Harm reduction is a set of strategies that aim to reduce negative consequences of drug use, by mitigating the potential dangers and health risks. UNODC has significantly expanded its HIV/AIDS programme thanks to support from harm reduction-friendly donor countries, despite ambiguities on the issue within UN drug control agencies. There is a need for up-scaling of basic services for HIV/AIDS prevention and the 'frontline' of heroin prescription and drug consumption rooms.
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Drug consumption rooms
Evidence and practice
Eberhard Schatz & Marie NougierIDPC Briefing
June 2012For the past 10 to 20 years, drug consumption rooms (DCRs) have become an integrated part of the drug treatment and harm reduction strategy in a variety of countries in Western Europe, North America and Australia. However, they have not yet been established in the majority of countries worldwide.
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New heroin-assisted treatment
Recent evidence and current practices of supervised injectable heroin treatment in Europe and beyond
John Strang, Teodora Groshkova and Nicola MetrebianEMCDDA Insights Nr. 11
April 2012The prescription of substitution drugs, such as methadone and buprenorphine, has become a mainstream, first-line treatment for opioid dependence, with around 700 000 of Europe’s 1.3 million problem opioid users receiving substitution treatment today. But a small minority of entrenched opioid users repeatedly fails to respond to interventions of this kind. Findings from international trials now suggest that the supervised use of medicinal heroin can be an effective second-line treatment for this small, and previously unresponsive, group. In this latest EMCDDA Insights report, experts describe the development as ‘an important clinical step forward’.
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Prescribing Cannabis for Harm Reduction
Mark CollenHarm Reduction Journal 2012, 9:1
January 2012Neuropathic pain affects between 5% and 10% of the US population and can be refractory to treatment. Opioids may be recommended as a second-line pharmacotherapy but have risks including overdose and death. Cannabis has been shown to be effective for treating nerve pain without the risk of fatal poisoning. The author suggests that physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids. This harm reduction strategy may reduce the morbidity and mortality rates associated with prescription pain medications.
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Amphetamine Type Stimulants and Harm Reduction
Experiences from Myanmar, Thailand and Southern China
Tom BlickmanTNI Drug Policy Briefing Nr. 37
October 2011Little is known about the methamphetamine market in the region, but there are strong indications that the situation is deteriorating with substances becoming stronger, methods of use more harmful and the number of users steadily increasing. There is an urgent need for donors and governments to introduce effective harm reduction measures.
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Breaking the Silence
Cannabis prohibition, organized crime and gang violence in British Columbia
Report prepared by the Stop the Violence BC Coalition
October 2011This brief report outlines the links between cannabis prohibition in British Columbia (Canada) and the growth of organized crime and related violence in the province, and is the first report of a coalition of concerned citizens and experts known as Stop the Violence BC. The report also defines the public health concept “regulation” and seeks to set the stage for a much needed public conversation and action on the part of BC politicians.
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Tackling Violence in Mexico
A translation of an article by Eduardo Guerrero in Nexos
Eduardo Guerrero GutiérrezNexos (México)
June, 2011The Washington Office on Latin America (WOLA) translated the article La raíz de la violencia by Eduardo Guerrero Gutiérrez that was originally published in Spanish in the June 2011 edition of the Mexican magazine Nexos. Guerrero’s article, "At the Root of the Violence," deserves as wide an audience as possible. The author makes a compelling case for shifting to a strategy of "deterrence" to reduce the horrific violence that has been spreading in Mexico.
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Uptake, benefits of and barriers to safer crack use kit (SCUK) distribution programmes in Victoria, Canada
A qualitative exploration
Andrew Ivsins, Eric Roth, Nadine Nakamura, Mel Krajden & Benedikt FischerInternational Journal of Drug Policy 22(4):292-300
July 2011Crack use is prevalent amongst street drug users in Canadian cities, and associated with severe drug use, health and social problems. Whilst few targeted interventions are available for crack use, the common use and sharing of hazardous makeshift paraphernalia are a key concern, as these risks may be associated with oral injury and blood-borne virus (BBV) transmission amongst users. Recently, distribution programmes of so-called 'safer crack use kits' (SCUKs) have been initiated in select Canadian cities, primarily to reduce the use of unsafe materials and paraphernalia sharing amongst crack users. This study explored uptake and benefits of, barriers to, and possible improvements to two recently implemented SCUK distribution programme in Victoria, Canada.
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Do crack smoking practices change with the introduction of safer crack kits?
Leslie A. Malchy, Vicky Bungay, Joy L. Johnson & Jane BuxtonCanadian Journal of Public Health 102(3):188-92.
May-June 2011Crack smoking has increased in Vancouver despite the harms associated with its use. Many people who smoke crack share their equipment, thereby increasing their risk for infectious disease. This project explored the effects of outreach distribution of "safer crack kits" on smoking practices. While kit distribution made safer use items more accessible, its impact on safer use practice was limited. Our findings highlight the need for targeted distribution of safer use items. Future research should explore the dynamics of unsafe crack smoking practices and ways to leverage safer use messaging.
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On the Frontline of Northeast India
Evaluating a Decade of Harm Reduction in Manipur and Nagaland
TNI Drug Policy Briefing Nr. 35
March 2011Conflict and underdevelopment in the region have contributed to drug consumption and production, and are hampering access to treatment, care and support for drug users. Obstacles include curfews imposed by the national government, as well as punitive actions by armed opposition groups against drug users, and discrimination and stigmatization from the local population.
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The Dutch treatment and social support system for drug users
Recent developments and the example of Amsterdam
Eberhard Schatz, Katrin Schiffer & John Peter KoolsIDPC Briefing Paper
January 2011This paper, written in collaboration with the Correlation Network, briefly describes the history and the basic elements of the Dutch drug dependence treatment policy, including recent trends in drug use and the current drug treatment system implemented in the four largest cities in the Netherlands. Building on more than 30 years’ experience, the Dutch approach focuses on an integrated treatment system, which provides comprehensive support and services to the most vulnerable groups, including homeless people, problematic drug users and chronic psychiatric patients. At the same time, a strong emphasis is given to public order and crime reduction.
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