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Author |
Fromberg, Erik |
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Title |
The ideologies behind harm reduction |
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Conference Article |
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Year |
1995 |
Publication |
6th International Conference on the Reduction of Drug Related Harm |
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6 |
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harm reduction; government and politics; public policy on illicit drugs conference; international area |
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Abstract  |
The Harm reduction-movement has clearly gathered momentum since the first conference in Liverpool, both on the scientific as at the political level. Since the first conference, where most participants were grass root workers, there is a clear trend in these conferences to address more and more the scientists, at the cost of the former. We have however to remind ourselves that the strength of the movement has been the combination of the scientists and the workers, united as they were by some common ideology. The always stronger scientific basis for “harm reduction”, as aptly demonstrated in the title of the conference book of the 3rd conference in Melbourne “From faith to science”, may however obscure that our actions have roots in ideology. Now that we become an ever more mixed bunch it is necessary to make our ideologies more explicit. This emphasis on ideology is not to belittle the scientific aspects, but to make clear that no value free science exists. Science, history tells us, is one of the most powerful instruments in political conflicts and so we need to be clear about our ideologies. And the more scientific we become the more obscure our ideological motives, the semiconscious roots of our so called scientific data. It is not that I favour any censorship on ideologies within the harm reduction movement, but clearness about them seems necessary for the health of it. We cannot avoid ideology, even when we are scientific. The main ideology, if any, at the first conference seemed that of the legalisers although this was rarely if ever mentioned, let alone that any arguments were produced in favour of it. The other main ideology with regard to the drug issue, the prohibitionist one, was hardly represented, but five years later even convinced prohibitionist organisations as the ICAA start to embrace harm reduction within the framework of prohibitionism. This visible dichotomy however is more on the level of political approaches than of the basic ideologies supporting those two approaches are manifold. These basic ideologies will be described. |
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Erik Fromberg |
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Florence |
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English |
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50-e |
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61222 |
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Author |
Medical Working Group |
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Title |
Substance misuse detainees in police custody : guidelines for clinical management |
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Report |
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Year |
2011 |
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xiii, 66 |
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AOD use, abuse, and dependence; harm reduction; report; recommendations or guidelines; United Kingdom |
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The guidelines recognise that the assessment and treatment of substance misusers present forensic physicians with particular challenges that require certain skills and experience to ensure appropriate management. They stress the importance of good communication, of working closely with custody officers and of shared responsibility for the safety and care of detainees with substance misuse. In particular, they stress the importance of : the full participation of forensic physicians in all aspects and at all stages of the healthcare of detainees with substance misuse/dependence providing advice to custody officers and others involved with detainees with substance misuse/dependence comprehensive contemporaneous records appropriate sharing of information in accordance with the law and the General Medical Council’s advice on professional confidentiality being aware when making all interventions that the interests of the detainee as a patient are paramount. We believe that these guidelines will be of immense value to all practitioners in helping and supporting detainees and that they will also be useful for teaching purposes for medical and nursing staff and arrest referral officers. |
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Royal College of Psychiatrists |
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London |
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English |
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no |
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50-12208 |
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50918 |
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Author |
Rutter, Scott; Dolan, Kate; Wodak, Alex; Heilpern, Hans |
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Title |
Prison-based syringe exchange programs : a review of international research and program development |
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Report |
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Year |
2001 |
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57 |
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Keywords |
harm reduction; needle distribution and exchange; prison; research; knowledge, attitudes, and practices; HIV infection; viral hepatitis; hepatitis B; hepatitis C; prison guard; international area; Switzerland; Germany; Spain; Italy; Portugal; Greece |
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Abstract |
