Emergency Departments (ED) staff, including nurses and physicians, are most directly involved in the care of people who use unregulated substances, and are ideally positioned to provide harm reduction interventions. Conceptualizing the ED as a complex adaptive system, this paper examines how ED staff experience opioid-specific harm reduction provision and engage in harm reduction practice, including potential facilitators and barriers to engagement. Using a mixed methods approach, ED nurses and physicians completed a self-administered staff survey (n = 99) and one-on-one semi-structured interviews (n = 15). Five additional interviews were completed with clinical leaders. Survey data were analyzed to generate descriptive statistics and to compute scale scores. De-identified interview data were analyzed using a reflexive thematic analysis approach, which was informed by the theory of complex adaptive systems, as well as understandings of harm reduction as both a technical solution and a contextualized social practice. The final analysis involved mixed analysis through integrating both quantitative and qualitative data to generate overarching analytical themes. Study findings illustrated that, within the context of the ED as a complex adaptive system, three interrelated contextual factors shape the capacity of staff to engage in harm reduction practice, and to implement the full range of opioid-specific harm reduction interventions available. These factors include opportunities to leverage benefits afforded by working collaboratively with colleagues, adequate preparation through receiving the necessary education and training, and support in helping patients establish connections for ongoing care. There is a need for harm reduction provision across all health and social care settings where people who use unregulated opioids access public sector services. In the context of the ED, attention to contextual factors including teamwork, preparedness, and connections is warranted to support that ED staff engage in harm reduction practice.
{"title":"Opioid-specific harm reduction in the emergency department: how staff provide harm reduction and contextual factors that impact their capacity to engage in harm reduction practice","authors":"Sunny Jiao, Vicky Bungay, Emily Jenkins, Marilou Gagnon","doi":"10.1186/s12954-024-01088-6","DOIUrl":"https://doi.org/10.1186/s12954-024-01088-6","url":null,"abstract":"Emergency Departments (ED) staff, including nurses and physicians, are most directly involved in the care of people who use unregulated substances, and are ideally positioned to provide harm reduction interventions. Conceptualizing the ED as a complex adaptive system, this paper examines how ED staff experience opioid-specific harm reduction provision and engage in harm reduction practice, including potential facilitators and barriers to engagement. Using a mixed methods approach, ED nurses and physicians completed a self-administered staff survey (n = 99) and one-on-one semi-structured interviews (n = 15). Five additional interviews were completed with clinical leaders. Survey data were analyzed to generate descriptive statistics and to compute scale scores. De-identified interview data were analyzed using a reflexive thematic analysis approach, which was informed by the theory of complex adaptive systems, as well as understandings of harm reduction as both a technical solution and a contextualized social practice. The final analysis involved mixed analysis through integrating both quantitative and qualitative data to generate overarching analytical themes. Study findings illustrated that, within the context of the ED as a complex adaptive system, three interrelated contextual factors shape the capacity of staff to engage in harm reduction practice, and to implement the full range of opioid-specific harm reduction interventions available. These factors include opportunities to leverage benefits afforded by working collaboratively with colleagues, adequate preparation through receiving the necessary education and training, and support in helping patients establish connections for ongoing care. There is a need for harm reduction provision across all health and social care settings where people who use unregulated opioids access public sector services. In the context of the ED, attention to contextual factors including teamwork, preparedness, and connections is warranted to support that ED staff engage in harm reduction practice.","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"7 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1186/s12954-024-01089-5
Siena C. Napoleon, Carolyn J. Park, Jacqueline Goldman, Yu Li, Jane A. Buxton, Alexandria Macmadu, Katie B. Biello, Julia Noguchi, Brandon D.L. Marshall
Fentanyl is increasingly pervasive in the unregulated drug supply and is a driver of drug overdose deaths in the United States. The aims of this study were to characterize and identify correlates of fentanyl preference among people who use drugs (PWUD) in Rhode Island (RI). Using bivariate analysis, we examined associations between fentanyl preference and sociodemographic and psychosocial characteristics at baseline among participants enrolled in the RI Prescription Drug and Illicit Drug Study from August 2020-February 2023. Fentanyl preference was operationalized based on responses to a five-point Likert scale: “I prefer using fentanyl or drugs that have fentanyl in them.” Participants who responded that they “strongly disagree,” “disagree,” or were “neutral” with respect to this statement were classified as not preferring fentanyl, whereas participants who responded that they “agree” or “strongly agree” were classified as preferring fentanyl. Among 506 PWUD eligible for inclusion in this analysis, 15% expressed a preference for fentanyl or drugs containing fentanyl as their drug of choice. In bivariate analyses, preference for fentanyl was positively associated with younger age, white race, lifetime history of overdose, history of injection drug use, past month enrollment in a substance use treatment program, past month treatment with medications for opioid use disorder, and preferences for heroin and crystal methamphetamine (all p < 0.05). Descriptive data yielded further insight into reasons for fentanyl preference, the predominant having to do with perceived effects of the drug and desire to avoid withdrawal symptoms. Only a relatively small subset of study participants preferred drugs containing fentanyl. Given the increased prevalence of fentanyl contamination across substances within the unregulated drug market, the result for PWUD is increasingly less agency with respect to choice of drug; for example, people may be forced to use fentanyl due to restricted supply and the need to mitigate withdrawal symptoms, or may be using fentanyl without intending to do so. Novel and more effective interventions for PWUD, including increased access to age-appropriate harm reduction programs such as fentanyl test strips and overdose prevention centers, are needed to mitigate fentanyl-related harms.
