Harm Reduction Essay Example

Harm Reduction Essay WHAT IS HARM REDUCTION? Harm reduction is a set of practical strategies intended to reduce the negative consequences of high risk behavior such as over drinking or drug abuse. Harm reduction is a non judgmental approach that attempts to meet people where they are at with their drinking or drug abuse. Instead of demanding perfect abstinence, this pragmatic approach is supportive of anyone who wishes to minimize the harm associated with a high risk behavior such as drinking or drug abuse. Harm reduction accepts that high risk behaviors such as recreational alcohol intoxication or part of world and works to minimize their harmful effects rather than simply ignore or condemn them. Harm reduction does not attempt to force people to change in ways which they don’t choose for themselves. Harm reduction is a compassionate approach whose primary concern is the increased well-being of its constituency. Harm reduction works on the premise that it is easier to get people to make small changes than to get them make big changes. Because of this it is possible to have a far greater positive change than getting only a few people to make big changes. It is easier and far more effective to get people to use seat belts than to eliminate auto-mobile and driving entirely. And it is easier and more effective to teach people how to plan their drinking and drink safely than to try and eliminate recreational intoxication entirely. Prohibition and coerce abstinence do not work, harm reduction does. We will write a custom essay sample on Harm Reduction specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Harm Reduction specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Harm Reduction specifically for you FOR ONLY $16.38 $13.9/page Hire Writer WHY SHOULD HARM REDUCTION APPROACHES BE IMPLEMENTD? The main reason that harm reduction approaches should be implemented is that these strategies save lives and diminish the likelihood of drug use problems for the individual, their families and the surrounding community. 1. Liver problems: related to the user’s physical or psychological health such as cirrhosis, cancer, overdose, psychiatric, psychological or emotional problems (amnesia, depression. paranoma, etc) accidents or other injuries while intoxicated. . Lover: problems related to relationships, family, friends, intimate partner and children. 3. Livelihood; problems related to the user professional life (e. g, lack of concentration at work or school) and other non-professional activities such as hobbies. 4. Law: legal problems related to illegal drug use, drug acquisition, and /or trafficking including driving under the influence of drugs Other effects of drug and alcohol abuse . work places: Substance use can cause m ajor consequences on the â€Å"work place†: absenteeism, lost production, staff retention, interpersonal conflicts, increase number of accidents/injuries, all these have happened as a result of alcohol and drug use and have been documented on occupational health and safety. Alcohol/drug abuse makes someone to fail to acquire or hold a job because of the effects of drugs on coordination, balance and the ability to think and retain. 2. Politics/drug policy reform Alcohol and smoking are more or less socially acceptable drugs none the less, they are killers. Other socially acceptable or prescription drugs include tranquillizers and sleeping tablets. The danger of abuse of over the counter medicines, although receiving less public attention, is probably greater than â€Å"controlled† or illegal drugs because they are more generally available. Everyone knows that the trade in hard drugs is big business, few are aware that the business involved in prescription drugs is even bigger. The pharmaceutical industry is one of the fast growing in the world. Millions of monies are spent on advertising and the promotion of brand names to doctors has a great influence on what product will eventually prescribed to patients. The pharmaceutical industry spends on average over twice as much as on advertising as it does on research and development on new products. In some countries especially developed, there is one drug company representative for every 8 doctors. Minor tranquilizers, such as valium and sleeping pills are the most common drug on repeat prescription and taken in prolonged use. They will control the initial symptoms of anxiety, but simply used on their own cannot control emotional or spiritual problems. Most attention has been focused on drugs like heroin, cocaine, cannabis, etc. These substances have been made illegal. Why? It is an issue of politics and profit not about any great concern for individual’s health or functioning. As opposed to more radical responses to immoral and risky lifestyles, harm reduction is a certain healthcare philosophy that approaches such lifestyles from a just and social point of view. Most frequent risky lifestyles are drug and alcohol abuse, and casual sex. Harm reduction is rather a new alternative which is aimed at reducing the risk and possible harm from these lifestyles. Unlike other healthcare philosophies, harm reduction does not intend to abolish such risky and dangerous lifestyles. Rather it accepts that abusers would willfully engage in such activities. Thus, the central idea is that if they would anyway opt for such risks and potential harm, let then this harm be reduced and these individuals less exposed