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Author |
Matheï, C.; Buntinx, F.; Van Damme, P. |
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Title |
Seroprevalence of hepatitis C markers among intravenous drug users in western European countries : a systematic review |
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Journal Article |
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Year |
2002 |
Publication |
Journal of viral hepatitis |
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Volume |
9 |
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3; 05/2002 |
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157-173 |
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Keywords |
intravenous injection; hepatitis C; epidemiology; prevalence; hepatitis C antibodies |
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Abstract |
Currently, the most important risk factor for hepatitis C virus (HCV) infection in Europe is intravenous drug use. To establish a better insight into the epidemiology of hepatitis C among intravenous drug users (IVDUs) in western European countries a systematic review on the prevalence of hepatitis C markers and their determinants was performed. Reports were identified by searches on Medline and on the internet and by screening reference lists of selected papers. The prevalence rates of anti-HCV in western European IVDUs reported in the 66 studies selected for analysis, ranged between 37 and 98%. No relation was found between prevalence rates and mean age, mean duration of intravenous drug use, geographical area, setting of the study, method of recruitment or the year(s) of collection of samples. Eleven studies concerning the prevalence of HCV-RNA in hepatitis C-infected IVDUs were selected for analysis. Prevalence rates ranged from 26 to 86%. Based on five studies, a statistically significant positive linear relation was found between the mean age of study population and the prevalence of HCV-RNA. Our analysis revealed considerable variation in prevalence rates of hepatitis C markers among IVDUs in western Europe. We found no conclusive explanation for this variability. Further research investigating the dynamics of the hepatitis C epidemic in IVDUs is necessary. |
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1365-2893 |
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50-ad |
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59507 |
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Author |
Mandell, Wallace; Vlahov, David; Latkin, Carl A.; Oziemkowska, Maria; Cohn, Sylvia |
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Title |
Correlates of needle sharing among injection drug users |
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Journal Article |
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Year |
1994 |
Publication |
American journal of public health : official journal of the American Public Health Association |
Abbreviated Journal |
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Volume |
84 |
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6; 06/1994 |
Pages |
920-923 |
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Keywords |
AOD use, abuse, and dependence; intravenous drug user; needle sharing; HIV infection; risk factors; United States; study |
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Abstract |
OBJECTIVES. The sharing of contaminated injection equipment is the primary mode of human immunodeficiency virus (HIV) transmission for injection drug users. This study examined demographic factors, life events, and drug use practices that are potential risk factors for sharing injection equipment. METHODS. Between February 1988 and March 1989, 2921 active injection drug users were interviewed and questioned about their backgrounds, life-styles, and patterns of injection drug use. RESULTS. Of 2524 participants who reported injecting drugs within the 6 months prior to study enrollment, 70.4% reported recent needle sharing. A multivariate analysis found needle sharing to be more frequent among those with a history of arrest and lower socioeconomic status, even after accounting for other demographic and drug use variables. In addition, recent needle sharing was higher in male homosexual or bisexual men than in their heterosexual counterparts. CONCLUSIONS. These data suggest that injection drug users have an economic motive to share needles and that the availability of free and legal needles may reduce levels of needle sharing. |
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0090-0036 (Print); 1541-0048 (Electronic) |
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50-ac |
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59506 |
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Author |
MacMaster, Samuel A. |
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Title |
Harm reduction : a new perspective on substance abuse services |
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Journal Article |
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Year |
2004 |
Publication |
Social Work : journal of the National Association of Social Workers |
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49 |
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3; 07/2004 |
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356-363 |
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Keywords |
harm reduction; treatment goals; stages of change; AOD abuse; social work service |
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Complete abstinence from nonmedical drugs has been the goal of most substance abuse treatment in the United States. Although nonabstinence-based interventions have existed since the inception of substance abuse treatment, the harm reduction model provides a new perspective on these services. Harm reduction is increasingly used in substance abuse practice. Viewed from the perspective of the stages of change (Prochaska & DiClemente, 1982) model, strict adherence to an abstinence-only perspective is questionable. This issue is critical to all social workers, because individuals with substance abuse issues are encountered in every practice setting. This article outlines the abstinence and harm-reduction perspectives and the stages of change model and discusses how these perspectives can be integrated in social work practice in substance abuse. Examples of how these perspectives inform services provision and a discussion of the fit of harm reduction with social work ethics are also provided. |
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0037-8046 |
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50-ab |
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59505 |
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Author |
Friedman, Samuel R.; Sterk, Claire; Sufian, Meryl; Des Jarlais, Don C. |
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Title |
Will bleach decontaminate needles during cocaine binges in shooting galleries? |
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Journal Article |
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Year |
1989 |
Publication |
JAMA : the journal of the American Medical Association |