The Government of the Australian Capital Territory commissioned this review. Few papers have been published reporting evaluation of Prison Syringe Exchange Programs. Only some of this material has been published in English or has been previously translated into English. This review has been based on a comprehensive search of electronic databases, contact with experts in this field to identify any missed publications and the existing published literature and material which was translated specially for this review. Some of this review is based on the ‘grey literature’ of reports and other official documents. The first prison syringe exchange program in the world was established in Switzerland in 1992. A total of 19 prison syringe exchange programs were operating as of December 2000 (7 in Switzerland, 7 in Germany and 5 in Spain). A further three countries (Italy, Portugal and Greece) were also seriously considering the introduction of prison syringe exchange programs. Prison regulations have been modified to allow these facilities to operate under certain conditions. Most programs are in small prisons with fewer than 200 inmates. Programs operate in both male and female prisons. In some prisons, injecting equipment is provided by health professionals while in other prisons, automatic vending machines exchange sterile injecting equipment for used needles and syringes. Evaluation of pilot prison syringe exchange programs in Switzerland, Germany and Spain has been favourable in all cases. Drug use patterns reported at interview were stable or decreased over time (six prisons). Reported syringe sharing declined dramatically and was virtually non-existent at the conclusion of most pilot studies. No cases of inmates seroconverting for HIV, hepatitis B or hepatitis C have been reported in any prison with a prison syringe exchange program. No serious unintended negative consequences have been reported. There have been no reported instances of initiation of injecting. The use of needles or syringes as weapons has not been reported. One inmate (in Germany) is reported to have been injured by a discarded used needle. The number of needles and syringes distributed correlated with increased quantities of drugs detected in prisons and also when inmates receive payment. Staff attitudes were generally positive but response rates to these surveys varied. Attempts were made in all prisons to involve staff in planning. Staff from prisons where programs had been successfully established were involved in planning new programs in different prisons. In each country, negative attitudes of prisons staff to these programs reflected similar attitudes to harm reduction programs in the community. The rationale for establishing syringe exchange programs in prisons is even stronger than in communities. This rationale is accepted by an impressive number of prestigious bodies. Because of the rapid turnover of inmate populations, spread of blood borne viral infections among prisoners cannot be considered to remain for long within the confines of correctional facilities. There is increasing evidence that experience of incarceration is a strong predictor of HIV and hepatitis C infection. Overall, this review confirms that prison syringe exchange programs are feasible. Based on the data available and extrapolating from the vast literature on community-based programs, prison syringe exchange programs appear to be effective in reducing blood borne viral infections. At this stage, there is no evidence to suggest that these programs have serious unintended negative consequences. |
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University of New South Wales, National Drug and alcohol Research Centre |
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Sydney |
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English |
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50-z |
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56053 |
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Author |
Kwasniewski, Aleksander; Jahangir, Asma; Fuentes, Carlos; Gaviria, César; Zedillo, Ernesto; Cardoso, Fernando Henrique; Papandreou, George; Shultz, George P.; Solana, Javier; Whitehead, John; Arbour, Louise; Cattaui, Maria; Vargas Llosa, Mario; Caspers-Merk, Marion; Kazatchkine, Michel; Volcker, Paul; Bém, Pavel; Lagos, Ricardo; Branson, Richard; Dreifuss, Ruth; Stoltenberg, Thorvald |
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Title |
The war on drugs and HIV/AIDS : how the criminalization of drug use fuels the global pandemic |
Type |
Report |
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Year |
2012 |
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Abbreviated Journal |
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20 |
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Keywords |
government and politics; laws and regulations; law enforcement; prison; war; public health; communicable disease; HIV infection; Aids; epidemiology; intravenous drug user; AOD consumption; illicit drug; heroin; AODR mortality; harm reduction; needle distribution and exchange; prevention; criminalization; social and economic cost of AOD; AODR violence; drug market; political activism; recommendations or guidelines; international area |
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Abstract |
The global war on drugs is driving the HIV/AIDS pandemic among people who use drugs and their sexual partners. Throughout the world, research has consistently shown that repressive drug law enforcement practices force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated. Mass incarceration of non-violent drug offenders also plays a major role in increasing HIV risk. This is a critical public health issue in many countries, including the United States, where as many as 25 percent of Americans infected with HIV may pass through correctional facilities annually, and where disproportionate incarceration rates are among the key reasons for markedly higher HIV rates among African Americans. Aggressive law enforcement practices targeting drug users have also been proven to create barriers to HIV treatment. Despite the evidence that treatment of HIV infection dramatically reduces the risk of HIV transmission by infected individuals, the public health implications of HIV treatment disruptions resulting from drug law enforcement tactics have not been appropriately recognized as a major impediment to efforts to control the global HIV/AIDS pandemic. The war on drugs has also led to a policy distortion whereby evidence-based addiction treatment and public health measures have been downplayed or ignored. While this is a common problem internationally, a number of specific countries, including the US, Russia and Thailand, ignore scientific evidence and World Health Organization recommendations and resist the implementation of evidence-based HIV prevention programs – with devastating consequences. In Russia, for example, approximately one in one hundred adults is now infected with HIV. In contrast, countries that have adopted evidence-based addiction treatment and public health measures have seen their HIV epidemics among people who use drugs – as well as rates of injecting drug use – dramatically decline. Clear consensus guidelines exist for achieving this success, but HIV prevention tools have been under-utilized while harmful drug war policies have been slow to change. This may be a result of the mistaken assumption that