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Article
Publication date: 11 September 2017

Gen Sander and Fionnuala Murphy

Raise awareness about the disproportionate impact of HIV and hepatitis C (HCV) on prisoners worldwide and the need for key harm reduction services such as needle and syringe…

Abstract

Purpose

Raise awareness about the disproportionate impact of HIV and hepatitis C (HCV) on prisoners worldwide and the need for key harm reduction services such as needle and syringe programmes and opioid substitution therapy in prisons offer practical recommendations to assist policy makers in implementing or scaling up these services. The paper aims to discuss these issues.

Design/methodology/approach

This study is a desk review of existing data and evidence on HIV, HCV and harm reduction in prisons, analysis of political barriers and formulation of key policy recommendations.

Findings

Harm reduction works, yet service provision in prisons remains extremely limited. There is an urgent need for governments to enhance political leadership and funding for harm reduction in prisons. Authorities must also work to remove obstacles to the implementation of harm reduction services in prisons, enhance the monitoring and evaluation of laws, policies and programmes relating to HIV, HCV and drugs in prison settings, and recognise access to harm reduction in prisons as a fundamental human right. Until these obstacles are addressed, the world will not meet the Sustainable Development Goal of eradicating HIV and HCV by 2030.

Originality/value

More than just a desk review, this policy brief provides a political analysis of the harm reduction crisis in prisons and offers clear-cut recommendations for policy makers.

Details

International Journal of Prisoner Health, vol. 13 no. 3/4
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 6 July 2010

Charlie Place

Assertive outreach teams work with some individuals who experience severe problems and are also injecting drug users. These people can be at risk due to their injecting behaviour…

Abstract

Assertive outreach teams work with some individuals who experience severe problems and are also injecting drug users. These people can be at risk due to their injecting behaviour, and also not be in contact with harm reduction agencies. This article describes, through case discussion, a collaborative initiative where assertive outreach case managers and harm reduction workers worked together to provide an individual harm reduction service to this vulnerable group. The project successfully engaged service users and was able to deliver harm reduction support.

Details

Advances in Dual Diagnosis, vol. 3 no. 2
Type: Research Article
ISSN: 1757-0972

Keywords

Article
Publication date: 5 September 2016

Gerry V. Stimson

The purpose of this paper is to compare the response to HIV/AIDS and drug use (drugs harm reduction) with tobacco harm reduction.

Abstract

Purpose

The purpose of this paper is to compare the response to HIV/AIDS and drug use (drugs harm reduction) with tobacco harm reduction.

Design/methodology/approach

Analysis of historical and contemporary sources, combined with personal knowledge of key stakeholders in the history and development of both fields.

Findings

Both drugs harm reduction and tobacco harm reduction share a similar objective – to reduce health risks for people who are unwilling or unable to stop using their drug of choice. Both also share a broader public health aim of helping people to make healthier decisions. Drugs harm reduction – as a response to HIV/AIDS – included the adoption of a wide range of radical harm reduction interventions and was a public health success. It became an established part of the professional Public Health agenda. In contrast the Public Health response to e-cigarettes and tobacco harm reduction has ranged from the negative to the cautious. A recent Public Health England report is exceptional for its endorsement of e-cigarettes.

Originality/value

Highlights contradictions in Public Health responses to drugs and tobacco; and that public health interventions can be implemented without and despite the contribution of professional Public Health.

Details

Drugs and Alcohol Today, vol. 16 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 8 December 2021

Julia Anne Silano, Carla Treloar, Thomas Wright, Tracey Brown, Colette McGrath and Phillip Snoyman

This commentary aims to reveal how a steering committee has effectively responded to advancing accessibility to harm reduction resources, hepatitis C virus (HCV) policy and health…

Abstract

Purpose

This commentary aims to reveal how a steering committee has effectively responded to advancing accessibility to harm reduction resources, hepatitis C virus (HCV) policy and health strategies within adult prison settings in New South Wales (NSW).

Design/methodology/approach

By reviewing the audit approach taken by the of the Justice Health and Forensic Mental Health Network and Corrective Services New South Wales Harm Reduction Reference Group (JHFMHN/CSNSW HRRG), this commentary emphasizes the committee’s success in identifying contemporary harm reduction issues that affect people in custodial settings. This commentary is a compilation of data gathered through the 2018 JHFMHN/CSNSW HRRG audit and corresponding program materials. Conclusions regarding the effectiveness of the working group’s audit were drawn by critically appraising the JHFMHN/CSNSW HRRG’s Final Audit Report (JHFMHN and CSNSW, 2018) with reference to current harm reduction literature.

