PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Harm Reduction”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed2003

Supply control and harm reduction: lessons from the Australian heroin 'drought'.

AIMS: To examine the effects of supply-side drug law enforcement on the dynamics of the Australian heroin market and the harms associated with heroin. SETTING: Around Christmas 2000, heroin users in Sydney and other large capital cities in Australia began reporting sudden and significant reductions in the availability of heroin. The changes, which appear to have been caused at least in part by drug law enforcement, provided a rare opportunity to examine the potential impact of such enforcement on the harm associated with heroin. DESIGN: Data were drawn from a survey of 165 heroin users in South-Western Sydney, Australia; from the Drug Use Monitoring in Australia (DUMA) project; from NSW Health records of heroin overdoses; and from the Computerized Operational Policing System (COPS) database. FINDINGS: Heroin price increased, while purity, consumption and expenditure on the drug decreased as a result of the shortage. The fall in overall heroin use was accompanied by a significant reduction in the rate of overdose in NSW. However, the health benefits associated with the fall in overdose may have been offset by an increase in the use of other drugs (mainly cocaine) since the onset of the heroin shortage. There does not appear to have been any enduring impact on crime rates as a result of the heroin 'drought'. CONCLUSION: Supply control has an important part to play in harm reduction; however, proponents of supply-side drug law enforcement need to be mindful of the unintended adverse consequences that might flow from successfully disrupting the market for a particular illegal drug.

Adult↗
PubMed2004

Recent quitters' interest in recycling and harm reduction.

Many smoking cessation attempts are followed by failure or relapse. The optimal time to initiate a new quit attempt is not known. Administrative databases documenting recent use of a pharmacological aid for smoking cessation provide access to a population of smokers recently in the action phase of quitting. This study describes interest in further treatment among this population. A total of 2,340 smokers from the Minneapolis Veterans Administration Medical Center received prescriptions for a smoking cessation aid during an 18-month period. We conducted a cross-sectional survey of a random sample of this population a minimum of 3 months following the prescription, using a structured telephone interview (N=391). The response rate was 75.8%. The 1-month point-prevalent abstinence rate was 19.7%. Of continuing smokers, 98% were willing to make another quit attempt--50% immediately, and 28% within 1 month. There was no relationship between time since the last quit attempt and interest in trying again immediately. Some 95% of continuing smokers were willing to try a reduction strategy. Of these, 82.7% were interested in using nicotine replacement therapy (NRT) to accomplish this goal. Most cessation programs do not systematically approach participants who relapse. These data suggest that this population would welcome further help in quitting or reducing smoking shortly following failure, and that smokers do not commonly relapse to a precontemplation stage of change.

Administration, Cutaneous↗
PubMed2002

Expanding harm reduction services through a wound and abscess clinic.

A wound and abscess clinic, held concurrently with a syringe exchange, provided economical treatment and aftercare for injection-associated soft tissue infections. During 20 two-hour clinic sessions, 173 treatment episodes were logged, and the visit cost was estimated at $5 per patient. Increased patient-clinician interactions provided opportunities beyond those afforded by the syringe exchange for patients to obtain resources and referrals to services such as HIV counseling and testing, medical care, and drug treatment. Distribution of cards advertising the clinic was substantially less effective than word of mouth in increasing community awareness of the clinic.

Abscess↗
PubMed2004

Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis.

OBJECTIVES: We examined the longitudinal effects of a Housing First program for homeless, mentally ill individuals' on those individuals' consumer choice, housing stability, substance use, treatment utilization, and psychiatric symptoms. METHODS: Two hundred twenty-five participants were randomly assigned to receive housing contingent on treatment and sobriety (control) or to receive immediate housing without treatment prerequisites (experimental). Interviews were conducted every 6 months for 24 months. RESULTS: The experimental group obtained housing earlier, remained stably housed, and reported higher perceived choice. Utilization of substance abuse treatment was significantly higher for the control group, but no differences were found in substance use or psychiatric symptoms. CONCLUSIONS: Participants in the Housing First program were able to obtain and maintain independent housing without compromising psychiatric or substance abuse symptoms.

Adolescent↗
PubMed2002

Snuff use and smoking in U.S. men: implications for harm reduction.