drug seizures, arrests, criminal convictions and other commonly reported indices of drug law enforcement “success” have been effective overall in reducing illegal drug availability. However, data from the United Nations Office on Drugs and Crime demonstrate that the worldwide supply of illicit opiates, such as heroin, has increased by more than 380 percent in recent decades, from 1000 metric tons in 1980 to more than 4800 metric tons in 2010. This increase coincided with a 79 percent decrease in the price of heroin in Europe between 1990 and 2009. Similar evidence of the drug war’s failure to control drug supply is apparent when US drug surveillance data are scrutinized. For instance, despite a greater than 600 percent increase in the US federal anti-drug budget since the early 1980s, the price of heroin in the US has decreased by approximately 80 percent during this period, and heroin purity has increased by more than 900 percent. A similar pattern of falling drug prices and increasing drug potency is seen in US drug surveillance data for other commonly used drugs, including cocaine and cannabis. As was the case with the US prohibition of alcohol in the 1920s, the global prohibition of drugs now fuels drug market violence around the world. For instance, it is estimated that more than 50,000 individuals have been killed since a 2006 military escalation against drug cartels by Mexican government forces. While supporters of aggressive drug law enforcement strategies might assume that this degree of bloodshed would disrupt the drug market’s ability to produce and distribute illegal drugs, recent estimates suggest that Mexican heroin production has increased by more than 340 percent since 2004. With the HIV epidemic growing in regions and countries where it is largely driven by injection drug use, and with recent evidence that infections related to injection drug use are now increasing in other regions, including sub-Saharan Africa, the time for leadership is now. Unfortunately, national and United Nations public health agencies have been sidelined. While the war on drugs has been fueling the HIV epidemic in many regions, other law enforcement bodies and UN agencies have been actively pursuing an aggressive drug law enforcement agenda at the expense of public health. Any sober assessment of the impacts of the war on drugs would conclude that many national and international organizations tasked with reducing the drug problem have actually contributed to a worsening of community health and safety. This must change. |
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Global Commission on Drug Policy (GCDP) |
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Rio de Janeiro |
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Auch auf Deutsch vorhanden: 50-13079; aussi disponible en français: 50-12673 |
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no |
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Call Number |
50-13081 |
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56626 |
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Author |
Jahangir, Asma; Fuentes, Carlos; Gaviria, César; Zedillo, Ernesto; Cardoso, Fernando Henrique; Papandreou, George; Shultz, George P.; Solana, Javier; Whitehead, John; Annan, Kofi; Arbour, Louise; Cattaui, Maria; Vargas Llosa, Mario; Caspers-Merk, Marion; Kazatchkine, Michel; Volcker, Paul; Branson, Richard; Dreifuss, Ruth; Stoltenberg, Thorvald |
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Title |
War on drugs : report of the Global Commission on Drug Policy |
Type |
Report |
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2011 |
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20 |
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AOD use, abuse, and dependence; HIV infection; harm reduction; public policy on AOD; recommendations or guidelines; law enforcement; violence; drug decriminalization; case study; international area; Switzerland; United Kingdom; Netherlands; Portugal; United States; Australia; West Africa; report |
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The global war on drugs has failed, with devastating consequences for individuals and societies around the world. Fifty years after the initiation of the UN Single Convention on Narcotic Drugs, and 40 years after President Nixon launched the US government’s war on drugs, fundamental reforms in national and global drug control policies are urgently needed. Vast expenditures on criminalization and repressive measures directed at producers, traffickers and consumers of illegal drugs have clearly failed to effectively curtail supply or consumption. Apparent victories in eliminating one source or trafficking organization are negated almost instantly by the emergence of other sources and traffickers. Repressive efforts directed at consumers impede public health measures to reduce HIV/AIDS, overdose fatalities and other harmful consequences of drug use. Government expenditures on futile supply reduction strategies and incarceration displace more cost-effective and evidence-based investments in demand and harm reduction. |
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Global Commission on Drug Policy (GCDP) |
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Rio de Janeiro |
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Auch auf Deutsch vorhanden: 50-12492 |
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50-11925 |
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56465 |
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World Health Organization |
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Title |
Global status report on alcohol and health |
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2011 |
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xii, 58, appendices |
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addiction; AOD use, abuse, and dependence; chemical addiction; alcohol; AOD use pattern; AOD effects and AODR problems; public policy on health; statistical data; harm reduction; international area |
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The Global status report on alcohol and health (2011) presents a comprehensive perspective on the global, regional and country consumption of alcohol, patterns of drinking, health consequences and policy responses in Member States. It represents a continuing effort by the World Health Organization (WHO) to support Member States in collecting information in order to assist them in their efforts to reduce the harmful use of alcohol, and its health and social consequences. The report was launched in Geneva on Friday 11 Februray 2011 during the first meeting of the WHO global counterparts for implementation of the global strategy to reduce the harmful use of alcohol. |
