Responsible drug use

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Responsible drug use seeks to maximize the benefits and minimize the risks associated with psychoactive drug use. For illegal psychoactive drugs that are not diverted prescription controlled substances, some critics [1] [2] believe that illegal recreational drug use is inherently irresponsible, due to the unpredictable and unmonitored strength and purity of the drugs and the risks of addiction, infection, and other side effects.

Contents

Nevertheless, harm reduction advocates claim that the user can be responsible by employing the same general principles applicable to the use of alcohol: avoiding hazardous situations, excessive doses, and hazardous combinations of drugs; avoiding injection; and not using drugs at the same time as activities that may be unsafe without a sober state. [3] Drug use can be thought of as an activity that is potentially beneficial but also potentially risky. Similar to other risky activities such as skydiving or mountain climbing, the varied risks of drug use can be minimized by using harm-reduction strategies such as education, caution, and common sense. These advocates also point out that government action (or inaction) makes responsible drug use more difficult by artificially increasing risks, such as by making drugs of known purity and strength unavailable due to prohibition.

Harm reduction

A label on alcoholic drinks promoting zero alcohol during pregnancy Zero alcool pendant la grossesse.svg
A label on alcoholic drinks promoting zero alcohol during pregnancy
Contaminated currency such as banknotes frequently used for snorting should be avoided as they may spread hepatitis C Cocaine lines 2.jpg
Contaminated currency such as banknotes frequently used for snorting should be avoided as they may spread hepatitis C

Responsible drug use is emphasized as a primary prevention technique in harm-reduction drug policies. Harm-reduction policies were popularized in the late 1980s although they began in the 1970s counter-culture where cartoons were distributed to users explaining responsible drug use and consequences of irresponsible drug use. [5]

Harm reduction as applied to drug use began as a philosophy in the 1980s aiming to minimize HIV transmission between intravenous drug users. It also focused on condom usage to prevent the transmission of HIV through sexual contact. Harm reduction worked so effectively that researchers and community policy makers adapted the theory to other diseases to which drug users were susceptible, such as Hepatitis C.

Professor Graham Foster, of St Mary's Hospital, London, said: "Sharing banknotes or straws is a significant risk factor that people need to be more aware of. Although the risk of contracting hepatitis C through snorting is lower than through sharing a needle, it is still there." [4]

Harm reduction seeks to minimize the harms that can occur through the use of various drugs, whether legal (e.g. ethanol (alcohol), caffeine and nicotine), or illegal (e.g. heroin and cocaine). For example, people who inject drugs can minimize harm to both themselves and members of the community through proper injecting technique, using new sterile needles and syringes each time, utilizing sterile water, employing sterile micron filters to purify solutions, using antiseptic pads to prepare injection sites and clean drug mixing vials/containers, and through proper disposal of all injecting equipment.

Other harm reduction methods have been implemented with drugs such as crack cocaine. In some cities, peer health advocates (Weeks, 2006) have participated in passing out clean crack pipe mouthpiece tips to minimize the risk of Hepatitis A, B and C and HIV due to sharing pipes while lips and mouth contain open sores. Also, a study by Bonkovsky and Mehta reported that, just like shared needles, the sharing of straws used to "snort" cocaine can spread blood diseases such as Hepatitis C.

The responsible user therefore acts to minimize the spread of blood-borne viruses such as hepatitis C and HIV in the wider community and reduce their own risk exposure to drug-related harms.

Supervised injection sites (SiS)

The provision of supervised injection sites, also referred to as safe injection sites, operates under the premise of harm reduction by providing the injection drug user with a clean space and clean materials such as needles, sterile water, alcohol swabs, and other items used for safe injection.

Vancouver, British Columbia [6] opened a SiS called Insite in its poorest neighbourhood, the Downtown Eastside. Insite was opened in 2003 and has dramatically reduced many harms associated with injection drug use. The research arm of the site, [6] run by The Centre of Excellence for HIV/AIDS has found that SiS leads to increases in people entering detox and addiction treatment without increasing drug-related crime. As well, it reduces the littering of drug paraphernalia (e.g., used needles) on the street and reduces the number of people injecting in public areas. The program is attracting the highest-risk users, which has led to less needle-sharing in the Downtown Eastside community, and in the 453 overdoses which occurred at the facility, health care staff have saved every person.