{"title":"Correlates of fentanyl preference among people who use drugs in Rhode Island","authors":"Siena C. Napoleon, Carolyn J. Park, Jacqueline Goldman, Yu Li, Jane A. Buxton, Alexandria Macmadu, Katie B. Biello, Julia Noguchi, Brandon D.L. Marshall","doi":"10.1186/s12954-024-01089-5","DOIUrl":"https://doi.org/10.1186/s12954-024-01089-5","url":null,"abstract":"Fentanyl is increasingly pervasive in the unregulated drug supply and is a driver of drug overdose deaths in the United States. The aims of this study were to characterize and identify correlates of fentanyl preference among people who use drugs (PWUD) in Rhode Island (RI). Using bivariate analysis, we examined associations between fentanyl preference and sociodemographic and psychosocial characteristics at baseline among participants enrolled in the RI Prescription Drug and Illicit Drug Study from August 2020-February 2023. Fentanyl preference was operationalized based on responses to a five-point Likert scale: “I prefer using fentanyl or drugs that have fentanyl in them.” Participants who responded that they “strongly disagree,” “disagree,” or were “neutral” with respect to this statement were classified as not preferring fentanyl, whereas participants who responded that they “agree” or “strongly agree” were classified as preferring fentanyl. Among 506 PWUD eligible for inclusion in this analysis, 15% expressed a preference for fentanyl or drugs containing fentanyl as their drug of choice. In bivariate analyses, preference for fentanyl was positively associated with younger age, white race, lifetime history of overdose, history of injection drug use, past month enrollment in a substance use treatment program, past month treatment with medications for opioid use disorder, and preferences for heroin and crystal methamphetamine (all p < 0.05). Descriptive data yielded further insight into reasons for fentanyl preference, the predominant having to do with perceived effects of the drug and desire to avoid withdrawal symptoms. Only a relatively small subset of study participants preferred drugs containing fentanyl. Given the increased prevalence of fentanyl contamination across substances within the unregulated drug market, the result for PWUD is increasingly less agency with respect to choice of drug; for example, people may be forced to use fentanyl due to restricted supply and the need to mitigate withdrawal symptoms, or may be using fentanyl without intending to do so. Novel and more effective interventions for PWUD, including increased access to age-appropriate harm reduction programs such as fentanyl test strips and overdose prevention centers, are needed to mitigate fentanyl-related harms.","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"1 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1186/s12954-024-01084-w
Lakshmi Ganapathi, Aylur K. Srikrishnan, Allison M. McFall, Mihili P. Gunaratne, Muniratnam Suresh Kumar, Gregory M. Lucas, Shruti H. Mehta, Sunil S. Solomon
Over the last decade, India has had an alarming rise in injection of opioids across several cities. Although scale-up of public sector services for people who inject drugs (PWID) in India has occurred over decades, accessibility has been diminished by fragmented services across physical locations. To circumvent this barrier, and in alignment with the World Health Organization’s guidelines to provide comprehensive care to key populations, Integrated Care Centers (ICCs) were established across 8 Indian cities as a public–private service delivery model for providing free single-venue services to PWID. ICCs have been very successful in expanding service availability and convenience for PWID generally. However, few studies from low- and middle-income countries (LMIC) have evaluated how well young PWID (defined as those ≤ 29 years of age) engage with single-venue service models like ICCs or specific services provided in such models. Young PWID are an important subpopulation in India, as they bear a disproportionate burden of new HIV infections because of greater risk and evidence of lower receipt of HIV testing and harm reduction services compared to older PWID. In this comment, we offer insights specific to young PWID drawn from multiple quantitative and qualitative studies examining the reach and effectiveness of ICCs, which may provide generalizable insights into limitations of services for young PWID more broadly in India and globally. Our studies suggest that while ICCs have expanded service availability, particularly in cities with emerging injection drug use epidemics, population-level reach to foster initial engagement among young PWID can be optimized. Additionally, young PWID who do engage with ICCs experience gaps in substance use treatment receipt and retention, and experience barriers to receipt of ICC services that are distinct from those experienced by older PWID. Notably, HIV incidence among ICC clients is concentrated in young PWID. Finally, ICCs were not intended to reach adolescent PWID, and new services are needed for this subpopulation. In addition to co-locating services, iterative optimization of models such as ICCs should incorporate youth-specific differentiated interventions and be accompanied by policy changes that are critical to improving the reach and effectiveness of harm reduction and HIV services among young PWID in India.