BACKGROUND: Encouraging smokers to switch to snuff may have unintended public health implications. This study examined the associations between snuff use and smoking in a representative sample of U.S. men. METHODS: Subjects were males aged >or=18 years in the National Health Interview Survey (N=13,865). The data analysis was conducted between August 2001 and April 2002. Multiple logistic regression modeling was used to examine the association between using snuff and quitting smoking. RESULTS: In 1998, 26.4% of U.S. men smoked, 3.6% used snuff, and 1.1% used both products. Adjusting for age and race/ethnicity, current smoking was most prevalent among males who used snuff on some days (38.9%) and lowest among those who used snuff every day (19.2%). Daily snuff users were significantly more likely than never-users to have quit smoking in the preceding 12 months (odds ratio [OR]=4.23; 95% confidence interval [CI]=2.16-8.28). However, U.S. men were more likely to be former snuff users who currently smoked (2.5%) than to be former smokers who currently used snuff (1.0%). Occasional snuff users (some day users) were more likely than never users to have tried to quit smoking in the preceding year (OR=1.69; 95% CI=1.04-2.76) but tended to be less likely to succeed (OR=0.50; 95% CI=0.19-1.33). CONCLUSIONS: Some men may use snuff to quit smoking, but U.S. men more commonly switch from snuff use to smoking. Some smokers may use snuff to supplement their nicotine intake, and smokers who also use snuff are more likely than nonusers to try to quit smoking but tend to have less success.

Adult↗
PubMed2003

A Premiere example of the illusion of harm reduction cigarettes in the 1990s.

OBJECTIVE: To use the product launch of Player's Premiere as a case study for understanding the new cigarette product development process during the 1990s. We determine the (in)validity of industry claims that: (1) development of the physical product preceded the promotional promise of "less irritation"; (2) "less irritation" was actually realised; (3) advertising informed consumers; and (4) advertising regulations caused the product's failure in the marketplace. SETTING: Court proceedings assessing the constitutionality of Canada's Tobacco Act, which substantially restricts cigarette advertising. The 2002 Quebec Superior Court trial yielded a new collection of internal documents from Imperial Tobacco Ltd (ITL), including several about the development and marketing of Player's Premiere. METHOD: Trial testimony and corporate documents were reviewed to determine the validity of the industry representations about the new cigarette product development process, focusing on the case history of Player's Premiere. RESULTS: In direct contradiction to industry testimony, the documentary evidence demonstrates that (1) communications for Player's Premiere, which claimed less irritation, were developed long before finding a product that could deliver on the promise; (2) ITL did not sell a "less irritating" product that matched its promotional promise; (3) the advertising and other communications for Player's Premiere were extensive, relying on the hi-tech appearances ("tangible credibility") of a "unique" filter, yet were uninformative and vague; and (4) Player's Premiere failed in the marketplace, despite extensive advertising and retail support, because it was an inferior product that did not live up to its promotional promise, not because of regulation of commercial speech. CONCLUSIONS: New product development entails extensive consumer research to craft all communications tools in fine detail. In the case of Player's Premiere, this crafting created a false and misleading impression of technological advances producing a "less irritating" cigarette. This product was solely a massive marketing ploy with neither consumer benefits, nor public health benefits. The industry attempted to deceive both consumers and the court.

Advertising↗
PubMed2002

Animal retroviral infections suggest third kind of potential treatment: HIV harm reduction.

Besides antivirals and immune-based treatments, a third approach is to reduce the harm caused indirectly by HIV, which is probably more important than the direct killing of infected cells. Some animals do not get sick when infected with HIV-like viruses despite very high viral loads--suggesting that they have successfully evolved to tolerate the virus instead of eradicating or suppressing it. Understanding how they do so might lead to a new kind of HIV treatment.

Animals↗
PubMedDate not supplied

[The prevention of HIV infection and other blood-contact diseases among intravenous narcotic users in Nizhniy Novgorod within the framework of the Harm Reduction program].

The results of the development and realization principles of the project on the decrease of harm, envisaging work in three directions (the determination of the technology of using drugs, the exchange of syringes/needles and other accessories, as well as laboratory examination for the presence of antibodies to HIV, hepatitis B and hepatitis C viruses and consultations of narcologists). 1075 injecting drug users took part in this project. Out of 611 participants filling-in the questionnaires, 338 persons underwent tests for HIV and 3 of them were found to be HIV-infected; out of 305 persons screened for the presence of markers of hepatitis B virus, positive results were obtained in 98 (32% of cases); in 218 (65%) out of 335 persons antibodies to hepatitis C virus were found (49 persons, i.e. 14%, had hepatitis C registered in the medical history and in the rest antibodies were detected for the first time). The preventive program of the decrease of harm was assessed as effective.

