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Harm Reduction, week 7.docx

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Queen's University
Health Studies
HLTH 323
Stevenson Fergus

Harm Reduction as a Health Promotion Strategy Other Approaches to Drug Problems  Prohibition o Attempt to ban use o Tries to get people to stop using substance entirely  Legalization o Allowing substances to be used o Regulated by law  Medicalization o Recognize substance use is not a moral failing o Medical problem  Not moral problem o Treated as a disease o People need treatment and help  Harm Reduction o No other approaches work o No moral failing o Other approaches not practical o Start where people are (change continuum) o Reduce harms Prohibitionist Approach to Drugs  U.S “War on Drugs” o Just say no to drugs  All drugs are bad, all drugs are the same  Moralistic approach o Stigmatize, marginalize o People are bad, immoral if they use drugs  Assumes all consequences of drug use are the same o Eg cocaine is just as bad as marijuana  Not realistic o Substance use is common, people cant just stop  Limited efficacy o Strains the criminal justice system o USA has largest substance use problem, not working o Not successful approach Opposite Spectrum – Legalization Approach to Drugs  Recognizing drugs and regulating drugs o Taxing and improving the quality of the substance o Eg. Ohio, Washington State  California said yes to legalization  Colorado said no  Naïve? o Making drugs legal does not solve the problem o Can make more problems  Condoning against others o Going against what people believe in  Could potentially increase use  Not appropriate for all types of drugs to be legalized  Arguments for Legalization o Alcohol is allowed to drugs should be allowed o Black market and criminal behaviour around drugs would be eliminated Harm Reduction Approach To Drug Use  Value neutral view of drug use and users o Drugs are not good or bad, but recognize that people always use them o No stigma  Focus is on reducing harms with drug use o Limiting dangers o Removing negative outcomes  Health promotion is broadly focused o Focus on many options o Flexible on how to help  Recognizes varying stages of change (change continuum) o Transtheoretical Model  Assess where people are on stages of change  Do people even want to change?  Some people have started change but need more help  Different stages of change, different strategies to help change  Abstinence does not work  Harm Reduction Strategies o Supervised injection sites o Needle exchanges o Methadone maintenance  Daily doses  Those who are addicted to opiates  Physical dependence is treated with methadone  Methadone may not work o Heroin prescription  Methadone may not work o Distribution of crack stems  Eliminate dangers from burns from cack stems  Sharing pipes leads to hepatitis C  Reduce harm with clean pipes o Managed alcohol programs Insite Program – Supervised injection site  Part of the requirements for the program to progress was that they needed a proper evaluation to demonstrate that it worked  Vanc
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