{"title":"Expanding single-venue services to better engage young people who inject drugs: insights from India","authors":"Lakshmi Ganapathi, Aylur K. Srikrishnan, Allison M. McFall, Mihili P. Gunaratne, Muniratnam Suresh Kumar, Gregory M. Lucas, Shruti H. Mehta, Sunil S. Solomon","doi":"10.1186/s12954-024-01084-w","DOIUrl":"https://doi.org/10.1186/s12954-024-01084-w","url":null,"abstract":"Over the last decade, India has had an alarming rise in injection of opioids across several cities. Although scale-up of public sector services for people who inject drugs (PWID) in India has occurred over decades, accessibility has been diminished by fragmented services across physical locations. To circumvent this barrier, and in alignment with the World Health Organization’s guidelines to provide comprehensive care to key populations, Integrated Care Centers (ICCs) were established across 8 Indian cities as a public–private service delivery model for providing free single-venue services to PWID. ICCs have been very successful in expanding service availability and convenience for PWID generally. However, few studies from low- and middle-income countries (LMIC) have evaluated how well young PWID (defined as those ≤ 29 years of age) engage with single-venue service models like ICCs or specific services provided in such models. Young PWID are an important subpopulation in India, as they bear a disproportionate burden of new HIV infections because of greater risk and evidence of lower receipt of HIV testing and harm reduction services compared to older PWID. In this comment, we offer insights specific to young PWID drawn from multiple quantitative and qualitative studies examining the reach and effectiveness of ICCs, which may provide generalizable insights into limitations of services for young PWID more broadly in India and globally. Our studies suggest that while ICCs have expanded service availability, particularly in cities with emerging injection drug use epidemics, population-level reach to foster initial engagement among young PWID can be optimized. Additionally, young PWID who do engage with ICCs experience gaps in substance use treatment receipt and retention, and experience barriers to receipt of ICC services that are distinct from those experienced by older PWID. Notably, HIV incidence among ICC clients is concentrated in young PWID. Finally, ICCs were not intended to reach adolescent PWID, and new services are needed for this subpopulation. In addition to co-locating services, iterative optimization of models such as ICCs should incorporate youth-specific differentiated interventions and be accompanied by policy changes that are critical to improving the reach and effectiveness of harm reduction and HIV services among young PWID in India.","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"9 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1186/s12954-024-01085-9
Geoff Bardwell, Manal Mansoor, Ashley Van Zwietering, Ellery Cleveland, Dan Snell, Thomas Kerr
<p><b>Correction to: Harm Reduction Journal (2022) 19:136 </b> <b>https://doi.org/10.1186/s12954-022-00725-2</b></p><br/><p>Following publication of the original article [1], part of the first quotation in the Results section has been removed for legal reasons.</p><br/><p>The original article has been corrected.</p><ol data-track-component="outbound reference" data-track-context="references section"><li data-counter="1."><p>Bardwell G, Mansoor M, Van Zwietering A, et al. The “goldfish bowl”: a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting. Harm Reduct J. 2022;19:136. https://doi.org/10.1186/s12954-022-00725-2.</p><p>Article PubMed PubMed Central Google Scholar </p></li></ol><p>Download references<svg aria-hidden="true" focusable="false" height="16" role="img" width="16"><use xlink:href="#icon-eds-i-download-medium" xmlns:xlink="http://www.w3.org/1999/xlink"></use></svg></p><h3>Authors and Affiliations</h3><ol><li><p>School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada</p><p>Geoff Bardwell</p></li><li><p>British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada</p><p>Geoff Bardwell, Manal Mansoor & Thomas Kerr</p></li><li><p>Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada</p><p>Geoff Bardwell & Thomas Kerr</p></li><li><p>Qathet Community Action Team, 218-6975 Alberni Street, Powell River, BC, V8A 2B8, Canada</p><p>Ashley Van Zwietering, Ellery Cleveland & Dan Snell</p></li><li><p>Lift Community Services of Qathet Society, 218-6975 Alberni Street, Powell River, BC, V8A 2B8, Canada</p><p>Ellery Cleveland & Dan Snell</p></li><li><p>Substance Users Society Teaching Advocacy Instead of Neglect (SUSTAIN), 218-6975 Alberni Street, Powell River, BC, V8A 2B8, Canada</p><p>Dan Snell</p></li></ol><span>Authors</span><ol><li><span>Geoff Bardwell</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Manal Mansoor</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Ashley Van Zwietering</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Ellery Cleveland</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Dan Snell</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Thomas Kerr</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Corresponding author</h3><p>Correspondence to Geoff Bard
更正：Harm Reduct J. (2022) 19:136 https://doi.org/10.1186/s12954-022-00725-2Following 原文[1]发表后，由于法律原因，结果部分第一段引文中的部分内容被删除。原文已更正。Bardwell G, Mansoor M, Van Zwietering A, et al. The "goldfish bowl": a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting.Harm Reduct J. 2022; 19:136. https://doi.org/10.1186/s12954-022-00725-2.Article PubMed PubMed Central Google Scholar Download references作者及工作单位滑铁卢大学公共卫生科学学院，200 University Avenue West, Waterloo, ON, N2L 3G1, CanadaGeoff BardwellBritish Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, CanadaGeoff Bardwell, Manal Mansoor & Thomas Kerr不列颠哥伦比亚大学医学系，St.Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, CanadaGeoff Bardwell & Thomas KerrQathet Community Action Team, 218-6975 Alberni Street, Powell River, BC, V8A 2B8, CanadaAshley Van Zwietering, Ellery Cleveland &；Dan SnellLift Community Services of Qathet Society, 218-6975 Alberni Street, Powell River, BC, V8A 2B8, CanadaEllery Cleveland &；Dan SnellSubstance Users Society Teaching Advocacy Instead of Neglect (SUSTAIN), 218-6975 Alberni Street, Powell River, BC, V8A 2B8、加拿大Dan Snell作者Geoff Bardwell查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者Manal Mansoor查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者Ashley Van Zwietering查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者ElleryClevelandView 作者发表作品您也可以在 PubMed Google Scholar 中搜索该作者Dan SnellView 作者发表作品您也可以在 PubMed Google Scholar 中搜索该作者Thomas KerrView 作者发表作品您也可以在 PubMed Google Scholar 中搜索该作者通信作者：Geoff Bardwell。开放获取本文采用知识共享署名 4.0 国际许可协议进行许可，该协议允许以任何媒介或格式使用、共享、改编、分发和复制，只要您适当注明原作者和来源，提供知识共享许可协议的链接，并说明是否进行了修改。本文中的图片或其他第三方材料均包含在文章的知识共享许可协议中，除非在材料的署名栏中另有说明。如果材料未包含在文章的知识共享许可协议中，且您打算使用的材料不符合法律规定或超出许可使用范围，您需要直接从版权所有者处获得许可。要查看该许可的副本，请访问 http://creativecommons.org/licenses/by/4.0/。除非在数据的信用行中另有说明，否则知识共享公共领域专用免责声明（http://creativecommons.org/publicdomain/zero/1.0/）适用于本文提供的数据。转载和许可引用本文Bardwell, G., Mansoor, M., Van Zwietering, A. et al. Correction：金鱼缸"：关于加强监控对加拿大农村和沿海地区吸毒者影响的定性研究。Harm Reduct J 21, 168 (2024). https://doi.org/10.1186/s12954-024-01085-9Download citationPublished: 11 September 2024DOI: https://doi.org/10.1186/s12954-024-01085-9Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative.