Adolescent↗
PubMed1995

Harm reduction in Australia: has it worked? A review.

The literature is reviewed with a view to determining what evidence exists for the success of Australia's policy of harm minimization in relation to drug use. While there are relatively few examples of strategies which can unequivocally be said to have succeeded, there are many more for which the evidence is suggestive. While there has been a considerable mushrooming of research since the advent of the National Campaign on Drug Abuse, it would appear that little of this has measured the extent to which harm has been reduced. The National Drug Strategy would benefit from more policy-orientated research which measures drug-related harm if it is to be, as claimed, research driven.

Journal Article↗
PubMed1995

Harnessing harm reduction in Australia: an interview with the Hon. Neal Blewett. Interview by Steve Allsop.

The National Campaign Against Drug Abuse (NCADA) was established in April 1985. Aiming to provide a national framework to minimize the harmful consequences of drug use, the original 3-year programme was extended to 1997. A key figure in the NCADA, Dr Neal Blewett, was interviewed to gain his perspective on the development and implementation of the Campaign over its first 10 years.

Interview↗
PubMed2004

College student binge drinking and the "prevention paradox": implications for prevention and harm reduction.

Considerable attention has been paid to heavy episodic or "binge" drinking among college youth in the United States. Despite widespread use, the binge measure is perceived by some as a low intervention threshold. We use data from the Harvard School of Public Health College Alcohol Study (n = 49,163) to describe patterns of consumption and harms along a continuum including the binge measure to demonstrate the validity of the binge threshold and prevention paradox in college. While the heaviest drinkers are at greatest risk for harm, they are relatively few and generate proportionately small amounts of all drinking-harms. The risk of harms is not zero among lower level drinkers in college. Because they are numerous, they account for the majority of harms. This paradoxical pattern suggests we moderate consumption among the majority using environmental approaches, the efficacy of which are described using case study data from a national prevention demonstration. Implications for prevention policy, programming, and media advocacy are discussed.

Adolescent↗
PubMed1995

Drug legalization, harm reduction, and drug policy.

The current U.S. policy options on drug use are reviewed in the context of the history of drug policy in the United States. A restrictive drug policy is a deterrent to drug use and helps reduce drug-related costs and societal problems. Although legalization or decriminalization of drugs might reduce some of the legal consequences of drug use, increased drug use would result in harmful consequences.

Costs and Cost Analysis↗
PubMed2002

Tobacco smoking, harm reduction, and biomarkers.

The only known way to reduce cancer risk in smokers is complete cessation, but many smokers are unable or unwilling to quit. Consequently, tobacco companies are now marketing products that purport to reduce carcinogen exposure, with the implication that such products provide a safer way to smoke. Moreover, researchers are exploring ways to reduce the amount of cigarette smoke carcinogens to which the smokers are exposed. Although these methods are, in theory beneficial, it is possible that the perceived availability of "safe" ways to smoke will cause some former smokers to resume smoking and some current smokers to delay quitting. Thus, the extent of exposure reduction and the impact on public health of these methods need to be considered carefully. However, risk reduction and its relation to exposure are not simple to estimate. The way people smoke and the way they respond to carcinogen exposure are both highly variable, as evidenced by the previous history of smokers who switched to light, or low-tar cigarettes. This can actually increase risk in some smokers. The evaluation of exposure reduction will therefore need to be multidisciplinary and include in vitro cell culture studies, animal studies, human clinical studies, and epidemiologic studies. Biomarkers will be critical for rapidly evaluating the effects of new strategies or products to reduce exposure to tobacco smoke carcinogens. No single biomarker will likely satisfy our assessment needs, and so a panel of biomarkers should be used that includes biomarkers of exposure, biologically effective dose, and potential harm. In addition, usefulness of new products will need to be tested in people of different susceptibilities (i.e., who vary in behavior, sex, age, genetics, and prior tobacco use). Even if the new products are shown to be effective at reducing lung carcinogens, they should not be used alone but rather be incorporated into a comprehensive tobacco control program.

