Related Research Articles
Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.
Naloxone, sold under the brand name Narcan among others, is a medication used to reverse or reduce the effects of opioids. It is used to counter decreased breathing in opioid overdose. Effects begin within two minutes when given intravenously, and within five minutes when injected into a muscle. The medicine can also be administered by spraying it into a person's nose. Naloxone blocks the effects of opioids for 30 to 90 minutes. Multiple doses may be required, as the duration of action of some opioids is greater than that of naloxone. Emergency medical services data from Massachusetts found that 93.5% of people given naloxone survived their overdose.
A needle and syringe programme (NSP), also known as needle exchange program (NEP), is a social service that allows injecting drug users (IDUs) to obtain clean and unused hypodermic needles and associated paraphernalia at little or no cost. It is based on the philosophy of harm reduction that attempts to reduce the risk factors for blood-borne diseases such as HIV/AIDS and hepatitis.
Needle sharing is the practice of intravenous drug-users by which a needle or syringe is shared by multiple individuals to administer intravenous drugs such as heroin, steroids, and hormones. This is a primary vector for blood-borne diseases which can be transmitted through blood. People who inject drugs (PWID) are at an increased risk for Hepatitis C (HCV) and HIV due to needle sharing practices. From 1933 to 1943, malaria was spread between users in the New York City area by this method. Afterwards, the use of quinine as a cutting agent in drug mixes became more common. Harm reduction efforts including safe disposal of needles, supervised injection sites, and public education may help bring awareness on safer needle sharing practices.
Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.
Students for Sensible Drug Policy (SSDP) is an international nonprofit organization advocacy and education organization with focus on drug policy, war on drugs, marijuana legalization, psychedelics, juvenile justice and youth rights, drug decriminalization, criminal justice reform. SSDP promotes global youth civic engagement as a tool in reforming drug policy.
The Drug Policy Alliance (DPA) is a New York City–based nonprofit organization that seeks to advance policies that “reduce the harms of both drug use and drug prohibition, and to promote the sovereignty of individuals over their minds and bodies” The organization prioritizes reducing the role of criminalization in drug policy, advocating for the legal regulation of marijuana, and promoting health-centered drug policies. DPA has been led by executive director Kassandra Frederique since September 2020.
Drug injection is a method of introducing a drug into the bloodstream via a hollow hypodermic needle, which is pierced through the skin into the body. Intravenous therapy, a form of drug injection, is universally practiced in modernized medical care. As of 2004, there were 13.2 million people worldwide who self-administered injection drugs outside of medical supervision, of which 22% are from developed countries.
Thomas R. Frieden is an American infectious disease and public health physician. He serves as president and CEO of Resolve to Save Lives, a $225 million, five-year initiative to prevent epidemics and cardiovascular disease.
An opioid overdose is toxicity due to excessive consumption of opioids, such as morphine, codeine, heroin, fentanyl, tramadol, and methadone. This preventable pathology can be fatal if it leads to respiratory depression, a lethal condition that can cause hypoxia from slow and shallow breathing. Other symptoms include small pupils, and unconsciousness, however its onset can depend on the method of ingestion, the dosage and individual risk factors. Although there were over 110,000 deaths in 2017 due to opioids, individuals who survived also faced adverse complications, including permanent brain damage.
HIV prevention refers to practices that aim to prevent the spread of the human immunodeficiency virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may be instituted by governments and community-based organizations as public health policies.
Low-threshold treatment programs are harm reduction-based health care centers targeted towards people who use substances. "Low-threshold" programs are programs that make minimal demands on the patient, offering services without attempting to control their intake of drugs, and providing counselling only if requested. Low-threshold programs may be contrasted with "high-threshold" programs, which require the user to accept a certain level of control and which demand that the patient accept counselling and cease all drug use as a precondition of support.
Infectious diseases within American correctional settings are a concern within the public health sector. The corrections population is susceptible to infectious diseases through exposure to blood and other bodily fluids, drug injection, poor health care, prison overcrowding, demographics, security issues, lack of community support for rehabilitation programs, and high-risk behaviors. The spread of infectious diseases, such as HIV and other sexually transmitted diseases, hepatitis C (HCV), hepatitis B (HBV), and tuberculosis, result largely from needle-sharing, drug use, and consensual and non-consensual sex among prisoners. HIV and hepatitis C need specific attention because of the specific public health concerns and issues they raise.
The Baltimore City Health Department(BCHD) is the public health agency of the city of Baltimore, Maryland. BCHD convenes and collaborates with other city agencies, health care providers, community organizations and funders to "empower Baltimoreans with the knowledge, access, and environment that will enable healthy living."