{"title":"Correction: The “goldfish bowl”: a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting","authors":"Geoff Bardwell, Manal Mansoor, Ashley Van Zwietering, Ellery Cleveland, Dan Snell, Thomas Kerr","doi":"10.1186/s12954-024-01085-9","DOIUrl":"https://doi.org/10.1186/s12954-024-01085-9","url":null,"abstract":"<p><b>Correction to: Harm Reduction Journal (2022) 19:136 </b> <b>https://doi.org/10.1186/s12954-022-00725-2</b></p><br/><p>Following publication of the original article [1], part of the first quotation in the Results section has been removed for legal reasons.</p><br/><p>The original article has been corrected.</p><ol data-track-component=\"outbound reference\" data-track-context=\"references section\"><li data-counter=\"1.\"><p>Bardwell G, Mansoor M, Van Zwietering A, et al. The “goldfish bowl”: a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting. Harm Reduct J. 2022;19:136. https://doi.org/10.1186/s12954-022-00725-2.</p><p>Article PubMed PubMed Central Google Scholar </p></li></ol><p>Download references<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><h3>Authors and Affiliations</h3><ol><li><p>School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada</p><p>Geoff Bardwell</p></li><li><p>British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada</p><p>Geoff Bardwell, Manal Mansoor & Thomas Kerr</p></li><li><p>Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada</p><p>Geoff Bardwell & Thomas Kerr</p></li><li><p>Qathet Community Action Team, 218-6975 Alberni Street, Powell River, BC, V8A 2B8, Canada</p><p>Ashley Van Zwietering, Ellery Cleveland & Dan Snell</p></li><li><p>Lift Community Services of Qathet Society, 218-6975 Alberni Street, Powell River, BC, V8A 2B8, Canada</p><p>Ellery Cleveland & Dan Snell</p></li><li><p>Substance Users Society Teaching Advocacy Instead of Neglect (SUSTAIN), 218-6975 Alberni Street, Powell River, BC, V8A 2B8, Canada</p><p>Dan Snell</p></li></ol><span>Authors</span><ol><li><span>Geoff Bardwell</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Manal Mansoor</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Ashley Van Zwietering</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Ellery Cleveland</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Dan Snell</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Thomas Kerr</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Corresponding author</h3><p>Correspondence to Geoff Bard","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"175 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1186/s12954-024-01087-7
Samah Alageel, Noura Alomair
The purpose of this study was to explore Muslim’s perceptions and views of raising awareness on safe alcohol use and counterfeit alcohol harms in Islamic countries. Qualitative semi-structured interviews with a purposive sample from the Gulf Council Cooperation (GCC) countries. The data were analysed using a reflexive thematic analysis method. Twenty-three participants took part in this study. We have identified five themes from the data, including perceptions on alcohol use in the GCC, community’s openness to alcohol discussions, approaches to raising awareness on alcohol use, all forbidden is desirable, and legalisation is the solution. All participants acknowledged the existence of alcohol use in GCC communities and advocated for the need to raise public awareness about the harms of alcohol use. Opinions on approaches to raising awareness varied. Some participants suggested focusing awareness on the religious messages prohibiting alcohol use, emphasising that alcohol is harmful in any quantity. For some, raising awareness of safe alcohol consumption was viewed as accepting and encouraging alcohol use, which goes against Islamic religious beliefs. Some participants attributed alcohol misuse and the consumption of counterfeit alcohol to the ban on alcohol products in some GCC countries. Muslims acknowledge the existence of alcohol use in Muslim communities, yet there is a hesitancy in raising awareness of safe alcohol use. Although challenging, there is a need to combine the public health perspective on safe alcohol use while providing messages that acknowledge the religious aspect.