Since the drug policy of the Netherlands considers substance use a social and health-related issue and not a legal one, the government has opened clinics where drug users may consume their substances in a safe, clean environment. Users are given access to clean needles and other paraphernalia, monitored by health officials and are given the ability to seek help from drug addiction. [7]

Due to the project's initial success in reducing mortality ratios and viral spread amongst injection drug users, other projects have been started in Switzerland, Germany, Spain, Australia, Canada and Norway. France, Denmark and Portugal also opened multiple drug consumption facilities. [8] [9] [10]

Principles

Duncan and Gold argue that to use controlled and other drugs responsibly, a person must adhere to a list of principles. [11] They and others [12] argue that drug users ought to proceed by:

Some proposed ethical guidelines include:

Duncan and Gold suggested that responsible drug use involves three areas of responsibility:

Criticism and counterarguments

Health and social consequences

Drug use and users are often not considered socially acceptable; they are often marginalized socially and economically. [19]

Drug use may affect work performance; however, drug testing should not be necessary if this is so, as a user's work performance would be observably deficient, and be grounds in itself for dismissal. In the case of discriminate use of amphetamines, substituted amphetamines and other stimulants, work capacity actually increases, which in itself raises additional ethical considerations. [20] [21]

Illegality

Illegality causes supply problems, and artificially raises prices far above the production and transportation costs. Purity and potency of many drugs is difficult to assess, as the drugs are illegal. Unscrupulous and unregulated middlemen are drawn by profit into the industry of these valuable commodities, directly affecting the users ability to obtain and use the drugs safely and forcing the user to take avoidable risks. Drug dosaging with varying purity is problematic. Profit motivation rewards illegal sellers who dilute substances with a cutting agent; when a user, expecting a low dose, procures "uncut" drugs, an overdose can result.

The morality of buying certain illegal drugs is also questioned given that the trade in cocaine, for instance, has been estimated to cause 20,000 deaths a year in Colombia alone. [22] [ needs update? ] Increasing Western demand for cocaine causes several hundred thousand people to be displaced from their homes every year, indigenous people are enslaved to produce cocaine and people are killed by the land mines drug cartels place to protect their coca crops. [22] However, the majority of deaths currently caused by the illegal drug trade can only take place in a situation in which the drugs are illegal and some critics blame prohibition of drugs and not their consumption for the violence surrounding them. [23] The illegality of drugs in itself may also cause social and economic consequences for those using them, and legal regulation of drug production and distribution could alleviate these and other dangers of illegal drug use. [24]

On festivals

As drugs are very prevalent in festival culture more and more consider taking measures for responsible usage there. [25] Some music festival organizers have chosen to provide services meant to inform about responsible drug use and drug checking for the disposal of dangerously laced ones. [26] [27] [28] As a result, some have reported a significant reduction of the workload of festival's medics, welfare team and police officers. [26]

Organizations

Many organizations exist to promote responsible drug use and harm reduction throughout the world.

Some, such as Students for Sensible Drug Policy or Drug Policy Alliance, are primarily activist groups concerned with drug policy reform, promoting scientific research on drugs, and opposing stigma and misinformation about drug use and drug users. Others exist primarily as drug testing services for drug users (e.g. Energy Control or DrugsData), or as supervised injection services (e.g. Insite), or as informational sources (e.g. Bluelight or Erowid). Governments have begun to address responsible drug use within their respective jurisdictions. The U.S. Department of Health and Human Services addresses harm reduction through the Substance Abuse and Mental Health Services Administration as a part of the department's Overdose Prevention Strategy. [29] [30]

See also

Related Research Articles

<span class="mw-page-title-main">Recreational drug use</span> Use of drugs with the primary intention to alter the state of consciousness

Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Recreational drugs are commonly divided into three categories: depressants, stimulants, and hallucinogens.