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262 |
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11; 15.09.1989 |
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1467 |
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letter to the editor |
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0098-7484 |
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50-z |
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59503 |
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Author |
Fitzgerald, John L. |
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Title |
Making new drug policy narratives |
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Journal Article |
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1999 |
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Deakin Addiction Policy Research Annual |
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5 |
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3-13 |
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public policy on AOD; history; government and politics; drug user; public health; law enforcement; harm reduction; street work; legal regulation; Australia; conference |
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The 1999 Stanton Peele Addiction Lecture (at Deakin University in Melbourne) was delivered by John Fitzgerald, of the University of Melbourne. John examines perspectives on drug use from the standpoint of narratives, or cognitive frameworks in terms of which we — particularly Westerners — interpret our worlds. Without changing these narratives, efforts to change policies for drug regulation face almost impossible odds, and may be doomed. Fitzgerald presents a consumer narrative of heroin use, and the consequences of this narrative for public health, law enforcement, users themselves, et al. Fitzgerald’s work represents a brilliant conceptual shift for approaching drug use and addiction. |
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50-y |
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59502 |
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Author |
van Ameijden, Erik J.C.; van den Hoek, Anneke A.R.; Coutinho, Roel A. |
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Title |
Injecting risk behavior among drug users in Amsterdam, 1986 to 1992, and its relationship to AIDS prevention programs |
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Journal Article |
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Year |
1994 |
Publication |
American journal of public health : official journal of the American Public Health Association |
Abbreviated Journal |
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Volume |
84 |
Issue |
2; 02/1994 |
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275-281 |
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Keywords |
intravenous drug user; risk-taking behavior; needle sharing; HIV infection; treatment and maintenance; methadone maintenance; drug substitution therapy; harm reduction; needle distribution and exchange; Netherlands; Amsterdam |
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OBJECTIVES. Serial, cross-sectional trends in injecting risk behavior were studied among drug users from 1986 to 1992. METHODS. From a cohort study in Amsterdam, 616 intake visits of drug users who had injected in the 6 months preceding intake were selected. RESULTS. The proportion of drug users who reported borrowing and lending used injection equipment and reusing needles/syringes (in the previous 6 months), continuously declined from 51% to 20%, from 46% to 10% and from 63% to 39%, respectively. In multivariate analysis, it appeared unlikely that a selective recruitment of participants over time was responsible for these trends. Participants, recruited later in time, had been previously tested for human immunodeficiency virus (HIV) more often, had received daily methadone less often, and had obtained a higher proportion of new needles via exchange programs. Indications were found that (1) voluntary HIV testing and counseling leads to less borrowing, lending, and reusing equipment; and (2) obtaining needles via exchange programs leads to less reusing needles/syringes. It appeared that nonattenders of methadone and exchange programs have reduced borrowing and lending to the same extent as attenders. CONCLUSIONS. Methodologically, evaluating specific measures is difficult. However, the combination of various preventive measures in Amsterdam is likely to be responsible for the observed decrease in injecting risk behavior. |
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0090-0036 (Print); 1541-0048 (Electronic) |
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50-x |
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59501 |
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Author |
Wieviorka, Sylvie |
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Title |
La réduction des risques |
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Journal Article |
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1996 |
Publication |
Revue Toxibase |
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1996 |
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3 |
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20 |
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harm reduction; chemical addiction; prevention; risk-taking behavior; needle distribution and exchange; contact center; drug substitution therapy; medical care; laws and regulations; communication; coordination of activities; prison; self-help group; HIV infection; Aids; France |
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French |
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1240-2494 |
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50-w |
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59500 |
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Author |
Larrey, Dominique |
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Title |
La biopsie hépatique est-elle indispensable à l'indication thérapeutique dans l'hépatite chronique C? |
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Journal Article |
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2001 |
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THS : la revue des addictions : publication trimestrielle de la SETHS (Société européenne toxicomanies, hépatites, sida) |
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3 |
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12; 12/2001 |
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684-685 |
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viral hepatitis; hepatitis C; chronic disease; biopsy; diagnosis |
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1624-0898 |
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50-v |
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59499 |
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Author |
Landry, Michel; Lecavalier, Marie |
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Title |
L'approche de réduction des méfaits : un facteur de changement dans le champ de la réadaptation en toxicomanie |
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Journal Article |
