Transcript Harm Reduction - La Salle University

Harm Reduction
Presented by Mike Nielsen
Introduction
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Brief History
Definition
Relationship to Therapy
Controversies
Areas of Effectiveness
Example of Programs
Therapy Continuum
Research
Conclusion
Brief History
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Social Constructionism
Postmodern Knowledge
Licit versus Illicit
Person = Problem
Substance = Problem
Relationship = Problem
Prevention Models
Policy Models
Substitution Therapy
Disease Prevention
Merseyside Model
Harm Reduction
Definition
The term “harm reduction” refers to
policies, programmes and projects which
aim to reduce the health, social and
economic harms associated with the use
of psychoactive substances. It is an
evidence-based and cost-effective
approach – bringing benefits to the
individual, community and society.
Harm reduction is a targeted approach
that focuses on specific harms. It requires
that politicians, policymakers,
communities, researchers and frontline
workers ask two questions:
1. What specifically are the harms
associated with different
psychoactive drugs?
2. What can be done to reduce the
risk of those harms occurring?
International Harm Reduction Association
Relationship to
Therapy
• Abstinence Model
• 5 Stage Change Model
Abstinence
Relationship to Therapy
What is Abstinence?
• Abstain from heroin, but
continue on methadone?
• Abstain from all drugs
but allow occasional
alcohol? (cannabis?)
• Abstain from all illegal
drugs and alcohol, but
cigarettes and caffeine
are OK?
• Abstain from ALL mind
affecting substances.
Abstinence
Relationship to Therapy
Contradictory or
Complimentary
5 Stages of Change
Relationship to Therapy
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Precontemplation
Contemplation
Preparation
Action
Maintenance
Relapse
Controversies
• Safer vs Safe
• Short term gain vs allor-nothing approach
• Politics, Morals &
Religion
• Recreational Drug Use
vs. Medicinal
• Corollary controversies
not directly related to
drug use
Areas of High
Effectiveness
• HIV/AIDS
• STD
• Alcohol
Example of
Program Types
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Needle Exchange
Alcohol
Information Sharing
Drug Testing
Housing Initiatives
Continuum of
Therapy Styles
• Harm Elimination /
Abstinence
• Recovery Readiness
• Moderation
Management &
Controlled Use
• Substitution Therapy
• Relapse Prevention
• Overdose Prevention
• Alternative approaches
Research
• Risk Reduction
• Current Limitations
• Measures Development
Conclusion
Resources
Conclusion
www.harmreduction.org
Harm Reduction Coalition
www.ihra.net
International Harm Reduction Association
www.ohtn.on.ca/nep.htm
Needle Exchange Best Practices
www.harmreductionjournal.com
Harm Reduction Journal
www.dancesafe.org
Harm reduction organization promoting health and safety
within the rave and nightclub community
www.habitsmart.com
Alternative theories of addictive change behavior
www.fox.com/pause
Considers issues surrounding care of body, mind and
relationships. Not overtly labeled as ‘harm reduction’, but
follows the tenets.