<span class="mw-page-title-main">Harm reduction</span> Public health policies which lessen negative aspects of problematic activities

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.

<span class="mw-page-title-main">Club drug</span> Category of recreational drugs

Club drugs, also called rave drugs or party drugs, are a loosely defined category of recreational drugs which are associated with discothèques in the 1970s and nightclubs, dance clubs, electronic dance music (EDM) parties, and raves in the 1980s to today. Unlike many other categories, such as opiates and benzodiazepines, which are established according to pharmaceutical or chemical properties, club drugs are a "category of convenience", in which drugs are included due to the locations they are consumed and/or where the user goes while under the influence of the drugs. Club drugs are generally used by adolescents and young adults.

<span class="mw-page-title-main">Needle and syringe programmes</span> Method of providing drug users with uninfected equipment

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.

<span class="mw-page-title-main">Supervised injection site</span> Medical facility

Supervised injection sites (SIS) or drug consumption rooms (DCRs) are a health and social response to drug-related problems. They are fixed or mobile spaces where people who use drugs are provided with sterile drug use equipment and can use illicit drugs under the supervision of trained staff. They are usually located in areas where there is an open drug scene and where injecting in public places is common. The primary target group for DCR services are people who engage in risky drug use.

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.

<span class="mw-page-title-main">National Institute on Drug Abuse</span> Branch of the National Institutes of Health in the United States

The National Institute on Drug Abuse (NIDA) is a United States federal government research institute whose mission is to "advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health."

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

<span class="mw-page-title-main">Polysubstance use</span> Use of multiple psychoactive substances

Polysubstance use or poly drug use refers to the use of combined psychoactive substances. Polysubstance use may be used for entheogenic, recreational, or off-label indications, with both legal and illegal substances. In many cases one drug is used as a base or primary drug, with additional drugs to leaven or compensate for the side effects, or tolerance, of the primary drug and make the experience more enjoyable with drug synergy effects, or to supplement for primary drug when supply is low.

<span class="mw-page-title-main">Chasing the dragon</span> Cantonese drug slang phrase

"Chasing the dragon" (CTD), or "foily" in Australian English, refers to inhaling the vapor of a powdered psychoactive drug off a heated sheet of aluminium foil. The moving vapor is chased after with a tube through which the user inhales. The "chasing" occurs as the user gingerly keeps the liquid moving in order to keep it from overheating and burning up too quickly, on a heat conducting material such as aluminium foil.

<span class="mw-page-title-main">Insite</span> Safe drug injection facility in Vancouver, B.C., Canada

Insite is a supervised drug injection site in the Downtown Eastside (DTES) neighbourhood of Vancouver, British Columbia, Canada The DTES had 4,700 chronic drug users in 2000 and has been considered to be the centre of an "injection drug epidemic". The site provides a supervised and health-focused location for injection drug use, primarily heroin. The clinic does not supply any drugs. Medical staff are present to provide addiction treatment, mental health assistance, and first aid in the event of an overdose or wound. In 2017, the site recorded 175,464 visits by 7,301 unique users; 2,151 overdoses occurred with no fatalities, due to intervention by medical staff. The site also offers a free checking service so clients can check their substances for fentanyl and carfentanil. Health Canada has provided $500,000 per year to operate the site, and the BC Ministry of Health contributed $1,200,000 to renovate the site and cover operating costs. Insite also serves as a resource for those seeking to use a harm reduction approach for people who inject drugs around the world. In recent months and years, delegations from a number of countries are on record touring the facility, including various U.S. states, Colombia and Brazil. 95% of drug users who use Insite also inject on the street according to a British Columbia health official.

<span class="mw-page-title-main">Drug injection</span> Method of introducing a drug

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.

<span class="mw-page-title-main">Drug liberalization</span> Process of reducing drug prohibition laws

Drug liberalization is a drug policy process of decriminalizing or legalizing the use or sale of prohibited drugs. Variations of drug liberalization include drug legalization, drug relegalization, and drug decriminalization. Proponents of drug liberalization may favor a regulatory regime for the production, marketing, and distribution of some or all currently illegal drugs in a manner analogous to that for alcohol, caffeine and tobacco.