{"title":"Muslims perceptions of safe alcohol use: a qualitative study in the Gulf Council Cooperation countries","authors":"Samah Alageel, Noura Alomair","doi":"10.1186/s12954-024-01087-7","DOIUrl":"https://doi.org/10.1186/s12954-024-01087-7","url":null,"abstract":"The purpose of this study was to explore Muslim’s perceptions and views of raising awareness on safe alcohol use and counterfeit alcohol harms in Islamic countries. Qualitative semi-structured interviews with a purposive sample from the Gulf Council Cooperation (GCC) countries. The data were analysed using a reflexive thematic analysis method. Twenty-three participants took part in this study. We have identified five themes from the data, including perceptions on alcohol use in the GCC, community’s openness to alcohol discussions, approaches to raising awareness on alcohol use, all forbidden is desirable, and legalisation is the solution. All participants acknowledged the existence of alcohol use in GCC communities and advocated for the need to raise public awareness about the harms of alcohol use. Opinions on approaches to raising awareness varied. Some participants suggested focusing awareness on the religious messages prohibiting alcohol use, emphasising that alcohol is harmful in any quantity. For some, raising awareness of safe alcohol consumption was viewed as accepting and encouraging alcohol use, which goes against Islamic religious beliefs. Some participants attributed alcohol misuse and the consumption of counterfeit alcohol to the ban on alcohol products in some GCC countries. Muslims acknowledge the existence of alcohol use in Muslim communities, yet there is a hesitancy in raising awareness of safe alcohol use. Although challenging, there is a need to combine the public health perspective on safe alcohol use while providing messages that acknowledge the religious aspect.","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"40 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Opioid use disorder (OUD) poses a global health challenge, and despite medications for opioid use disorder (MOUD) and psychosocial interventions, relapse remains a significant concern. Comorbid psychiatric disorders, including attention deficit hyperactivity disorder (ADHD), are one of the major factors associated with poor OUD treatment outcome. We aimed to estimate the frequency of probable ADHD (in childhood and in adulthood) in patients with OUD; to assess the factors associated with this comorbidity; and to explore the factors that mediate the relationship between ADHD and OUD treatment outcome. We conducted an observational study using a sample of 229 patients aged 18 years and older who were diagnosed with OUD and had received MOUD for at least six months. Participants were assessed through a structured interview and self-report questionnaires. Multivariate logistic regressions and a mediation analysis were performed. Almost half of the participants reported probable ADHD in childhood, and ADHD persisted into adulthood among two-thirds of the patients. The factors associated with poor OUD treatment outcome included earlier onset of OUD, lower education, and greater impulsivity. There was no direct effect of probable ADHD in childhood on OUD treatment outcome, but there was an indirect effect through negative urgency, the tendency to respond impulsively to negatively connoted emotional experiences. The findings suggest that ADHD symptoms, particularly impulsivity, may contribute to vulnerability in opioid use and play a crucial role in treatment outcomes for this population. Trial registration: ClinicalTrials identifier NCT01847729.
{"title":"ADHD: prevalence and effect on opioid use disorder treatment outcome in a French sample of patients receiving medication for opioid use disorder—the influence of impulsivity as a mediating factor","authors":"Auxane Beslot, Marie Grall-Bronnec, Marianne Balem, Benoit Schreck, Edouard-Jules Laforgue, Caroline Victorri-Vigneau, Morgane Guillou-Landreat, Juliette Leboucher, Gaëlle Challet-Bouju, Clémence Cabelguen","doi":"10.1186/s12954-024-01079-7","DOIUrl":"https://doi.org/10.1186/s12954-024-01079-7","url":null,"abstract":"Opioid use disorder (OUD) poses a global health challenge, and despite medications for opioid use disorder (MOUD) and psychosocial interventions, relapse remains a significant concern. Comorbid psychiatric disorders, including attention deficit hyperactivity disorder (ADHD), are one of the major factors associated with poor OUD treatment outcome. We aimed to estimate the frequency of probable ADHD (in childhood and in adulthood) in patients with OUD; to assess the factors associated with this comorbidity; and to explore the factors that mediate the relationship between ADHD and OUD treatment outcome. We conducted an observational study using a sample of 229 patients aged 18 years and older who were diagnosed with OUD and had received MOUD for at least six months. Participants were assessed through a structured interview and self-report questionnaires. Multivariate logistic regressions and a mediation analysis were performed. Almost half of the participants reported probable ADHD in childhood, and ADHD persisted into adulthood among two-thirds of the patients. The factors associated with poor OUD treatment outcome included earlier onset of OUD, lower education, and greater impulsivity. There was no direct effect of probable ADHD in childhood on OUD treatment outcome, but there was an indirect effect through negative urgency, the tendency to respond impulsively to negatively connoted emotional experiences. The findings suggest that ADHD symptoms, particularly impulsivity, may contribute to vulnerability in opioid use and play a crucial role in treatment outcomes for this population. Trial registration: ClinicalTrials identifier NCT01847729.","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"1 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1186/s12954-024-01083-x
Jihoon Lim, W Alton Russell, Mariam El-Sheikh, David L. Buckeridge, Dimitra Panagiotoglou
