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Author |
Vanderkloot, Pete |
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Title |
Methadone : medicine, harm reduction or social control |
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Journal Article |
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2001 |
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Harm Reduction Communication |
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11 |
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1-4 |
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chemical addiction; opioids in any form; methadone; drug; treatment and maintenance; drug substitution therapy; social control; harm reduction; bureaucracy |
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50-ah |
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59511 |
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Author |
Van Wormer, Katherine |
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Title |
Harm induction vs. harm reduction : comparing American and British approaches to drug use |
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Journal Article |
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Year |
1999 |
Publication |
Journal of offender rehabilitation |
Abbreviated Journal |
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Volume |
29 |
Issue |
1/2 |
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35-48 |
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harm reduction; government and politics; public policy on illicit drugs; HIV infection; Aids; criminalization; international differences; United Kingdom; United States |
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The disease model, while still the predominant conceptualization guiding U.S. treatment is now being challenged by the harm reduction model, highly developed in Britain. This paper examines both positions in light of historical/cultural differences related to Puritan zealotry and argues that with regard to illegal drugs, America’s War on Drugs actually inflicts harm. The huge government expenditure, spread of AIDS, criminalization of drug users, and treatment neglect are just several of the negative consequences. |
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1050-9674 |
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50-ag |
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59510 |
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Thorpe, Lorna E.; Ouellet, Lawrence J.; Hershow, Ronald; Bailey, Susan L.; Williams, Ian T.; Williamson, John; Monterroso, Edgar R.; Garfein, Richard S. |
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Title |
Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment |
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Journal Article |
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Year |
2002 |
Publication |
American journal of epidemiology |
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Volume |
155 |
Issue |
7 |
Pages |
645-653 |
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Keywords |
risk assessment; intravenous drug user; young adult; needle sharing; viral hepatitis; hepatitis C; infection; United States; Chicago; study |
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Designing studies to examine hepatitis C virus (HCV) transmission via the shared use of drug injection paraphernalia other than syringes is difficult because of saturation levels of HCV infection in most samples of injection drug users (IDUs). The authors measured the incidence of HCV infection in a large cohort of young IDUs from Chicago, Illinois, and determined the risk of HCV seroconversion associated with specific forms of sharing injection paraphernalia. From 1997 to 1999, serum samples obtained from 702 IDUs aged 18–30 years were screened for HCV antibodies; prevalence was 27%. Seronegative participants were tested for HCV antibodies at baseline, at 6 months, and at 12 months. During 290 person-years of follow-up, 29 participants seroconverted (incidence: 10.0/100 person-years). The adjusted relative hazard of seroconversion, controlling for demographic and drug-use covariates, was highest for sharing “cookers” (relative hazard = 4.1, 95% confidence interval: 1.4, 11.8), followed by sharing cotton filters (relative hazard = 2.4, 95% confidence interval: 1.1, 5.0). Risks associated with syringe-sharing and sharing of rinse water were elevated but not significant. After adjustment for syringe-sharing, sharing cookers remained the strongest predictor of seroconversion (relative hazard = 3.5, 95% confidence interval: 1.3, 9.9). The authors conclude that sharing of injection equipment other than syringes may be an important cause of HCV transmission between IDUs. |
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0002-9262 |
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50-af |
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59509 |
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Author |
Siegal, Harvey A.; Carlson, Robert G.; Falck, Robert; Wang, Jichuan |
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Title |
Injection drug users' needle-cleaning practices |
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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 |
9; 09/1994 |
Pages |
1523-1524 |
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Keywords |
letter to the editor |
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Abstract |
The effectiveness of bleach in inactivating HIV in drug users’ injection equipment is in question. In a letter to the editor published in the American Journal of Public Health, Harvey Siegal et al respond to the report by Shapshak and his colleagues that a minimum of 30 seconds in bleach is needed for sufficient cleaning of the equipment. Through their own observations of 77 intravenous drug users, Siegal et al noted a great disparity in the amount of bleaching time–from 1 to 75 seconds–as well as in the methods of cleaning of the equipment. Despite the fact that the study was conducted in project offices, the results provide some evidence of how drug users really use bleach when cleaning. It is important to clearly state disinfection techniques in prevention messages that target drug users, because a few seconds’ difference can make all the difference between becoming infected with HIV or remaining uninfected. |
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0090-0036 (Print); 1541-0048 (Electronic) |
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50-ae |
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59508 |
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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 |
Abbreviated Journal |
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9 |
Issue |
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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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 |
Issue |
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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2004 |
Publication |
Social Work : journal of the National Association of Social Workers |
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49 |
Issue |
3; 07/2004 |
Pages |
356-363 |
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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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50-ab |
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59505 |
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Friedman, Samuel R.; Sterk, Claire; Sufian, Meryl; Des Jarlais, Don C. |
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Will bleach decontaminate needles during cocaine binges in shooting galleries? |
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Journal Article |
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1989 |
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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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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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van Ameijden, Erik J.C.; van den Hoek, Anneke A.R.; Coutinho, Roel A. |
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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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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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59501 |
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