Illicit drug use in Australia is the recreational use of prohibited drugs in Australia. Illicit drugs include illegal drugs, pharmaceutical drugs when used for non-medical purposes, and other substances used inappropriately. According to government and community organisations, the use and abuse, and the illegality, of illicit drugs is a social, health and legal issue that creates an annual illegal market estimated to be worth A$6.7 billion. Estimates made in 2022 place the figure at A$11.3 billion per year.

<span class="mw-page-title-main">Vancouver Area Network of Drug Users</span> Organization

The Vancouver Area Network of Drug Users or VANDU is a not-for-profit organization and advocacy group based in Vancouver, British Columbia, Canada. The group believes that all drug users should have their own rights and freedoms. The group's members have been actively involved in lobbying for support of Insite, North America's first safe injection site, located in the Downtown Eastside of Vancouver.

<span class="mw-page-title-main">Psychoactive drug</span> Chemical substance that alters nervous system function

A psychoactive drug, psychopharmaceutical, psychoactive agent, or psychotropic drug is a chemical substance that changes the function of the nervous system and results in alterations of perception, mood, cognition, and behavior. These substances have various applications, including medical use like psychedelic therapy, recreationally, or for spiritual reasons. Some categories of psychoactive drugs may be prescribed by physicians and other healthcare practitioners because of their therapeutic value.

Discrimination against drug addicts is a form of discrimination against people who suffer from a drug addiction.

Liz Evans is a Canadian nurse and harm reduction pioneer. She is the founder of the nonprofit Portland Hotel Society and a cofounder of North America's first sanctioned supervised-injection facility, Insite.

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.

Access, Harm Reduction, Overdose Prevention and Education, commonly referred to as AHOPE Boston or AHOPE Needle Exchange, and formerly called Addicts Health Opportunity Prevention Education, is a needle exchange and public health initiative of the Boston Public Health Commission.

