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The Philosophy of Harm Reduction - Is there a philosophy of harm reduction?

'The philosophy of harm reduction' is a phrase that's been used by many people over the years. When someone says it we all nod and agree with what the person is saying as if we understand exactly what they mean. But do we, in fact do they understand it themselves? 

Harm reduction grew out of community organizing, research, and clinical practice in the last quarter of the 20th century. At the same time, many of the arguments for harm reduction echo discussions in the history of ideas, as found in pragmatism, utilitarianism, and the ancient Greek philosopher, Epicurus.

We wish to explore if harm reduction can, as well as being a collection of practical interventsions, be seen as a lifestyle philosophy in it's own right.

Mission statement

Many of us came to harm reduction out of necessity, idealism, or both. We don’t kid ourselves that the real work of harm reduction is performed through the daily struggle of individuals and communities. At the same time, we believe that exploring the philosophical foundations of harm reduction can benefit the movement and the lives of people. (harmreductionphilosophy.com, März 2018)

http://harmreductionphilosophy.com/

UK. Night Lives: Reducing Drug-Related Harm in the Night Time Economy

The UK’s night time economy is failing to protect its most valuable asset: the people who go out and enjoy it. Night Lives: Reducing Drug-Related Harm in the Night Time Economy, a joint report by the All-Party Parliamentary Group for Drug Policy Reform, Durham University, The Loop and Volteface, advocates for the adoption of a set of bold yet practical initiatives across our towns and cities to address this failure. Aimed at stakeholders including the night time industry, local authorities, police forces and public health, Night Lives offers new ideas for reducing drug-related harm in the UK’s night time economy (NTE). (März 2018)

http://volteface.me/publications/night-lives/?preview_id=12608

From Long-Term Injecting to Long-Term Non-Injecting Heroin and Cocaine Use: The Persistence of Changed Drug Habits.

Jarlais DC, Arasteh K, Feelemyer J, McKnight C, Barnes DM, Tross S, Perlman DC, Campbell AN, Cooper HL, Hagan H.

J Subst Abuse Treat. 2016 Dec;71:48-53. doi: 10.1016/j.jsat.2016.08.015.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117630/

Another frontier for harm reduction: contraceptive needs of females who inject drugs in Estonia, a cross-sectional study

Anneli Uusküla, Mait Raag, Sigrid Vorobjov and Don Des Jarlais

Harm Reduction Journal 2018, 15:10, doi.org/10.1186/s12954-018-0215-0

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-018-0215-0

Österreich. Drogenabhängige in Wien : Getrieben von der Sucht

Irene Köhler wollte Drogenabhängigen helfen und sie nicht bestrafen. Damit brach sie ein Tabu – am Wiener Karlsplatz und auf den Straßen von New York.

Der Wiener Karlsplatz ist für Irene Köhler ein Ort der Toten. Auch heute noch. In den frühen neunziger Jahren erlebte sie hier das Elend der Drogenszene. Sie sah junge Menschen dahinvegetieren, sie reanimierte Junkies in den Büschen und in den weitläufigen U-Bahn-Passagen. Viele starben unter ihren Händen. Die Bilder begleiten die heute 50-Jährige noch immer, wenn sie hierherkommt. (Zeit online, 22.01.2018)

http://www.zeit.de/2018/04/drogenabhaengige-wien-karlsplatz-irene-koehler/komplettansicht

Richtig filtern!

Eine der wichtigsten Maßnahmen zur Vermeidung schwerer Gesundheitsschäden beim intravenösen Konsum ist die Wahl des richtigen Filters. Das Filtern hat den Zweck, die für den Druck vorbereitete Lösung von losen Teilchen und Schmutz zu befreien. (DAH – Deutsche AIDS-Hilfe, 2018)

https://www.aidshilfe.de/shop/pdf/9392

USA. New York City Program Takes Controversial Approach to Opioid Crisis (Audio)

There's no single solution to the opioid crisis, but a New York City program is taking a controversial approach to fighting the epidemic.