<p><b>Correction: Harm Reduction Journal (2024) 21:126</b></p><p><b>https://doi.org/10.1186/s12954-024-01037-3</b></p><p>Following publication of the original article [1], the author would like to include missing co-author W Alton Russell in the author group. The author contribution is mentioned in the acknowledgement section, however inadvertently not provided in the author group.</p><p>The author group should appear as mentioned below:</p><p>Jihoon Lim<sup>1</sup>, W Alton Russell<sup>1</sup>, Mariam El Sheikh<sup>1</sup>, David L Buckeridge<sup>1</sup> and Dimitra Panagiotoglou<sup>1*</sup></p><p>The original article has been corrected.</p><ol data-track-component="outbound reference" data-track-context="references section"><li data-counter="1."><p>Lim, J., El-Sheikh, M., Buckeridge, D.L. et al. Economic evaluation of the effect of needle and syringe programs on skin, soft tissue, and vascular infections in people who inject drugs: a microsimulation modelling approach. Harm Reduct J 2024;21:126. https://doi.org/10.1186/s12954-024-01037-3</p></li></ol><p>Download references<svg aria-hidden="true" focusable="false" height="16" role="img" width="16"><use xlink:href="#icon-eds-i-download-medium" xmlns:xlink="http://www.w3.org/1999/xlink"></use></svg></p><h3>Authors and Affiliations</h3><ol><li><p>Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 2001 McGill College Avenue, Suite 1200, Montreal, QC, H3A 1G1, Canada</p><p>Jihoon Lim, W Alton Russell, Mariam El-Sheikh, David L. Buckeridge & Dimitra Panagiotoglou</p></li></ol><span>Authors</span><ol><li><span>Jihoon Lim</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>W Alton Russell</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Mariam El-Sheikh</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>David L. Buckeridge</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Dimitra Panagiotoglou</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Corresponding author</h3><p>Correspondence to Dimitra Panagiotoglou.</p><h3>Publisher’s note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p>The online version of the original article can be found at https://doi.org/10.1186/s12954-024-01037-3.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) a
更正：Harm Reduction Journal (2024) 21:126https://doi.org/10.1186/s12954-024-01037-3Following 原文[1]发表后，作者希望将缺失的合著者W Alton Russell列入作者群。作者在致谢部分提到了作者的贡献，但不慎未在作者群中提供。作者群应如下所示：Jihoon Lim1, W Alton Russell1, Mariam El Sheikh1, David L Buckeridge1 and Dimitra Panagiotoglou1*原文已更正、El-Sheikh, M., Buckeridge, D.L. et al. 针头和注射器计划对注射吸毒者皮肤、软组织和血管感染影响的经济评估：微观模拟建模方法。Harm Reduct J 2024;21:126. https://doi.org/10.1186/s12954-024-01037-3Download 参考文献作者和工作单位麦吉尔大学流行病学、生物统计学和职业健康系，2001 McGill College Avenue, Suite 1200, Montreal, QC, H3A 1G1, CanadaJihoon Lim, W Alton Russell, Mariam El-Sheikh, David L. Buckeridge & Dimensions.Buckeridge & Dimitra Panagiotoglou作者Jihoon Lim查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者W Alton Russell查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者Mariam El-Sheikh查看作者发表的文章您也可以在PubMed Google Scholar中搜索该作者David L.BuckeridgeView author publications您也可以在PubMed Google Scholar中搜索该作者Dimitra PanagiotoglouView author publications您也可以在PubMed Google Scholar中搜索该作者Corresponding authorCorrespondence to Dimitra Panagiotoglou.Publisher's note施普林格-自然对出版地图和机构隶属关系中的管辖权主张保持中立。原文的在线版本可在 https://doi.org/10.1186/s12954-024-01037-3.Open Access 上找到。本文采用知识共享署名 4.0 国际许可协议进行许可，该协议允许以任何媒介或格式使用、共享、改编、分发和复制，只要您适当注明原作者和来源，提供知识共享许可协议的链接，并说明是否进行了修改。本文中的图片或其他第三方材料均包含在文章的知识共享许可协议中，除非在材料的署名栏中另有说明。如果材料未包含在文章的知识共享许可协议中，且您打算使用的材料不符合法律规定或超出许可使用范围，您需要直接从版权所有者处获得许可。如需查看该许可的副本，请访问 http://creativecommons.org/licenses/by/4.0/。除非在数据的信用行中另有说明，否则本文提供的数据适用知识共享公共领域专用免责声明 (http://creativecommons.org/publicdomain/zero/1.0/)。转载与许可引用本文Lim, J., Russell, W., El-Sheikh, M. et al. Correction：针头和注射器计划对注射吸毒者皮肤、软组织和血管感染影响的经济评估：微观模拟建模方法。Harm Reduct J 21, 164 (2024). https://doi.org/10.1186/s12954-024-01083-xDownload citationPublished: 09 September 2024DOI: https://doi.org/10.1186/s12954-024-01083-xShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative.
{"title":"Correction: Economic evaluation of the effect of needle and syringe programs on skin, soft tissue, and vascular infections in people who inject drugs: a microsimulation modelling approach","authors":"Jihoon Lim, W Alton Russell, Mariam El-Sheikh, David L. Buckeridge, Dimitra Panagiotoglou","doi":"10.1186/s12954-024-01083-x","DOIUrl":"https://doi.org/10.1186/s12954-024-01083-x","url":null,"abstract":"<p><b>Correction: Harm Reduction Journal (2024) 21:126</b></p><p><b>https://doi.org/10.1186/s12954-024-01037-3</b></p><p>Following publication of the original article [1], the author would like to include missing co-author W Alton Russell in the author group. The author contribution is mentioned in the acknowledgement section, however inadvertently not provided in the author group.</p><p>The author group should appear as mentioned below:</p><p>Jihoon Lim<sup>1</sup>, W Alton Russell<sup>1</sup>, Mariam El Sheikh<sup>1</sup>, David L Buckeridge<sup>1</sup> and Dimitra Panagiotoglou<sup>1*</sup></p><p>The original article has been corrected.</p><ol data-track-component=\"outbound reference\" data-track-context=\"references section\"><li data-counter=\"1.\"><p>Lim, J., El-Sheikh, M., Buckeridge, D.L. et al. Economic evaluation of the effect of needle and syringe programs on skin, soft tissue, and vascular infections in people who inject drugs: a microsimulation modelling approach. Harm Reduct J 2024;21:126. https://doi.org/10.1186/s12954-024-01037-3</p></li></ol><p>Download references<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><h3>Authors and Affiliations</h3><ol><li><p>Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 2001 McGill College Avenue, Suite 1200, Montreal, QC, H3A 1G1, Canada</p><p>Jihoon Lim, W Alton Russell, Mariam El-Sheikh, David L. Buckeridge & Dimitra Panagiotoglou</p></li></ol><span>Authors</span><ol><li><span>Jihoon Lim</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>W Alton Russell</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Mariam El-Sheikh</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>David L. Buckeridge</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Dimitra Panagiotoglou</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Corresponding author</h3><p>Correspondence to Dimitra Panagiotoglou.</p><h3>Publisher’s note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p>The online version of the original article can be found at https://doi.org/10.1186/s12954-024-01037-3.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) a","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"96 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1186/s12954-024-01046-2