References

  1. ↑ Wilson, Richard; Kolander, Cheryl (2010). Drug Abuse Prevention: A School and Community Partnership. Jones & Bartlett Publishers. p. 147. ISBN   978-0-7637-7158-4 . Retrieved July 29, 2011.
  2. ↑ Robinson, Matthew B; Scherlen, Renee G (2007). Lies, Damned Lies, and Drug War Statistics: A Critical Analysis of Claims Made by the Office of National Drug Control Policy. State University of New York Pr. p. 97. ISBN   978-0-7914-6975-0 . Retrieved July 29, 2011.
  3. ↑ "Diplo Takes Aim at Media Over EDM Deaths". Rolling Stone. 12 September 2013. Retrieved 18 May 2017.
  4. 1 2 Laureen Veevers (1 October 2006). "'Shared banknote' health warning to cocaine users". The Observer. Retrieved 2008-07-26.
  5. ↑ Charles E. Faupel; Alan M. Horowitz; Greg S. Weaver. The Sociology of American Drug Use. McGraw Hill. p. 366.
  6. 1 2 Vancouver Coastal Health, 2007
  7. ↑ "Some Nations Giving Addicts Clean Needles". The New York Times. 9 March 1987.
  8. ↑ "Infographic. Location and number of drug consumption facilities throughout Europe". emcdda.europa.eu. European Monitoring Centre for Drugs and Drug Addiction. Retrieved 2 May 2024.
  9. ↑ "EMCDDA webinar: Drug consumption rooms in Europe". emcdda.europa.eu. European Monitoring Centre for Drugs and Drug Addiction.
  10. ↑ "PERSPECTIVES ON DRUGS Drug consumption rooms: an overview of provision and evidence". mass.gov. European Monitoring Centre for Drugs and Drug Addiction. Retrieved 2 May 2024.
  11. ↑ Duncan, D. F.; Gold, R. S. (1982). Drugs and the Whole Person. Wiley, New York. pp. Chapter 18: Responsibilities of the recreational drug user.
  12. 1 2 3 "Towards a Culture of Responsible Psychoactive Drug Use". Cato Unbound. 8 September 2008. Retrieved 18 May 2017.
  13. ↑ "Towards a Culture of Responsible Psychoactive Drug Use". Cato Unbound. 8 September 2008. Retrieved 2 February 2017.
  14. ↑ "Ulbricht's lawyer: Silk Road was "the most responsible" drug market in history". Ars Technica. 18 May 2015. Retrieved 2 February 2017.
  15. ↑ "The internet and drug markets" (PDF). Retrieved 2 February 2017.
  16. ↑ "What you need to know about taking drugs". www.nhsinform.scot. Retrieved 21 March 2023.
  17. ↑ Hanson, Glen R.; Venturelli, Peter J.; Fleckenstein, Annette E. (2006). Drugs and Society. Jones & Bartlett Learning. ISBN   9780763737320 . Retrieved 18 May 2017.
  18. ↑ Scheier, Lawrence M.; Hansen, William B. (March 2014). Parenting and Teen Drug Use: The Most Recent Findings from Research, Prevention, and Treatment. OUP USA. ISBN   9780199739028 . Retrieved 18 May 2017.
  19. ↑ Rick Lines. "The Politics Of Drug Use Marginalization" (PDF). PASAN, Ontario. Archived from the original (PDF) on 20 November 2008. Retrieved 14 July 2009.
  20. ↑ "DexedrineR: SmithKline Beecham: Dextroamphetamine Sulfate: Sympathomimetic". RxMed.
  21. ↑ "Human EnhancementR: SmithKline Beecham: Dextroamphetamine Sulfate: Sympathomimetic" (PDF). RxMed.
  22. 1 2 June 29, 2009 Yes, addicts need help. But all you casual cocaine users want locking up George Monbiot, guardian.co.uk
  23. ↑ Newman, Tony (May 15, 2009). "New Campaign Should Blame Prohibition, Not Pot Smokers for Violence in Mexico". HuffPost .
  24. ↑ "Failed states and failed policies, How to stop the drug wars". The Economist. 2009-03-05. Retrieved 2009-03-10.
  25. ↑ "Explaining the prevalence of drug-related deaths at EDM festivals". 24 May 2016. Retrieved 18 May 2017.
  26. 1 2 "I spent my weekend testing drugs at a festival". The Independent. 25 July 2016. Retrieved 18 May 2017.
  27. ↑ "We spent a day at the drugs testing station at Shambhala festival in Canada". Mixmag. Retrieved 18 May 2017.
  28. ↑ "KOSMICARE: Taking care of each other". Boom Festival. Retrieved 5 December 2023.
  29. ↑ SAMHSA. "Harm Reduction". www.samhsa.gov. Retrieved 2022-10-31.
  30. ↑ Assistant Secretary for Public Affairs (ASPA) (2021-09-14). "Overdose Prevention Strategy". Overdose Prevention Strategy. Retrieved 2022-10-31.
  31. ↑ "Harm Reduction Advocates Want to Make Echostage Safer". 22 February 2018. Retrieved 23 November 2018.
  32. ↑ Francis, Phillip (2017-08-24). "The Future Of Dance Safe, With Mitchell Gomez [Exclusive Interview]". Dance Music NW. Retrieved 2022-09-04.
  33. ↑ White, Jeff B. "Rachael Leigh Cook and Her Frying Pan Are Back to Explain the War on Drugs - The Pacific Tribune". pacifictribune.com/. Retrieved 2022-09-04.
  34. ↑ "We envision a world in which drug policies uphold dignity, health and rights". Harm Reduction International. Retrieved 2023-12-05.
  35. ↑ "Vancouver Insite drug-injection facility can stay open". BBC News. 2011-09-30. Retrieved 2023-12-05.
  36. ↑ "Melbourne Uni's Student Union Will Soon Hand out Free Drug Testing Kits". 16 September 2016. Retrieved 23 November 2018.

Further reading

Harm reduction

Responsible drug use websites

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