It's called "harm reduction,” and it's not new. The non-punitive approach aims to reduce the harmful consequences of drug use. For some programs around the country that means giving access to sterile needles, and, in the case of The Washington Heights Corner Project, a bathroom where users can inject drugs knowing that if they overdose, someone will come to their aid. (WNYC – The Takeaway, 15.01.2018, Audio, 07:26)

https://www.wnyc.org/story/harm-reduction-how-one-new-york-city-program-tackles-opioids/

Schweiz. Ja, aber – für eine Drogenabgabe durch das Medizinsystem

Andre Seidenberg

Von politischer Seite und in den Medien wird vermehrt die Drogenabgabe durch das Medizinsystem gefordert. Dieses Vorgehen ist grundsätzlich richtig, doch stellen sich praktische Probleme. Eines davon ist die Verabreichungsform der Drogen. (Gastkommentar in NZZ, 21.02.2018)

https://www.nzz.ch/meinung/ja-aber-fuer-eine-drogenabgabe-durch-das-medizinsystem-ld.1346139

Potential deaths averted in USA by replacing cigarettes with e-cigarettes

Levy DT, Borland R, Lindblom EN, et al

Tobacco Control 2018;27:18-25.

http://tobaccocontrol.bmj.com/content/27/1/18

Russland. Andrey Rylkov Foundation: Provision of harm reduction services in Moscow in 2017

Since 2009, we provide harm reduction services to people who use drugs in Moscow. The political and financial climate as well as the epidemiologic situation are not very supportive for our work - Russia still has one of the fastest growing HIV epidemics in the world with more than 1 million cases being registered and more then 50 000 HIV positive people living in Moscow. Officially registered number of people who use drugs living in Moscow is over 30 000 people. Unsafe injection of drugs is still the major cause of HIV transmission in Russia (more than 60% of all new cases), HIV epidemic is escalating in the country and its capital, but the government still denies the effectiveness of harm reduction measures and provides zero support to NGOs working on HIV prevention among key affected populations. Russian drug policy is still known as one of the most conservative and repressive among those around the world - it continues to declare a zero tolerance towards drug use inflaming the stigma and discrimination towards people who use drugs because of their drug dependence and primarily they are considered not as patients who need proper treatment and support but as criminals. It restricts the access for drug users to vitally important for them information on health issues and to the health services needed such as needle exchange programs and opioid substitution treatment. (Andrey Rylkov Foundation, Russland, 01.03.2018)

http://idpc.net/publications/2018/03/provision-of-harm-reduction-services-moscow

Housing and overdose: an opportunity for the scale-up of overdose prevention interventions?

Geoff Bardwell, Alexandra B. Collins, Ryan McNeil and Jade Boyd

Harm Reduction Journal 2017, 14:77, doi.org/10.1186/s12954-017-0203-9

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-017-0203-9

Cannabis und Schadensminderung in Deutschland - Cannabis and Harm Reduction in Germany

Jakob Manthey, Heino Stöver, Hans-Günter Meyer-Thompson

CC BY-NC-ND 4.0 · Suchttherapie, DOI: 10.1055/s-0043-112067

https://www.thieme-connect.de/products/ejournals/html/10.1055/s-0043-112067

Kanada/British Columbia. Drug-vending machine pitched to cut overdose deaths

A vending machine that distributes hydromorphone pills to people with opioid addictions — who will likely crush and inject them — is one idea being explored in a pilot project to curb overdose deaths.

“Right now, we’re asking people to go to an alley to buy drugs that are likely poisoned [with fentanyl],” said project leader Dr. Mark Tyndall from B.C.’s Centre for Disease Control, at the South Island Community Overdose Response Network symposium at Victoria City Hall this past week.