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2003 |
Publication |
Drogues, santé et société |
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2 |
Issue |
1; 25.06.2003 |
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124-140 |
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government and politics; public policy on AOD; harm reduction; AOD use, abuse, and dependence; chemical addiction; history; AOD abstinence; Canada; Quebec |
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Au Québec, à la fin des années 80, l’approche de réduction des méfaits s’est conjuguée à d’autres courants qui avaient déjà commencé à y exercer leur influence pour provoquer une profonde remise en question de la philosophie de traitement et des méthodes d’intervention utilisées alors dans le domaine de la réadaptation en toxicomanie. Cet article décrit plus particulièrement l’impact de l’implantation de cette approche par le Centre Dollard-Cormier en 1997. On y affirme qu’elle a constitué un point de ralliement pour tous les intervenants de ce centre et favorisé, particulièrement à travers l’expression « haute tolérance », l’adoption de valeurs telles que la flexibilité, l’accessibilité, l’acceptation de toutes les personnes qui demandent de l’aide, quels que soient leurs motifs et la précarité de leur situation. À l’aide de l’expérience des cinq dernières années, nous établissons un bilan des forces et des limites de cette approche dans un contexte de réadaptation. Au nombre des forces, on doit compter un plus grand respect des objectifs de l’usager lui-même, notamment en ce qui concerne la consommation de substances psychoactives, une transformation des services pour les rendre plus flexibles et accessibles, et un préjugé favorable aux plus démunis. Au nombre des difficultés, on mentionnera l’adaptation de nos méthodes d’intervention à des objectifs variés en ce qui concerne la consommation et la conciliation de la haute tolérance avec un cadre thérapeutique qui impose des limites. Si l’approche de réduction des méfaits nous a appris à accepter toute amélioration de la situation des personnes toxicomanes comme un résultat légitime et valable en soi, notre mission de réadaptation nous invite à ne pas perdre de vue l’objectif qu’un grand nombre parmi elles poursuit néanmoins : arriver à se libérer de leur dépendance à ces substances, par l’abstinence ou autrement, et retrouver la maîtrise de leur vie. In the late 80’s, in Quebec, the harm reduction approach was mixed with other currents that had already started to influence and renew the philosophy of treatment and the methods of intervention used at the time in the field of drug abuse rehabilitation. This article will discuss the impact of the 1997 implementation of this approach at the Centre Dollard-Cormier. We assert that the care-givers of the centre rallied to the approach and that it facilitated, especially through the expression of “high tolerance”, the adoption of such values as flexibility, accessibility and acceptance of all persons who request help, whatever their motives or the precariousness of their situation. With a five-year background, we can assess the strengths and limits of the approach in the context of rehabilitation. Concerning the strengths, we must observe a higher respect of the user’s objectives, in particular those that concern the use of psychoactive substances, a transformation towards more flexible and accessible services, and a favourable prejudice towards the less fortunate. As for the difficulties, we will mention the adjustments made to our methods of intervention to meet the varied objectives of substance use and to conciliate high tolerance with the therapeutic framework. Even though the harm reduction approach has taught us to appreciate any improvement in the situation of addicted persons as a legitimate result, valid by itself, our mission requires us not to lose sight of the large number users who nevertheless pursue the objective of liberating themselves from their dependence, either by abstinence or otherwise, and take back control of their lives. En el Quebec, al final de los años 80, el enfoque de reducción de perjuicios se conjugó con otras corrientes que ya habían comenzado a ejercer su influencia, para provocar una puesta en duda profunda de la filosofía de tratamiento y de métodos de intervención que estaban en uso en el sector de la readaptación de la toxicomanía. Éste artículo describe más particularmente el impacto que tuvo la adopción de éste enfoque en el Centro Dollard-Cormier en 1997. Se afirma que se ganó la adesión de todos los trabajadores sociales que intervenían en ése Centro, y que particularmente la expresión « alta tolerancia » favoreció la adopción de valores tales como la flexibilidad, la accesibilidad, la acceptación de todas las personas que piden ayuda, cuales sean sus motivos y la precaridad de su situación. Gracias a la experiencia de los cinco últimos años, un balance de los puntos fuertes y de los límites de éste enfoque fue establecido en el contexto de la readaptación. Entre los puntos fuertes, se debe contar un respeto mayor de los objetivos proseguidos por el mismo usuario particularmente en lo que atañe al consumo de substancias psicoactivas, una transformación de los servicios para que se vuelvan más flexibles y accesibles y un prejuicio favorable a los más despojados. Entre las dificultades encontradas, se debe mencionar la adaptación de nuestros métodos de intervención a variados objetivos relativos al consumo y la conciliación de la alta tolerancia con un marco terapéutico que impone sus límites. Si el enfoque de reducción de perjuicios nos enseñó a aceptar toda mejora de la situación de las personas toxicómanas como un reslutado legítimo y válido de por sí, nuestra misión de readaptación nos invita a no perder de vista el objetivo proseguidoa pesar de todo por gran número de entre ellas : llegar a liberarse de su dependencia a estas substancias, por abstinencia o de otro modo, y volver a tener el control de su vida. |
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50-u |
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59498 |
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Author |
Icard, C.; Chossegros, P.; Barlet, P. |
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Title |
Comment vit-on l'hépatite C en prison? |
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Journal Article |
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Year |
2001 |
Publication |
THS : la revue des addictions : publication trimestrielle de la SETHS (Société européenne toxicomanies, hépatites, sida) |
Abbreviated Journal |
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3 |
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12; 12/2001 |
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681-683 |
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prison; viral hepatitis; hepatitis C; treatment and maintenance; France |
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1624-0898 |
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50-t |
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59497 |
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