Biomarkers↗
PubMed1998

Benzodiazepine self-poisoning in Pakistan: implications for prevention and harm reduction.

The pattern of all index admissions for benzodiazepine self-poisoning to a university hospital in Karachi, Pakistan are described. Of the 329 medication self-poisoning cases, 84% were benzodiazepine overdoses. Diazepam was the preferred drug in 69% of these cases, with majority ingesting between 20-30 tablets of 5 mg each, 44% bought the benzodiazepine over the counter (OTC) for the purpose of overdose. The preference for benzodiazepines over analgesics (as freely available) may be related to the motives underlying parasuicide acts and their popularity as 'sleeping pills' in Pakistan. Educating the 'chemist' and limiting the number of tablets dispensed at a time are areas to consider in reducing the incidence and harmful effects of benzodiazepine overdoses in Pakistan.

Adolescent↗
PubMed1999

Reducing risks associated with drinking among young adults: promoting knowledge-based perspectives and harm reduction strategies.

The situation with regard to drinking is particularly complex for young adults: they are typically faced with pressures on one hand to abstain or drink small quantities, and on the other hand there may be expectations to drink heroic amounts and engage in risk-taking while drinking. Furthermore, in some cultures a very short transition period time is evident between condoned occasional experimentation with alcohol and the expectations of being able to manage alcohol use in a wide range of settings. Also, the perceived invincibility among youth stands in sharp contrast to their high rates of traumatic events involving alcohol. The paper by Barbara Leigh examines the nature and dimensions of risk-taking particularly among young adults. For example, her analysis encourages us to look beyond preliminary associations about the proportion of certain events where drinking was involved, and consider whether drinking was a correlate or a contributing cause. The paper by James Mosher points to the importance of obtaining information about the population, situation and drinker as a basis for population-level interventions, involving environmental changes in the promotion and distribution of alcoholic beverages. The papers point to a search for interventions that are distinguished by their effectiveness in reducing harm, and not necessarily by their faddish value. An essential step is drawing the younger drinker into an accurate documentation of risk-taking experiences, and also in collaborating in developing humane, reasonable and effective approaches in reducing drinking-related harm.

Adolescent↗
PubMed2006

Street policing, injecting drug use and harm reduction in a Russian city: a qualitative study of police perspectives.

We undertook a qualitative exploration of police perspectives on injecting drug use and needle and syringe access among injecting drug users (IDUs) in a Russian city which has witnessed explosive spread of HIV associated with drug injecting. Twenty-seven in-depth qualitative interviews were conducted in May 2002 with police officers of varying rank who reported having regular contact with IDUs. All interviews were tape-recorded, transcribed, translated and coded thematically. Accounts upheld an approach to policing which emphasised high street-based visibility and close surveillance of IDUs. IDUs were depicted as 'potential criminals' warranting a 'pre-emptive' approach to the prevention of drug-related crime. Street policing was described as a means of maintaining close surveillance leading to the official registration of persons suspected or proven to be users of illicit drugs. Such registration enabled further ongoing surveillance, including through stop and search procedures. While aware of drug users' reluctance to carry injecting equipment linked to their fears of detention or arrest, accounts suggested that the confiscation of previously used injecting equipment can constitute evidence in relation to drugs possession charges and that discovery of clean injecting equipment may be sufficient to raise suspicion and/or further investigation, including through stop and search or questioning. Our findings suggest an uneasy relationship between street policing and needle and syringe access, whereby policing strategies can undermine an HIV prevention ethos promoting needle and syringe accessibility among IDUs. We conclude that facilitating partnerships between policing agencies and HIV prevention initiatives are a critical feature of creating environments conducive for risk reduction.

Adult↗
PubMed1993

Harm reduction--a common cause.

In a field as complex as heroin addiction, controversy is useful in stimulating exchange of ideas. An appeal for action, however, based on what we already know to be enormously beneficial to addicts and to the general society, must be given higher priority than proselytizing for any given approach. We know that narcotic addiction takes a terrible toll and that, like alcoholism, we are currently unable to cure it. We also know that many addicts desperately seek methadone treatment, that many can be helped by it, and that many will die without it. The conclusion is clear: methadone treatment, one therapeutic approach among many, must be available upon request to all those who want it.

Cost of Illness↗