to healthcare problems and other risks. Furthermore, the philosophy supports the rights of those risk takers for the same social security and healthcare. Because of the so facilitating and promoting nature of the approach, as the critics view it, this approach has become very controversial in the world, especially in the United States. Harm reduction practices are based on various policies that are aimed to reduce harm for abusers and risk takers. The broad categories of harm reduction policies include providing crucial information about safer sex and drug uses, arranging safe injection rooms for addicts to prevent disease spreading, controlling the distribution of alcoholic beverages for homeless shelters to prevent chronic alcoholic from drinking non-beverage alcohol products, and amendment of penalties for drugs. Some advocates of harm reduction claim that prohibition of soft drugs like marijuana is old-fashioned. Moreover, they claim that this prohibition is actually useless and ineffective, because despite the laws soft drug users still exist. Craig Reinarman and Harry Levine, in their book Crack in America, explain that such prohibition of drugs (although they referred to crack cocaine) has actually served as a cause for creation of harm reduction movement, because the old policy proved useless. Marijuana use, for example, is even used in medical treatment programs, and supporters of harm reduction argue that healthcare risks of marijuana use are rather low. Thus, risk reduction policies regarding the matter include providing high-quality marijuana in cafes and decriminalization of the drug, if kept in small quantities or grown for personal usage. Such policies reduce the risk of using low quality product (the harm), and also challenge the diminish market of marijuana. Testing hard drugs for harmful chemicals has also become a regular activity, supported by harm reductionists. Volunteers from non-profit organizations test samples of pills brought by users in order to prevent these users from taking low quality substances from the underground market. Pills and crystals sold illegally are often impure and contain harmful chemicals. So, anyone can test his or her pill and make sure the drug is pure. This way, such organizations simply reduce the harm of taking low quality crack, ecstasy, or other drug. Safe injection sites and needle exchange are among the most popular yet the most controversial harm reduction policies. Safe injection sites are places where drug addicts can receive a clean needle and a dose of a drug for free, and use these in safe environment. The idea behind such allegedly immoral activity is that these people would find a way out to have that single next shot. But due to the risk of catching some disease or injecting unclear chemicals, or committing a crime, certain organizations that support harm reduction philosophy provide such services to addicts. Barring the actual harm and risk reduction, providing high quality drugs for free discourages illegal trade of drugs on the streets. Less effective, but still significant, is the needle exchange practice, which provides safe clean needles and syringes to anybody for free. Such policy significantly reduces the risk of catching diseases (or HIV virus) from used needles. The Dutch, as opposed to Americans, as described in Adam Smith’s Americas Lonely Drug War, have implemented a unique drug policy, where they treated addiction as a health problem, and decriminalized use of drugs completely. Harm reductionist approach appeared to be much more successful to fight drug-related crime, diseases, and drug use in general in the long-term. The outcomes and the effects of harm reduction policies have been questionable for a long time. The Dutch drug policy suffered a huge increase in drug use (especially marijuana) amongst youngsters during the year after implementation, reports Susan Kaplin in her report The Effects of Harm Reduction Vs Harm Prevention: An International Assessment. Critics of harm reduction philosophy predicted this outcome, because legalizing something which had been banned would certainly tempt many to try during the first several years. However, such drug policies based on harm reduction like in the Netherlands are aimed at long-term improvement. Interestingly, the American Academy for Educational Development conducted another study in New York Does harm reduction programming make a difference in the lives of highly marginalized, at-risk drug users? in 2004 to find out the effects of harm reduction drug policies. They have discovered that â€Å"there was significant client progress across most outcomes from entrance in the harm reduction program to the last follow-up assessment. † However, it is important to note that the policies and the circumstance under which the participants have been were rather different, because in the Netherlands, methadone has been given out for free to heroin addicts (1993 study), and the New York research was limited in time, scale, space, and offered only support, counseling, and healthcare services by mobile units (2004 study). Thus, the New York study shows that there is enough evidence to believe that harm reduction practices do help reduce drug related harm, and improve the health of subjects. Harm reductionist philosophy requires complete rethinking of the approach to war against drug and alcohol abuse, and other risky lifestyles. As evidences have shown, harm