Transcript What is harm reduction?

Prison staff and harm reduction
Core module session 3
Training Criminal Justice Professionals
in Harm Reduction Services for Vulnerable Groups
funded by the
European Commission
Directorate General for Health and Consumers
Session 3
Harm Reduction
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Activity
How can we reduce harm from risk
behaviours?
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Lecture
Harm Reduction
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What is harm reduction?
Harm reduction is a term that defines policies,
programmes, services and actions that work to
reduce the health, social and economic harms to
individuals, communities and society
(Newcombe, 1992)
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Principles of harm reduction
Harm reduction:

Accepts that some use of psychoactive substances is
inevitable

Aims at the prevention of drug-related harm

Is non-judgemental and always respects the dignity and
rights of the drug users

Complements preventative measures for drug
consumption
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Why implement harm reduction?
 Protecting public and individual health by halting
the transmission of infectious diseases
 Cost-effective measure
 People in prison keep their fundamental rights
and are entitled to the level of health care that is
provided in the community
 Prisoners form part of our society
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Different kind of harm reduction measures
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Information, education and
communication
 Providing information on drugs, infectious
diseases and ways of transmission to inmates
 By health and social services or trained inmates
(peer educators)
 Providing individual/ group counselling,
brochures, leaflets and posters etc.
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Detoxification and opioid
substitution treatment I.
 Withdrawal symptoms of drug/ opioid dependent
prisoners can lead to self-harm and violence
 Opioid substitution treatment (OST) is a medically
supervised treatment (e.g. with methadone)
 The use of adequate medication and behavioural
change can improve the condition of an opioid
dependent person
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Detoxification and opioid
substitution treatment II.
 Relapse after detoxification is common
 In contrast, opioid substitution treatment
 Improves the overall health status
 Reduces criminal activity
 Prevents overdoses and deaths
 Reduces the transmission of infectious diseases,
 Improves the treatment of drug users living with HIV/AIDS
 Reduces the use of illegal drugs
 Stabilizes the drug users’ lives
 Improves the levels of social functioning and employment
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Detoxification and opioid
substitution treatment III.
 Why implement opioid substitution treatment in
prison?
 Difficulties for staff arising during withdrawal periods of
prisoners (violence, drug smuggling)
 Higher rates of self-harm and suicide during periods of
withdrawal
 Requirement to provide equal services in prison and
communities
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Needle/ syringe exchange
programmes I.
 HIV prevalence among prisoners is primarily related
to the sharing of injecting equipment
 Needle exchange reduces the spread of infectious
diseases by providing sterile injecting equipment
 Needle exchange links participants to drug
treatment, medical care and other social services
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Needle/ syringe exchange
programmes II.
 Needle/ syringe exchange programmes are
successfully introduced in prisons throughout Europe
 Neither drug use or injecting drug use increased
 Syringes were not misused (e.g. as weapons)
 Uncomplicated disposal of used syringes
 Reduction of drug use as needle exchange is embedded in
a improved structure of drug counselling and treatment
 Reduction of spread of infectious diseases
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Bleach kits
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Disinfecting injecting equipment with bleach is
a second-line strategy only
Bleach does not kill the infectious agent of
hepatitis and is also not totally effective in
eliminating HIV
Bleach can create a false sense of security
for prisoners sharing injecting equipment
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Condom distribution
 Effective measure in preventing the transmission
of infectious diseases
 Providing condoms in prison does not increase
sexual activity
 Provision in the form of dispensing machines or
condoms can be placed in common areas
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Voluntary HIV counselling and
testing (VCT)
 Helps prisoners learn their HIV status
 Should be offered to prisoners upon admission
and at any time during imprisonment
 Helps HIV positive prisoners benefit from
antiretroviral treatment, care and support
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Activity
Common concerns about harm reduction
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