In the United States, the opioid epidemic is an extensive ongoing overuse of opioid medications, both from medical prescriptions and illegal sources. The epidemic began in the United States in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years. The great majority of Americans who use prescription opioids do not believe that they are misusing them.
A take-home naloxone program is a governmental program that provides naloxone drug kits to those that are at risk of an opioid overdose. Naloxone is a medication that was created to reverse opioid overdoses. As an opioid antagonist, it binds to the μ-opioid receptors blocking the opioid's effects. Naloxone quickly restores normal respiration. The ongoing opioid epidemic has caused many public health authorities to expand access to naloxone.
Over a period of six months, Colorado legislation HB 20–1065, the Colorado Harm Reduction Substance Use Disorders Law, passed through both houses of the state legislature with bipartisan sponsorship and was signed into law by Governor Jared Polis (D). The law provides support mechanisms and medications to individuals with substance abuse disorder. It also provides protection to pharmacists and ordinary Good Samaritans who are attempting to assist those with the potential of drug overdose and its subsequent consequences.
Cheryl Healton is an American public health researcher who is Professor of Public Health Policy and Dean of School of Global Public Health at New York University. Her research considers public health policy surrounding tobacco control.
Harm reduction consists of a series of strategies aimed at reducing the negative impacts of drug use on users. It has been described as an alternative to the U.S.'s moral model and disease model of drug use and addiction. While the moral model treats drug use as a morally wrong action and the disease model treats it as a biological or genetic disease needing medical intervention, harm reduction takes a public health approach with a basis in pragmatism. Harm reduction provides an alternative to complete abstinence as a method for preventing and mitigating the negative consequences of drug use and addiction.
New Jersey's most recent revised policy was issued September 7, 2022 pursuant to P.L.2021, c.152 which authorized opioid antidotes to be dispensed without a prescription or fee. Its goal is to make opioid antidotes widely available, reducing mortality from overdose while decreasing morbidity in conjunction with sterile needle access, fentanyl test strips, and substance use treatment programs. A $67 million grant provided by the Department of Health and Human Services provides funding for naloxone as well as recovery services. This policy enables any person to distribute an opioid antidote to someone they deem at risk of an opioid overdose, alongside information regarding: opioid overdose prevention and recognition, the administration of naloxone, circumstances that warrant calling 911 for assistance with an opioid overdose, and contraindications of naloxone. Instructions on how to perform resuscitation and the appropriate care of an overdose victim after the administration of an opioid antidote should also be included. Community first aid squads, professional organizations, police departments, and emergency departments are required to "leave-behind" naloxone and information with every person who overdosed or is at risk of overdosing.
References
- 1 2 3 Yang, Carol; Favaro, Jamie; Meacham, Meredith C. (April 2021). "NEXT Harm Reduction: An Online, Mail-Based Naloxone Distribution and Harm-Reduction Program". American Journal of Public Health. 111 (4): 667–671. doi:10.2105/AJPH.2020.306124. ISSN 0090-0036. PMC 7958031 . PMID 33600254.
- 1 2 Hayes, Benjamin T.; Favaro, Jamie; Davis, Corey S.; Gonsalves, Gregg S.; Beletsky, Leo; Vlahov, David; Heimer, Robert; Fox, Aaron D. (2021-08-01). "Harm Reduction, By Mail: the Next Step in Promoting the Health of People Who Use Drugs". Journal of Urban Health. 98 (4): 532–537. doi:10.1007/s11524-021-00534-1. ISSN 1468-2869. PMC 7953942 . PMID 33710493.
- 1 2 "Jamie Favaro's Quest to Bring Online Naloxone Access Nationwide". 5 December 2018.
- ↑ "How the 'heroin heroine' saves lives from her living room". CNN . 2 October 2017.
- ↑ Kaur, Harmeet (May 7, 2020). "The opioid epidemic was already a national crisis. Covid-19 could be making things worse". CNN.
- ↑ "Our History". NEXT Distro.
We have increased the impact of our work by partnering with harm reduction programs across the country to mail naloxone within their own state through our affiliate hub-and-spoke model.
- ↑ Barnett, B. S.; Wakeman, S. E.; Davis, C. S.; Favaro, J.; Rich, J. D. (2021). "Expanding Mail-Based Distribution of Drug-Related Harm Reduction Supplies Amid COVID-19 and Beyond". American Journal of Public Health. 111 (6): 1013–1017. doi:10.2105/AJPH.2021.306228. PMC 8101586 . PMID 33950718.