reduction does help to improve the well-being and reduce harm in drug addicts. However, if implemented too quickly with decriminalization of drugs, the younger population may engage in mass drug abuse, as was in the Netherlands in the 80’s and 90’s. Thus, harm reduction should certainly be considered as one of the means in fighting against drug-related problems in society, but these harm reduction policies should be implemented accurately and carefully, so that they do not promote or encourage even more drug abuse. Ultimately, harm reduction philosophy is based on accepting the inevitable and making it less harmful, instead of blindly pretending that laws are obeyed. Health impacts Alcohol is the world’s third major disease, but alcohol and smoking are more or less socially acceptable drugs, nonetheless they are killers. Other socially acceptable or prescription drugs include tranquilizers and sleeping tablets. The dangers of abuse of the over the counter medicine although receiving less public attention are probably greater than â€Å"controlled† or illegal drugs because they are more generally available. Tackling the causes We should seriously consider tackling the stress of everyday life by making a supreme effort to get at the cause of the situation rather than dealing with the symptoms. Drug can be use to control and treat illness. These should always be used under medical supervision. Many of the conditions for which patients consult doctors these days could be better treated in ways other than by drugs. Many illnesses have a mental component which can be helped considerably by symptomatic understanding and explanation of the disease process. Risk Infectious Diseases Including HIV In spite of the growing efforts to address the AIDS epidemic, HIV and other infectious diseases continue to spread, particularly among infection drug users. The number of people living with HIV and also the number of deaths due to AIDS continues to increase. A total of 39. 5 million people live with HIV and estimated of 4. 3 million(3. 6 million-6. 6 million) adults and children were newly infected with HIV in 2006 according to the UNAIDS/WHO 2006. Effective principals for working IDU’S to prevent HIV 1. Save a non-judgmental attitude. 2. Emphasizes the drug users ability to care for himself or herself 3. Use short term pragmatic goals and scale of behaviour to achieve the goals 4. Provide information about the transmission of HIV, it is prevention and it is connection with risk behaviour 5. Focus on concrete risk behaviour and connect those with the individual’s reality(his/her own risk behaviour) 6. Provide different options to reduce the risk of infection 7. Provide a supportive environment (professionals, family, peers, etc) 8. Have a team of experienced professionals involved and digesting and implementing harm reduction programs and strategies GENERAL HARM REDUCTION STRATEGIES Education strategies: The first in harm reduction is to provide accurate information about the consequences and risk of drugs use and promote behaviors that reduce risk. Education should include information on physical and psycho-social risks of drug abuse, risks of overdose, infectious diseases, driving problems, and cardiovascular, metabolic, and physical disorders. Education needs to be combined with other interventions, such as brief interventions, in order to be effective. Educational strategies may include information on safer sex practices to reduce the risk of HIV transmission and information on the consequences of the various ways that drugs can be taken (routes of administration). These strategies also need to include information on health and social services available in your area. Education for drug users may include one-on-one sessions or group sessions that occur in clinical settings or other settings (institutions, prison, on the street). Brief interventions and Counseling: Brief interventions are focused on changing high-risk behaviors. These interventions might include single-session therapy, cognitive behaviour therapy, and/or motivational interviewing (see Volume B, Modules 1-3). These interventions may last between 15 minutes to 4 hours and, again, they may or may not be conducted in clinical settings. Interventions to reduce injury and violence: Drugs such as alcohol have been related to injury, violence, and public disorder. Strategies to change the environment may be helpful, such as changing alcohol containers (from bottles to plastic glasses), banning beverages with high concentrations of alcohol, community mobilization, etc. Other interventions can be aimed towards reducing road accidents by promoting public transportation, punishment for drinking and driving, etc. Availability of measures to prevent the acute consequences of stimulation abuse in the outlets of frequent abuse of these substances could contribute to the prevention of related emergencies. Harm reduction strategies for injection drug use: Preventing the spread of HIV and other adverse consequences: Low-threshold pharmacological interventions (opiod-antagonist drugs), not directly related to drug-free (non-methadone) programmes but to immediate health protection. One of the aims of these interventions is to reduce the risk of contraction or transmitting HIV and other infectious diseases by substituting non injecting drugs for the legal drugs dispensed under the care of a health professional, so the risk of overdose and other medical