Erin E. Gould, Siddhi S. Ganesh, Rachel Carmen Ceasar
Cannabis is the most common illicit substance used in pregnancy. As use continues to increase, understanding peoples’ behaviors surrounding cannabis use during pregnancy is needed to improve maternal and child health outcomes. The aim of this study was to better understand pregnant individuals' perceptions and knowledge of cannabis use and use patterns as well as the social and environmental factors that may influence their use. We conducted interviews with 19 participants between December 2022 and March 2023. Individuals self-identified as BIPOC (Black, Indigenous, People of Color), were over 21 years of age, spoke English or Spanish, resided in California, and had used cannabis during pregnancy in the last 0–2 years. Using qualitative, constructivist grounded theory methods, we analyzed the contexts that contributed to participants’ lived experiences surrounding cannabis use behaviors during pregnancy. Participants reported making conscious decisions to responsibly manage their cannabis use during pregnancy to minimize potential harm to the fetus. Participants prioritized making what they perceived to be safer adjustments to their use of cannabis: (1) changing the amount of cannabis used, (2) changing the types of cannabis products used, and (3) changing sources of cannabis procurement. Our findings show that pregnant individuals are seeking information about safe cannabis use beyond medical supervision and are open to altering their cannabis consumption patterns. However, they are unable to find trustworthy and evidence-based harm reduction practices which can be implemented to mitigate harm to their unborn children. A harm reduction approach is needed in the field of maternal cannabis use to promote positive maternal and fetal health outcomes. More data is needed on comprehensive harm reduction approaches to cannabis use during pregnancy. This requires implementation of education on these topics in healthcare settings presented by prenatal care clinicians.
{"title":"“I don’t need my kid to be high”: prioritizing harm reduction when using cannabis during pregnancy","authors":"Erin E. Gould, Siddhi S. Ganesh, Rachel Carmen Ceasar","doi":"10.1186/s12954-024-01046-2","DOIUrl":"https://doi.org/10.1186/s12954-024-01046-2","url":null,"abstract":"Cannabis is the most common illicit substance used in pregnancy. As use continues to increase, understanding peoples’ behaviors surrounding cannabis use during pregnancy is needed to improve maternal and child health outcomes. The aim of this study was to better understand pregnant individuals' perceptions and knowledge of cannabis use and use patterns as well as the social and environmental factors that may influence their use. We conducted interviews with 19 participants between December 2022 and March 2023. Individuals self-identified as BIPOC (Black, Indigenous, People of Color), were over 21 years of age, spoke English or Spanish, resided in California, and had used cannabis during pregnancy in the last 0–2 years. Using qualitative, constructivist grounded theory methods, we analyzed the contexts that contributed to participants’ lived experiences surrounding cannabis use behaviors during pregnancy. Participants reported making conscious decisions to responsibly manage their cannabis use during pregnancy to minimize potential harm to the fetus. Participants prioritized making what they perceived to be safer adjustments to their use of cannabis: (1) changing the amount of cannabis used, (2) changing the types of cannabis products used, and (3) changing sources of cannabis procurement. Our findings show that pregnant individuals are seeking information about safe cannabis use beyond medical supervision and are open to altering their cannabis consumption patterns. However, they are unable to find trustworthy and evidence-based harm reduction practices which can be implemented to mitigate harm to their unborn children. A harm reduction approach is needed in the field of maternal cannabis use to promote positive maternal and fetal health outcomes. More data is needed on comprehensive harm reduction approaches to cannabis use during pregnancy. This requires implementation of education on these topics in healthcare settings presented by prenatal care clinicians.","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"65 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1186/s12954-024-01071-1
Machteld Busz, Katrin Schiffer, Ancella Voets, Alice Pomfret
In this article the authors offer their perspective on the changes in the Dutch harm reduction field. From the 1970s to the 1990s, the Netherlands emerged as a leader in harm reduction services, driven by grassroots movements like the Medisch-sociale Dienst Heroïne Gebruikers (MDHG) (Medisch-sociale Dienst Heroïne Gebruikers (MDHG) translates to Medical-Social Service Heroin Users in English) in Amsterdam and Junkiebond in Rotterdam. These organisations advocated for health-centred policies, initiated needle exchange programmes, and created safe consumption spaces. Their efforts led to significant public health improvements and policy shifts towards harm reduction, reducing HIV and hepatitis rates among people who use drugs. By the 1980s, harm reduction became institutionalised within local health and social care systems, leading to notable declines in drug-related harm and crime. However, from the 2000s, a shift towards security and crime prevention emerged, influenced by socio-political changes. Increased criminal justice measures and budget cuts for harm reduction services strained the system, making it harder to address emerging drug trends and the complex needs of people who use drugs. Despite challenges, there is renewed momentum for reform, particularly at the local level, advocating for the responsible regulation of psychoactive substances. Amsterdam Mayor Femke Halsema's 2024 conference on drug regulation exemplifies this shift, calling for policies that address prohibition failures and centre harm reduction. International bodies like the UN High Commissioner for Human Rights support this approach, emphasising a health and rights-based framework. As the Netherlands navigates these evolving dynamics, there is a pressing need to reinvest in harm reduction infrastructure, ensuring it meets diverse community needs and reaffirms its foundational rights-affirming principles.