“What I’m proposing is not nearly as crazy. We need to blanket the province with an opportunity to get safer drugs.” (Times Colonist, 19.12.2017)

http://www.timescolonist.com/news/local/drug-vending-machine-pitched-to-cut-overdose-deaths-1.23124761#undefined.uxfs

Costa Rica: Zendo Project at Envision Festival: Psychedelic Peer Support (Video)

At Envision Festival in Costa Rica, the Zendo Project provides psychedelic peer counseling to help attendees transform difficult experiences into opportunities for growth. (ZENDO, 21.02.2018)

https://www.youtube.com/watch?v=F8f8KWRGpJ0&feature=youtu.be

SMOKE IT! Folie rauchen - eine Alternative zum Drücken (Video)

Mit diesem Video geht die Deutsche AIDS-Hilfe auf den inhalativen Konsum von Heroin ein. Der Film legt den Fokus auf die geringeren Risiken des inhalativen Konsums im Hinblick auf HIV- und Hepatitis-Infektionen sowie Überdosierungen. Er zeigt die Herstellung eigener Rauch-Röhrchen sowie den Ablauf des Konsumvorgangs. Hinweis: Dieses Schulungsvideo richtet sich an Mitarbeiter_innen in Aids- und Drogenhilfen sowie an Drogenkonsument_innen mit dem Ziel, die Risiken des Drogenkonsums zu reduzieren und das Überleben von Drogenkonsument_innen zu sichern. Der Videofilm ist Teil einer Medienserie zur Prävention von HIV- und Hepatitis-Infektionen durch einen Wechsel der Konsumform. (DAH – Deutsche AIDS-Hilfe, 19.10.2017, Video, 08:39)
https://www.youtube.com/watch?v=kvBymcfOoTs&t=8s

Kanada. Radical harm reduction: coming out from under the radar (managed alcohol programs)

The practice of providing alcohol to people with severe alcohol dependence is a complex and sometimes controversial approach to harm-reduction, and it’s one that many communities in Canada have tried—some very publically and some quietly under the radar. These programs which give alcohol in measured, regular doses throughout the day, usually along with housing and other supports, are known as Managed Alcohol Programs, or MAPs. (University of Victoria, 19.02.2018)

https://www.uvic.ca/news/topics/2018+cisur-managed-alcohol-programs+media-release

Comparing the cancer potencies of emissions from vapourised nicotine products including e-cigarettes with those of tobacco smoke

William E Stephens

Tobacco Control, Volume 27, Issue 1

http://tobaccocontrol.bmj.com/content/27/1/10

UK. Police and public health: collaboration

These documents highlight case studies of initiatives between police and health colleagues and identify barriers and enablers to collaboration. (Public Health England, 07.02.2018)

https://www.gov.uk/government/publications/police-and-public-health-collaboration-across-england

UK. Englischer NHS testet Ausnüchterungszentren

London – Der englische Gesundheitsdienst National Health Service (NHS) testet zum Jahreswechsel in Ausgehvierteln mobile Ausnüchterungszentren. In den sogenannten „drunk tanks“ (etwa: Auffangbecken für Betrunkene) können Partygänger medizinisch versorgt werden und sich sogar ausnüchtern. (aerzteblatt.de, 29.12.2017)

https://www.aerzteblatt.de/nachrichten/87285/Englischer-NHS-testet-Ausnuechterungszentren

Back to the core: A network approach to bolster harm reduction among persons who inject drugs

Bouchard, Martin et al.

International Journal of Drug Policy , Volume 51 , 95 - 104

http://www.ijdp.org/article/S0955-3959(17)30326-2/fulltext

UK. 'We're trying to give up cigarettes', says Philip Morris ad

Global tobacco giant Philip Morris International (PMI) has run a print ad claiming that it wishes "to stop selling cigarettes" in the UK.

(...) The ad is careful to stress that the best thing the UK’s 7.6 million smokers can do is to quit, but for those who will continue to smoke, PMI’s ambition is to get them to switch away from cigarettes to e-cigarettes and heated tobacco. (campaignlive.co.uk, 02.01.2018)
https://www.campaignlive.co.uk/article/were-trying-give-cigarettes-says-philip-morris-ad/1453528

Harm reduction program use, psychopathology and medical severity in patients with methadone maintenance treatment.

Martínez-Luna NG, Rodríguez-Cintas L, Esojo A, Palma-Álvarez RF, Robles-Martínez M, Grau-López L, Perea M, Roncero C.

Adicciones. 2018 Jan 15;0(0):897. doi: 10.20882/adicciones.897.

http://www.adicciones.es/index.php/adicciones/article/download/897/904