Transcript Harm Reduction

1
Drug-Related Harms…
Physical Harms
• Infections – local (abscess), systemic (HIV)
• Poor nutrition, debility, weight loss
• Overdose, death
Occupational /
Financial
Harms
• Absenteeism from work
• Frequent changes of job, loss of job
• Losses suffered/debts incurred
2
Familial /
Social Harms
• Marital disharmony, separation/divorce
• Loss of reputation, social outcast
• Stigma and discrimination
Psychological
Harms
• Guilt/shame, lack of motivation
• Depression, anxiety
• Other mental disorders
Legal Harms
• Involvement in illegal activities
• Arrests, imprisonment
• Drug dealing (NDPS Act)
How Can One Possibly Reduce
These Harms?
Let us do some brain mapping on this
issue…
3
Drug Abuse Management Strategies
4
Supply
Reduction
Strategies
To disrupt the supply and
availability of drugs
Demand
Reduction
Strategies
Aim to reduce the desire to use
drugs and to prevent, reduce or
delay the initiation of drug use
Harm
Reduction
Strategies
Aim to reduce the negative impact of
drug use and drug-related activities
on individuals and communities
Contd…
Drug Abuse Management Strategies
Supply
Reduction
Strategies
Aim to disrupt the supply and
availability of drugs
Regulated supply of legal drugs
• Alcohol only for certain people, in certain settings
• Medications available only through prescriptions
Total prohibition of illegal drugs
• Seizures of drug(s); punishment to drug dealers
5
Contd…
Drug Abuse Management Strategies
Demand
Reduction
Strategies
Aim to reduce the desire to
use drugs and to prevent,
reduce or delay the initiation
of drug use
Primary prevention
• Aimed at young people to discourage initiation
of drug use
Treatment
• Identification of drug users; providing effective
treatment for them
6
What is ‘Harm Reduction’?
“Policies, programs and practices that aim primarily to
reduce the adverse health, social and economic
consequences of drug use without necessarily
reducing drug consumption.”
Means ‘reducing harm from drugs even more
important than reducing drug consumption’
More effective:
• Seeks to achieve realistic, sub-optimal objectives rather
than setting, fail-to-reach, utopian goals
• ‘80% of something > 100% of nothing’
7
Why Harm Reduction?
Why not eliminate all forms of drug use
from the society?
8
Why Can’t Drugs be Eliminated?
 Substance use has been part of human society from
the very beginning
 ‘Zero Tolerance’ based strategies such as
 Legal prohibition of substances
 Abstinence-oriented treatment
have not been able to eliminate substance use
 Making a drug illegal may even increase the harms
associated with its use through marginalization and
criminalization of drug users
9
A drug
free
society:
impossible
to achieve
As a result…
• There will always be some people using drugs
• Among these users
• Some may not be willing to give up drug use altogether
• Many others may have tried but failed
• All such drug using individuals are at
continued risk of drug-related harms
• Harm reduction provides an alternative to deal
with these individuals
10
Strategies for Reducing Drugrelated Harms
Educational Interventions
• How to reduce risk
• Safer methods of drug use
Needle syringe exchange programmes
Substitution, e.g. Methadone, Buprenorphine
Other strategies, e.g. injecting rooms
11
This entire package = ‘harm reduction’
Let us rank
the harm-reduction
strategies!
12
IDU Risk Reduction Through Education
Reduce number of
sharers
Continue injecting with
cleaned needles
Continue injecting with
sterile needles
Substitution – agonist
medicines
Shift to illicit but noninjecting drug
13
Stop drug use
SAFER OPTIONS
Education on Risky Sexual Behaviours
No sex!
One faithful partner
Minimum number of
partners
14
Consistent
condom
use
STD / HIV testing
and treatment
Principles of Harm Reduction
 Recognizes the intrinsic value and dignity of all





human beings
Focuses on health concerns
Seeks to minimize repressive measures or
attributed criminalization of drug use
Does not judge drugs or drug use, views the issue
objectively and seeks to reduce associated harms
Encourages safer drug use
Recognizes the competency of individuals to make
choices that will change their lives in a positive way
 Challenges conventional drug policies and
their consequences
15
THANK YOU!
16