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World Health Organization (WHO) |
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Geneva |
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50-11692 |
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50823 |
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European Monitoring Centre for Drugs and Drug Addiction |
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Title |
General report of activities 2008 : including “Annual report of the EMCDDA's authorising officer” |
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2009 |
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101 |
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monitoring; administration and management; coordination of activities; epidemiology; crime; drug market; intervention (persuasion to treatment); law; public policy on AOD; cooperation; international area; communication; collaboration; quality control; assessment; Europe; annual report |
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The General report of activities is an annual publication providing a detailed progress report of the EMCDDA’s activities over a 12-month period. Published every spring, it catalogues the Centre’s achievements in each area of its annual work programme. The report is a useful information source for all those seeking comprehensive information on the Centre and its work. |
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Office for Official Publications of the European Communities |
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Luxembourg |
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General report of activities |
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1725-4558 |
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978-92-9168-376-5 |
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50705 |
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European Monitoring Centre for Drugs and Drug Addiction |
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General report of activities 2009 : including “Annual report of the EMCDDA's authorising officer” |
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2010 |
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80 |
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monitoring; administration and management; cost-effectiveness; cooperation; communication; quality control; assessment; international area; Europe; annual report |
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The General report of activities is an annual publication providing a detailed progress report of the EMCDDA’s activities over a 12-month period. It catalogues the Centre’s achievements in each area of its annual work programme. The report is a useful information source for all those seeking comprehensive information on the Centre and its work. |
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Office for Official Publications of the European Communities |
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Luxembourg |
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General report of activities |
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1725-4558 |
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978-92-9168-421-2 |
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50777 |
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European Monitoring Centre for Drugs and Drug Addiction |
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General report of activities 2010 : including “Annual report of the EMCDDA's authorising officer” |
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2011 |
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102 |
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monitoring; administration and management; cost-effectiveness; cooperation; communication; quality control; assessment; policy recommendations; European Monitoring Centre for Drugs and Drug Addiction (body); international area; Europe; annual report |
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Abstract |
The General report of activities is an annual publication providing a detailed progress report of the EMCDDA’s activities over a 12-month period. It catalogues the Centre’s achievements in each area of its annual work programme. The report is a useful information source for all those seeking comprehensive information on the Centre and its work. |
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Office for Official Publications of the European Communities |
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Luxembourg |
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English |
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General report of activities |
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1725-4558 |
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978-92-9168-461-8 |
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50-12602 |
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50964 |
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European Monitoring Centre for Drugs and Drug Addiction |
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Title |
General report of activities 2011 : key achievements and governance : a year in review |
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2012 |
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100 |
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monitoring; administration and management; financial management; cost-effectiveness; cooperation; communication; quality control; assessment; policy recommendations; financial statement; European Monitoring Centre for Drugs and Drug Addiction (body); international area; Europe; annual report |
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Abstract |
The General report of activities is an annual publication providing a detailed progress report of the EMCDDA’s activities over a 12-month period. It catalogues the Centre’s achievements in each area of its annual work programme. The report is a useful information source for all those seeking comprehensive information on the Centre and its work. |
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Office for Official Publications of the European Communities |
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Luxembourg |
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English |
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General report of activities |
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1725-4558 |
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978-92-9168-505-9 |
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50-12603 |
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50965 |
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