complications is minimized. Drug substitution helps to reduce crime and drug users high risk behaviors since it reduces the urgency of acquiring the drug. Drug substitution also allows health professionals to keep in contact with drug users, which aids in keeping them in treatment and thereby reduce relapse. Voluntary HIV Counseling and Testing Early detection of HIV infection is critical. Barriers such as lack of testing availability and the questionable accuracy of HIV test, and fears of discrimination, fears about getting a positive result from the test and fears of social stigma need to be overcome to better implement HIV testing as a prevention programme, Voluntary testing should, ideally be accompanied by HIV counselling. This includes a risk evaluation and information on prevention of transmission. Pre-test counselling should focus on assessment and getting the necessary information from the client on his/her medical history. , drug use knowledge of HIVand AIDS, sexual behaviour (number of patners, condom use, etc) exposure to high risk situations and other information, information about the test should also be provided at this moment. post counselling depends on the test results. If negative, the client should receive information that the results might not be reliable and that a new test should be conducted in 3-6 months. Over dose prevention Naloxone, a short-acting opioid antagonist, overturns the immediate effects of heroin and prevents overdose among injection drug users. other drugs such as methadone, which have similar properties to heroin and morphine, help to reduce overdose, risk of HIV and hepatitis, and criminal acts and other high risk behaviors’( the latter two because methadone is delivered legally). other overdose management strategies include peer-to-peer and encouraging peers to seek help and call an ambulance when an over dose is suspected. Prevention and services for the management of sexually transmitted infections: It is critical to provide information to drug users about the risk of HIV transmission and strategies to reduce such transmission. Strategies may include using condoms, reducing the number of sexual partners or being faithful to one partner, treating sexually transmitted diseases, abstinence, etc. What steps should we take to develop harm reduction strategies with our clients? Step 1: Be familiar with the potential harms associated with all types of drug use. Step 2: Assess the harms and risk associated with the clients drug use by analyzing their pattern of drug use. You could use forms such as the when? Where? Why? With/from Whom? What happened? Step 3: Assess with the client and provide feedback to them about how their behaviour is contributing to the harms they are experiencing, Step4: Use a collaborative approach with the client to consider as many harm reduction strategies as possible. It is equally important to identify barriers to the implementation of these strategies. Step 5: Have the client identify their goals regarding drug use and related behaviors’ and delineate how they will achieve these goals Step6: Monitor the client behavior, reinforce positive changes and address difficulties Conclusion Worries concerning financial, social and marital problems are rampant these days, a brief consultation with a general practioner is not the best answer to many stress related problems that arise. One is likely to come away with a prescription for tranquilizer pill as a temporary measure without understanding the underlying problem. If the real trouble is disharmony at home one needs to be honest instead of coming up with bizarre symptoms forcing the doctor to prescribe tranquilizer which may not cure the problem but addiction. The goal of harm reduction strategies and approaches is to reduce the negative consequences of drug abuse, not to eliminate the use of illicit drugs. Harm reduction is a practical approach that employs a range of different strategies with the goal of minimizing the risk of the client contracting infectious diseases, overdosing or suffering other consequences related to the use of substances. Strategies may include changing the way people consume the drugs or insuring that the environment in which they use minimizes the risk of negative consequences of their health (infectious, overdose) or quality of life Legal problems, social and familiar issues, etc). Strategies can vary depending on the drug, the type of harm related to its consumption and the individual who consumes the drugs. Bibliography 1. Mac Master, S. (2004). Harm Reduction: a new perspective on substance abuse services. Social Work. v49 i3 p356. 2. Reinarman, C. and Levine H. (1997). Crack in America: Demon Drugs and Social Justice. University of California Press. Ch 10, 17. 3. Smith, A. (2001). Americas Lonely Drug War. Mother Jones, United Kingdom, London page 41-45 4. Does harm reduction programming make a difference in the lives of highly marginalized, at-risk drug users? (2004). Academy of Educational Development. Retrieved May 4th 2006 from Harm Reduction Journal at http://www. harmreductionjournal. com/content/1/1/7 5. Kaplin, S. (1994). The Effects Of Harm Reduction Vs Harm Prevention: An International Assessment. Retrieved May 4th 2006 from Sarnia Online at http://www. sarnia. com 6. Clemency Mitchell, 2003 vibrant health in the twenty first century, England page 87-91 7. D. N Marshall 2009, A guide to family Health Grantham ,England page 29-63,