response

scholarly journals Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice

2021 ◽  
Vol 12 ◽  
Author(s):  
Ingmar Gorman ◽  
Elizabeth M. Nielson ◽  
Aja Molinar ◽  
Ksenia Cassidy ◽  
Jonathan Sabbagh
Keyword(s):  
Harm Reduction ◽  
Transtheoretical Model ◽  
Addiction Treatment ◽  
Therapeutic Potential ◽  
Historical Context ◽  
Academic Research ◽  
Clinical Approach ◽  
Mental Health Providers ◽  
Health Providers ◽  
Mainstream Media

Psychedelic Harm Reduction and Integration (PHRI) is a transtheoretical and transdiagnostic clinical approach to working with patients who are using or considering using psychedelics in any context. The ongoing discussion of psychedelics in academic research and mainstream media, coupled with recent law enforcement deprioritization of psychedelics and compassionate use approvals for psychedelic-assisted therapy, make this model exceedingly timely. Given the prevalence of psychedelic use, the therapeutic potential of psychedelics, and the unique cultural and historical context in which psychedelics are placed, it is important that mental health providers have an understanding of the unique motivations, experiences, and needs of people who use them. PHRI incorporates elements of harm reduction psychotherapy and psychedelic-assisted psychotherapy, and can be applied in both brief and ongoing psychotherapy interactions. PHRI represents a shift away from assessment limited to untoward outcomes of psychedelic use and abstinence-based addiction treatment paradigms and toward a stance of compassionate, destigmatizing acceptance of patients' choices. Considerations for assessment, preparation, and working with difficult experiences are presented.

scholarly journals Risky injection practices and HCV awareness in Chiang Mai Province, Thailand: a respondent-driven sampling study of people who inject drugs

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Myrtille Prouté ◽  
Sophie Le Coeur ◽  
Métrey H. Tiv ◽  
Timothée Dub ◽  
Parinya Jongpaijitsakul ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Addiction Treatment ◽  
People Who Inject Drugs ◽  
Civil Society Organizations ◽  
Public Health Approach ◽  
Minority Ethnic Group ◽  
Respondent Driven Sampling ◽  
Chiang Mai ◽  
Chiang Mai Province ◽  
Injection Practices

Abstract Background People who inject drugs (PWID) are the most exposed to hepatitis C virus (HCV). In Thailand, drug use is highly criminalized, and harm reduction services are scarce. This study estimates risky injection practices and assesses the proportion of HCV awareness and screening in the PWID population in Northern Thailand. Methods We used respondent-driven sampling (RDS) to recruit PWID in Chiang Mai Province. Social and behavioural data were collected through face-to-face interviews at an addiction treatment facility. Weighted population estimates were calculated to limit biases related to the non-random sampling method. Univariate and multivariate analyses were performed to study factors associated with HCV awareness and screening. Results One hundred seventy-one PWID were recruited between April 2016 and January 2017. Median age was 33 (Interquartile range: 26–40) years, 12.2% were women, and 49.4% belonged to a minority ethnic group. Among participants, 76.8% injected heroin, 20.7% methadone, and 20.7% methamphetamine. We estimate that 22.1% [95% CI: 15.7–28.6] of the population had shared needles in the last 6 months and that 32.0% [95% CI: 23.6–40.4] had shared injection material. Only 26.6% [95% CI: 17.6–35.6] had heard of HCV. Factors independently associated with knowledge of HCV included belonging to a harm reduction organization (adjusted odds ratio (aOR) = 5.5 [95% CI: 2.0–15.3]) and voluntary participation in a drug rehabilitation programme (aOR = 4.3 [95% CI: 1.3–13.9]), while Lahu ethnicity was negatively associated (aOR = 0.3 [95% CI: 0.1–0.9]). We estimate that 5% of the PWID population were screened for HCV; the only factor independently associated with being screened was membership of a harm reduction organization (aOR = 5.7 [95% CI: 1.6–19.9]). Conclusion Our study reveals that the PWID population is poorly informed and rarely screened for HCV, despite widespread risky injection practices. A public health approach aimed at reducing the incidence of HCV should target the PWID population and combine harm reduction measures with information and destigmatization campaigns. Civil society organizations working with PWID are a major asset for the success of such an approach, based on their current positive interventions promoting awareness of and screening for HCV.