Findings

The HRRG has provided leadership, professional representation and strategic advice on the development, implementation, monitoring and evaluation of best practice harm reduction strategies in prison settings. The HRRG developed and maintained networks and information exchange between the state-wide HCV health network, corrections services and the NSW harm reduction sector at large. Public health partnerships and advocacy that involve all key players, such as the HRRG, will continue to be crucial to remove barriers to enhancing HCV harm reduction measures especially in NSW prison settings.

Social implications

Strategies such as primary prevention and treatment can mitigate the spread of HCV in the custodial system. This audit of access to harm reduction resources was conducted on behalf of the diverse group of professionals, scholars and stakeholders comprising the HRRG. This audit and other advocacy efforts of this committee can facilitate future access to quality healthcare and the necessary policies required to support a healthier prison population at large.

Originality/value

Collaborating with health authorities, researchers and social service workers can enable prison health-care systems to be guided by wider health workforce programs and public health standards. This collaboration can reduce the professional isolation of custodial health-care staff and promote a balanced approach to harm reduction policies by ensuring an equitable focus on both health and security imperatives.

Details

International Journal of Prisoner Health, vol. 18 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 19 February 2018

Ellen Sofie Andvig, Knut Tore Sælør and Esther Ogundipe

Little is known about how harm reduction is practiced in Norwegian housing first (HF) projects. The purpose of this paper is to explore, describe, and interpret how providers…

Abstract

Purpose

Little is known about how harm reduction is practiced in Norwegian housing first (HF) projects. The purpose of this paper is to explore, describe, and interpret how providers apply a harm reduction approach within a housing project focused on individuals who are homeless with co-morbid substance use and mental health problems.

Design/methodology/approach

This qualitative study was part of a larger evaluation study of a three-year HF project in a Norwegian municipality. Data were collected using four multi-stage focus groups with five providers working in the HF project. Focus group interviews were transcribed verbatim and analyzed using thematic analysis.

Findings

Analysis resulted in three main themes: “Letting the service user sit in the driver’s seat,” “We don’t follow service provision contracts, we do everything,” and “Collaborating with the local community.”

Research limitations/implications

There is a need to develop increased knowledge about service users’ experiences within the harm reduction approach.

Practical implications

To practice effective harm reduction, treatment providers must have open authorizations and the opportunity to exercise professional judgment. Harm reduction practice must also focus on social, political, and economic factors influencing users’ everyday lives.

Originality/value

The paper contributes to the knowledge base on harm reduction within HF practice that differs from a traditional model wherein clients are expected to abstain from substance use. It highlights important preconditions for challenges practitioners might encounter at both individual and service system levels.

Details

Advances in Dual Diagnosis, vol. 11 no. 1
Type: Research Article
ISSN: 1757-0972

Keywords

Article
Publication date: 4 April 2011

David Macdonald

In 2006, IHRA received a 5‐year grant from DFID to develop a conducive policy environment for the implementation and scaling up of harm reduction activities on a global scale. An…

111

Abstract

In 2006, IHRA received a 5‐year grant from DFID to develop a conducive policy environment for the implementation and scaling up of harm reduction activities on a global scale. An independent evaluation of the DFID programme focused primarily on IHRA's work with multilateral agencies such as those of the United Nations and civil society organisations, in particular harm reduction networks and drug users groups. This work, based largely on a human rights approach to harm reduction, included developing and disseminating evidence‐ based reports and publications, advocacy and lobbying with a wide range of national and international partners and planning the annual International Harm Reduction Conference.

Details

Drugs and Alcohol Today, vol. 11 no. 1
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 1 September 2008

Grazia Zuffa

Following the example of many northern European countries, harm reduction strategies were introduced in Italy at the beginning of the 90s in response to the spread of HIV/Aids…

