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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.
Harm reduction principles and strategies are designed to minimize the destructive consequences of illicit drug use and other behaviors that may pose serious health risks. The first major harm reduction text, this provocative and timely volume examines a wide range of current applications¿from needle exchange and methadone maintenance programs, to alternative alcohol interventions and HIV/AIDS prevention campaigns. Insight is also offered into the often contentious philosophical and policy-related debates surrounding this growing movement.
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.
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.
Harm reduction entails policies, programs and practices aimed at reducing the harms associated with the use of psychoactive drugs in people who are unwilling or unable to stop. The focus is on the prevention of harm, rather than on the prevention of drug use itself. Harm reduction has been a principle of Australia¿s approach to drug use for several decades. However, recent overdose deaths and hospitalisations at music festivals have highlighted the clear harms of illicit drug use and prompted a debate over the introduction of pill testing, with political leaders being reluctant to implement the measure.
The ebook edition of this title is Open Access and freely available to read online. Examining the impact of drug criminalisation on a previously overlooked demographic, this book argues that women are disproportionately affected by a flawed policy approach.
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.
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.
Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.
Since the First International Conference on the Reduction of Drug-Related Harm, held in 1990, the term 'harm reduction' has gained wide currency in the areas of public health and drug policy. Previously the field was characterized by heated struggle between prohibition and legalization of addictive substances, and this debate tended to obscure practical, collective approaches. Harm reduction, an approach which encompasses various policy directives and program initiatives was inspired by the positive outcomes of such public measures as needle-exchange programs for reduction of HIV risk, methadone maintenance programs, education on the risks of tobacco use, and programs designed to limit alcohol consumption. The essays in this book illustrate the scope and vigour of the emerging harm reduction model. The essays, drawn from seven international conferences on harm reduction, cover a wide variety of topics, including public policy, women and reproductive issues, the experiences of special populations, human rights; defining and measuring harm, and intervention. Researchers and practitioners will benefit from the varied papers in the volume, which combine insights into policy-making and front-line outreach efforts with comprehensive conceptual and empirical approaches. Harm Reduction represents an important initiative in making academic work accessible and useful to a larger community, and provides guidance for the development of effective policies and programs.