scholarly journals Personas que se inyectan drogas en Hermosillo, Sonora. Metodología para su registro

2016 ◽  
Vol 28 (67) ◽  
Author(s):  
Angélica Ospina-Escobar
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Population Size ◽  
Addiction Treatment ◽  
People Who Inject Drugs ◽  
Hiv Transmission ◽  
Multiplier Methods ◽  
Qualitative And Quantitative ◽  
Treatment Services ◽  
Mixed Approach

Resumen: conocer el tamaño de las poblaciones es fundamental para estimar universos de necesidad, planear intervenciones y evaluarlas. La estigmatización y criminalización del uso de drogas en México hace que las personas que se las inyectan sean difíciles de alcanzar, sin embargo tienen derecho a la salud, y el Estado está obligado a garantizarla, lo que incluye diseñar acciones efectivas para prevenir el sida. En Hermosillo, Sonora, el peso de la trasmisión del virus de inmunodeficiencia humana por drogas inyectadas ha ganado relevancia en la última década, no obstante, se desconoce el tamaño de la población que se inyecta drogas. En este artículo se describe detalladamente cómo se construye una aproximación mixta de metodologías cualitativas y cuantitativas para estimar el tamaño de dicha población en Hermosillo, y se ofrecen recomendaciones para mejorar los sistemas para registrarla en los servicios de tratamiento de adicciones, y cómo potenciar las intervenciones comunitarias de reducción de daños en la ciudad.Palabras clave: métodos multiplicadores; métodos mixtos; personas que se inyectan drogas; reducción de daños; Hermosillo.Abstract: having estimations of the size of populations is critical to estimate universes of need, plan and evaluate interventions. Stigmatization and criminalization of drug use in Mexico makes pwid constitute a hard-to-reach population; however, they have a right to health and it is an obligation of the State to guarantee it, which includes designing effective actions to prevent aids. In Hermosillo, Sonora, the weight of hiv transmission via injecting drug use has gained prominence in the last decade; nevertheless, there are no estimations of pwid population size. In this paper we describe in detail how to build a mixed approach combining qualitative and quantitative techniques to estimate the population size of pwid in Hermosillo. We present recommendations to improve pwid registration systems in addiction treatment services and how to improve community harm reduction interventions in the city.Key words: multiplier methods; mixed methods; people who inject drugs; harm reduction; Hermosillo.

scholarly journals Community Care in Reach: Mobilizing Harm Reduction and Addiction Treatment Services for Vulnerable Populations

2020 ◽  
Vol 8 ◽  
Author(s):  
Craig Regis ◽  
Jessie M. Gaeta ◽  
Sarah Mackin ◽  
Travis P. Baggett ◽  
Joan Quinlan ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Vulnerable Populations ◽  
Addiction Treatment ◽  
Community Care ◽  
Treatment Services

scholarly journals Municipal police support for harm reduction services in officer-led referrals of people who inject drugs in Tijuana, Mexico

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Pieter Baker ◽  
Jaime Arredondo ◽  
Annick Borquez ◽  
Erika Clairgue ◽  
Maria L. Mittal ◽  
...  
Keyword(s):  
Law Enforcement ◽  
Drug Use ◽  
Harm Reduction ◽  
Addiction Treatment ◽  
People Who Inject Drugs ◽  
Police Training ◽  
Prevalence Ratio ◽  
Crime Reduction ◽  
High Drug ◽  
Addiction Services

