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SOC309Y1 (60)

Harm reduction

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Robb Travers

SOC309 Lecture 10 – Harm reduction and HIV prevention Carol Strike - Professer at the Dalla Lana school of Public Health - Done research for 10 years - Senior scientist of public health researcher - Interested in people who use street based drugs Cost of substance use in CANADA - Most cost related to substance use is around alcohol and tobacco o Most people have smoked cannabis o But most people is related to aclohal and tobacco o Small population is related to illegal drugs Cost associated with illegal drugs is high Large size of enforcement budget Effects of drugs - Type of drug used o Different effects - And how it is administered Swallow Sniff Inhail or smoke Inject – vein under skin / muscle - Speed of absorption in the body o Swallowing is slower - Where in the body the drug is distributed - How quilky it is metabolized - “duration of high” o Is determined by all of the above o Shorter duration drug (ie cocain) – intense but short Use more frequently o Smoking – quick absorption longer duration o Longer duration less frequent use Cocain , crack and stimulants - Effects o Increase alertness o Creates deep sense of euphoria o Elevated self confidence and sense of mastery o Rapid flight of ideas o Twitching seizures headaches, stroke - Cocain o Salt o White chrystalline powder that is easily desolved in water - Crack cocain o Base form of cocain- retains solvents used in its manufacture - Snorted sniffed absorved inheald smoked or inject Opiates - Another class of drugs - Olden days used to be heroin - Now a days its persription medicine - Morpine, dilaudid , oxycontin, Percocet - Replacement drugs- methadone - Effects o Suppresses pain, mental clouding, heightenind feeling of wellness, relaxation, drowsiness - Smoked inhailed trandermal injected Substance use, abuse and addiction - Most consume at leaset once in lifetime - Substance use embedded within processes o Determine its initiation and continuation o Biological (eg genes cognition) o Psychological (eg emotions peers and family relationships o Cultural – historical (eg normas and values) o Social structural (eg class gender labour force education) - Similar processes influence - Some places its completly criminal o Same substance however understanding of it varies depending on where u are in the world - Some people never develop an addiction o 31.9% tobacco o 23.1% heroin o 11.2% other stimulants o 15.4% alcohol o 16.7 %cocaine o 9.1 % for cannabis - Abuse – maladaptive pattern of use, despite knowledge of negative consequences - Addiction - compulsive drug use o Chronic relapsing condition o People may recover and relapse and become exposed to substance- related problems for multiple and variable lengths of time o Many recover without formal assistance o Some require help to reduce or eliminate substance use related problems - Depending on where people are in their drug career they are exposed to different risks - Addiction treatment system – one response - Harm reduction programs is another means to reduce drug use on top of treatment - Not all people use drugs and are addicted - Not all people who use drugs and want help Harms – individual - Variable – none to mild to severe - Health – related o List on slides - Social and economic o List on slides Harms – HIV and HCV - injection drug related o Multi person use of contaminated needle and drug preparation equipment o Scientific evidence of risk and transmission - Non – injection drug related o Pipes and such - Sexually transimitted Harms – Family and society - Family o Disfucnction breakdown separation - Community o Victimiza
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