{"title":"Reframing Dutch drug policies: a new era for harm reduction.","authors":"Machteld Busz, Katrin Schiffer, Ancella Voets, Alice Pomfret","doi":"10.1186/s12954-024-01071-1","DOIUrl":"https://doi.org/10.1186/s12954-024-01071-1","url":null,"abstract":"<p><p>In this article the authors offer their perspective on the changes in the Dutch harm reduction field. From the 1970s to the 1990s, the Netherlands emerged as a leader in harm reduction services, driven by grassroots movements like the Medisch-sociale Dienst Heroïne Gebruikers (MDHG) (Medisch-sociale Dienst Heroïne Gebruikers (MDHG) translates to Medical-Social Service Heroin Users in English) in Amsterdam and Junkiebond in Rotterdam. These organisations advocated for health-centred policies, initiated needle exchange programmes, and created safe consumption spaces. Their efforts led to significant public health improvements and policy shifts towards harm reduction, reducing HIV and hepatitis rates among people who use drugs. By the 1980s, harm reduction became institutionalised within local health and social care systems, leading to notable declines in drug-related harm and crime. However, from the 2000s, a shift towards security and crime prevention emerged, influenced by socio-political changes. Increased criminal justice measures and budget cuts for harm reduction services strained the system, making it harder to address emerging drug trends and the complex needs of people who use drugs. Despite challenges, there is renewed momentum for reform, particularly at the local level, advocating for the responsible regulation of psychoactive substances. Amsterdam Mayor Femke Halsema's 2024 conference on drug regulation exemplifies this shift, calling for policies that address prohibition failures and centre harm reduction. International bodies like the UN High Commissioner for Human Rights support this approach, emphasising a health and rights-based framework. As the Netherlands navigates these evolving dynamics, there is a pressing need to reinvest in harm reduction infrastructure, ensuring it meets diverse community needs and reaffirms its foundational rights-affirming principles.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"163"},"PeriodicalIF":4.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1186/s12954-024-01076-w
Jill Owczarzak, Emily Martin, Noelle Weicker, Imogen Evans, Miles Morris, Susan G Sherman
Background: Despite the widespread use of the phrase "harm reduction" and the proliferation of programs based on its principles during the current opioid epidemic, what it means in practice is not universally agreed upon. Harm reduction strategies have expanded from syringe and needle exchange programs that emerged in the mid-1980s primarily in response to the HIV epidemic, to include medication for opioid use disorder, supervised consumption rooms, naloxone distribution, and drug checking technologies such as fentanyl test strips. Harm reduction can often be in tension with abstinence and recovery models to address substance use, and people who use drugs may also hold competing views of what harm reduction means in practice. Street-based outreach workers are increasingly incorporated into harm reduction programs as part of efforts to engage with people more fully in various stages of drug use and nonuse.
Method: This paper explores how peer outreach workers, called "members," in a street-based naloxone distribution program define and practice harm reduction. We interviewed 15 members of a street-based harm reduction organization in an urban center characterized by an enduring opioid epidemic. Inductive data analysis explored harm reduction as both a set of principles and a set of practices to understand how frontline providers define and enact them.
Results: Analysis revealed that when members talked about their work, they often conceptualized harm reduction as a collection of ways members and others can "save lives" and support people who use drugs. They also framed harm reduction as part of a "path toward recovery." This path was complicated and nonlinear but pursued a common goal of life without drug use and its residual effects. These findings suggest the need to develop harm reduction programs that incorporate both harm reduction and recovery to best meet the needs of people who use drugs and align with the value systems of implementers.
{"title":"A qualitative exploration of harm reduction in practice by street-based peer outreach workers.","authors":"Jill Owczarzak, Emily Martin, Noelle Weicker, Imogen Evans, Miles Morris, Susan G Sherman","doi":"10.1186/s12954-024-01076-w","DOIUrl":"https://doi.org/10.1186/s12954-024-01076-w","url":null,"abstract":"<p><strong>Background: </strong>Despite the widespread use of the phrase \"harm reduction\" and the proliferation of programs based on its principles during the current opioid epidemic, what it means in practice is not universally agreed upon. Harm reduction strategies have expanded from syringe and needle exchange programs that emerged in the mid-1980s primarily in response to the HIV epidemic, to include medication for opioid use disorder, supervised consumption rooms, naloxone distribution, and drug checking technologies such as fentanyl test strips. Harm reduction can often be in tension with abstinence and recovery models to address substance use, and people who use drugs may also hold competing views of what harm reduction means in practice. Street-based outreach workers are increasingly incorporated into harm reduction programs as part of efforts to engage with people more fully in various stages of drug use and nonuse.</p><p><strong>Method: </strong>This paper explores how peer outreach workers, called \"members,\" in a street-based naloxone distribution program define and practice harm reduction. We interviewed 15 members of a street-based harm reduction organization in an urban center characterized by an enduring opioid epidemic. Inductive data analysis explored harm reduction as both a set of principles and a set of practices to understand how frontline providers define and enact them.</p><p><strong>Results: </strong>Analysis revealed that when members talked about their work, they often conceptualized harm reduction as a collection of ways members and others can \"save lives\" and support people who use drugs. They also framed harm reduction as part of a \"path toward recovery.\" This path was complicated and nonlinear but pursued a common goal of life without drug use and its residual effects. These findings suggest the need to develop harm reduction programs that incorporate both harm reduction and recovery to best meet the needs of people who use drugs and align with the value systems of implementers.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"161"},"PeriodicalIF":4.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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