Abstract Background Police constitute a structural determinant of health and HIV risk of people who inject drugs (PWID), and negative encounters with law enforcement present significant barriers to PWID access to harm reduction services. Conversely, police may facilitate access via officer-led referrals, potentiating prevention of HIV, overdose, and drug-related harms. We aimed to identify police characteristics associated with support for officer-led referrals to addiction treatment services and syringe service programs (SSP). We hypothesized that officers who believe harm reduction services are contradictory to policing priorities in terms of safety and crime reduction will be less likely to support police referrals. Methods Between January and June 2018, police officers (n = 305) in Tijuana, Mexico, completed self-administered surveys about referrals to harm reduction services during the 24-month follow-up visit as part of the SHIELD police training and longitudinal cohort study. Log-binomial regression was used to estimate adjusted prevalence ratios and model policing characteristics and attitudes related to officers’ support for including addiction treatment and SSP in referrals. Results Respondents were primarily male (89%), patrol officers (86%) with a median age of 38 years (IQR 33–43). Overall, 89% endorsed referral to addiction services, whereas 53% endorsed SSP as acceptable targets of referrals. Officers endorsing addiction services were less likely to be assigned to high drug use districts (adjusted prevalence ratio [APR] = 0.50, 95% CI 0.24, 1.08) and more likely to agree that methadone programs reduce crime (APR = 4.66, 95% CI 2.05, 9.18) than officers who did not support addiction services. Officers endorsing SSPs were younger (adjusted prevalence ratio [APR] = 0.96 95% CI 0.93, 0.98), less likely to be assigned to high drug use districts (APR = 0.50, 95% CI 0.29, 0.87), more likely to believe that methadone programs reduce crime (APR = 2.43, 95% CI 1.30, 4.55), and less likely to believe that SSPs increase risk of needlestick injury for police (APR = 0.44, 0.27, 0.71). Conclusions Beliefs related to the occupational impact of harm reduction services in terms of officer safety and crime reduction are associated with support for referral to related harm reduction services. Efforts to deflect PWID from carceral systems toward harm reduction by frontline police should include measures to improve officer knowledge and attitudes about harm reduction services as they relate to occupational safety and law enforcement priorities. Trial Registration: NCT02444403.

Harm reduction programs for addiction treatment

2020 ◽  
Vol 12 (1-2) ◽  
pp. 5-11
Author(s):  
Bartosz Łoza
Keyword(s):  
Harm Reduction ◽  
Addiction Treatment ◽  
Psychoactive Substance ◽  
Substitution Therapy ◽  
Tobacco Products ◽  
Limited Effectiveness ◽  
The Us ◽  
Economic Damages

The limited effectiveness of anti-addiction pharmacotherapy encourages the introduction of so called harm reduction programs. They allow you to significantly reduce the health, social and economic damages of addicts and their families. The simplest form of harm reduction is the substitution therapy. You can use the same psychoactive substance (e.g. nicotine in patches) or give a different one (e.g. methadone vs morphine). Harm reduction programs are typically criticized for allegedly extending the addiction period. However, the experience of many countries shows that they are effectively contributing to recovery from addiction. Considering the fact that smoking is the main modifiable cause of diseases, and at the same time that there are no sufficiently effective methods of treating this addiction, the use of harm reduction programs – based on the so-called novel tobacco products – seems to be the most appropriate choice. Precedent registrations of subsequent Modified Risk Tobacco Products in the US create conditions to pragmatically replace tobacco products in which smoking occurs – other, smokeless, and at the same time less harmful.

scholarly journals A Public Health Strategy for the Opioid Crisis

2018 ◽  
Vol 133 (1_suppl) ◽  
pp. 24S-34S ◽  
Author(s):  
Brendan Saloner ◽  
Emma E. McGinty ◽  
Leo Beletsky ◽  
Ricky Bluthenthal ◽  
Chris Beyrer ◽  
...  
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Addiction Treatment ◽  
The United States ◽  
Current Data ◽  
Structural Factors ◽  
Opioid Use ◽  
Public Health Perspective ◽  
Injury Death ◽  
Opioid Crisis

Drug overdose is now the leading cause of injury death in the United States. Most overdose fatalities involve opioids, which include prescription medication, heroin, and illicit fentanyl. Current data reveal that the overdose crisis affects all demographic groups and that overdose rates are now rising most rapidly among African Americans. We provide a public health perspective that can be used to mobilize a comprehensive local, state, and national response to the opioid crisis. We argue that framing the crisis from a public health perspective requires considering the interaction of multiple determinants, including structural factors (eg, poverty and racism), the inadequate management of pain, and poor access to addiction treatment and harm-reduction services (eg, syringe services). We propose a novel ecological framework for harmful opioid use that provides multiple recommendations to improve public health and clinical practice, including improved data collection to guide resource allocation, steps to increase safer prescribing, stigma-reduction campaigns, increased spending on harm reduction and treatment, criminal justice policy reform, and regulatory changes related to controlled substances. Focusing on these opportunities provides the greatest chance of making a measured and sustained impact on overdose and related harms.

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