Abstract

Following the example of many northern European countries, harm reduction strategies were introduced in Italy at the beginning of the 90s in response to the spread of HIV/Aids. The peculiarities of Italian culture and tradition led to the adoption of a ‘Latin’ model, while in northern countries the culture of pragmatism and evidence‐based practices, together with a long tradition of public health policy were determinant in promoting harm reduction. In Italy, the ‘social perspective’ on the drug problem adopted by a large part of professionals working in public services and by most non‐governmental organisations (NGOs), has prompted a synergy between ‘cure’ and ‘care’ (ie. treatment and harm reduction), leading to the ‘integration’ of harm reduction and the traditional drug‐free work on addiction. As a result, since the mid 90s, public services and therapeutic communities have been cooperating to build a complex system of low to high threshold facilities. Until the 90s, most NGOs only ran drug‐free programmes in therapeutic communities, but from then onwards many began running harm reduction programmes as well, especially street units and needle exchange programmes, secondary prevention units at rave parties, drop‐in centres, and low‐threshold detoxification centres. Similarly, there has been an increase in methadone maintenance in public services, after the ‘retention in treatment’ of clients was established as the primary objective in the effort to protect users from drug related death and HIV infection. Though harm reduction interventions are far from being fully implemented, data shows that in the past 15 years the harm reduction/treatment system has reduced health risks for drug users and has been instrumental in referring a remarkable number of injecting drug users into treatment programmes. In the mean time, drugs of choice, patterns of use and ways of drug consumption have substantially changed. Now the question is, will the Italian approach be able to address these new challenges?

Details

Drugs and Alcohol Today, vol. 8 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 7 June 2013

Kirsten Bell

This article examines the relationship between tobacco control and tobacco harm reduction, illuminating the differences and similarities between them.

Abstract

Purpose

This article examines the relationship between tobacco control and tobacco harm reduction, illuminating the differences and similarities between them.

Design/methodology/approach

Drawing on published sources, the author conducts a critical analysis of the prevailing discourses on tobacco control and tobacco harm reduction.

Findings

Although tobacco control and tobacco harm reduction differ in their views on the resolutions to the tobacco “problem”, they manifest similar underlying assumptions about the nature of “the smoker” and are equally silent on the topic of pleasure.

Originality/value

This article emphasises the need for tobacco harm reduction to take pleasure seriously and highlights the limitations of approaches focused exclusively on risk and harm reduction.

Details

Drugs and Alcohol Today, vol. 13 no. 2
Type: Research Article
ISSN: 1745-9265

Keywords

Book part
Publication date: 12 December 2022

Luke A. Turnock and Honor D. Townshend

With digital spaces an increasing feature of our everyday lives, and the internet now a primary means of sourcing IPEDs and information regarding their use, this chapter seeks to…

Abstract

With digital spaces an increasing feature of our everyday lives, and the internet now a primary means of sourcing IPEDs and information regarding their use, this chapter seeks to understand how digital fitness forum communities shape the dissemination of culturally embedded harm reduction advice. Findings are drawn from two netnographic studies of fitness forums, which identify several key areas in which community norms and structures served to inform harm reduction behaviours. This included embedded forum reputation systems and the ways in which these shaped IPED access, including through elevating ‘expert’ users and encouraging informed discussion regarding product quality, to the emergence of steroid testing services from forums as a community harm reduction tool. Second, forums were observed to often encourage users to conduct research and inform themselves regarding safe use, though limitations to this norm were also documented in relation to poor-quality medical advice, highlighting the issues with IPED users' reliance on anecdotal advice in the contexts of prohibition. Finally, the role of digital fitness forums as ‘digital backstage’ is considered, examining both how this can be harmful to IPED users from excluded or ‘otherised’ groups, but simultaneously offers cultural participants the opportunity for airing vulnerabilities in a space where their masculine identity is not threatened in doing so, thus facilitating harm reduction among cultural ‘insiders’.

Details

Doping in Sport and Fitness
Type: Book
ISBN: 978-1-80117-157-1

Keywords

Article
Publication date: 1 January 2009

Jonathan Caulkins and Peter Reuter

This article provides an overview of the opportunities enforcement has to undertake activities to reduce harms caused by drug markets. Four pathways are open to the police in…

Abstract

This article provides an overview of the opportunities enforcement has to undertake activities to reduce harms caused by drug markets. Four pathways are open to the police in relation to drug harmreduction: reducing the amount of drug use; reducing the harm that drug users experience; reducing the harms that drug users impose on others; and reducing the harms caused by drug markets. It is the latter pathway that is the main focus of this article, which draws on a range of international examples. After highlighting that ‘not all dealers are equally destructive’ it is argued that one aim for enforcement could be to shape the drug market by making the most noxious forms of selling uncompetitive relative to less harmful practices.

Details

Safer Communities, vol. 8 no. 1
Type: Research Article
ISSN: 1757-8043

Keywords

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