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Harm Reduction

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Jessica Bridgeman

on 16 May 2016

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Transcript of Harm Reduction

Philosophy & Practice
Harm Reduction
Aspects of Harm
Reduction
Services
Outreach
Education
Needle Exchange
Substitution Therapies
Supervised Consumption Facilities (InSite, Vancouver)
Peer Support Programs
Overdose Prevention
What are we
dealing with?
IVDU

Harm Reduction is policies, programs and practices that aim to reduce the negative health, social and economic consequences that may arise from the use of legal and illegal psychoactive drugs, without necessarily reducing drug use
WHAT ?
www.canadianharmreduction.com
STBBI Prevention & Education
Decriminalization
Connection to services
Public health
WHAT DOES IT DO?
BBI's
Infections
Sepsis
Endocarditis
Abscesses
Vein damage
Overdose
Death
BBI's
Burns
Infections
Tuberculosis
Pneumonia
Cirrhosis
Korsakoff's
Malnutrition
Heart Disease
Relationship
H
A
R
M
R
E
D
U
C
T
I
O
N
ealthy habits for users
bundant care for all
espect in the community
indful of safe drug use
educe the spread of disease
ducate others
iscourage sharing needles
tilize safe habits
oncern for all
raditional health care
nformation on treatment
utreach support
on-judgmental
Harm Reduction is rooted in the social and historical context of substance use;
harms are the consequences of the unregulated manufacture and trade of drugs and the enduring commitment to failed policies and ill-thought-out and inequitably applied laws, rather than the drugs themselves.
Harm Reduction ensures that people who use psychoactive substances are treated with respect, without stigma, and that substance-related problems and issues are addressed systemically.
Reduce Blood Borne Infections
Reduce overdose deaths and other early deaths among people who use substances
Reduce use and paraphernalia in public areas
Reduce the sharing of needles and other substance use equipment
Educate about safer injecting and reduce injecting frequency
Educate about safer sex and sexual health and increase condom use
Reduce crime and increase employment among people who use substances
Increase referrals to treatment programs and health and social services

How do we do this?
ETOH
INHALATION
No Expectation to Cure
We are here "to soften the impact of the legal &
social torments our culture uses to punish the drug addict"
Gabor Mate, Chapter 1. In the Realm of Hungry Ghosts
Education & Prevention
Blood Borne Infections
HIV
Hepatitis C
Hepatitis B
Contraction
HIV
Hep C
Hep B
Semen, vaginal fluid, breast milk, blood, cerebrospinal fluid
Blood
Blood, semen, vaginal secretions
STI's
Supplies
How do we educate?
info cards
programs
conversation
posters
Harm Reduction in Nursing
5 Things you need for transmission
A source of infection
Means of transmission
A host
An appropriate route of entry
Sufficient level of virus present
www.cdnaids.ca
"I don't want you to save me, I want you to stand by my
side while I save
myself."
Our issues are their barriers
Self examination is a must
"Titles mean nothing for these clients. They are searching for human beings, human connections."
Gabor Mate, In the Realm of Hungry Ghosts
Scenario
Pain management of an opioid addict
Did we consider the emotional pain?
Does that pain count?
Summary
It's all about communication
What can I say in less than one minute that makes them...
think
want to talk to me again
change a behaviour
Locally
Cammy LaFleur Street Nurse Outreach
Howard House Alcohol & Drug Treatment Program
Downtown Primary Care Center
Outreach Alcohol & Drug (Vernon Health Unit) and The A-Team
Who are we working with?
Street Entrenched
People who use drugs
People with mental illness
People in Sex Trade
Aboriginal / Indigenous
At Risk Youth
Homeless
LGBTQ2+ & MSM
Bio
Psycho
Social
Spiritual
Trauma
Abuse
Providing culturally competent care

Spirituality is often tied to recovery (eg. AA)

Instilling and supporting a sense of purpose
ealthy habits for users
Stigma & HIV
educe the spread of disease
HCV
73,500+ individuals in BC with HCV
est. 41,000 known chronic carriers
25% unknown (est.)
10% are via blood products
Risk of a needle stick injury - 2%
90% recent infections d/t IDU
IVDU is predominant risk factor with 1/2 of new IVDU's infected within 3 years!
HIV
2011 ~ reached lowest ever number of new cases 289
Aboriginals are disproportionately represented, especially females.
of all new female positives in 2010 33.3% were aboriginal.
Gay/Bisexual/MSM community remains the most affected population in BC
HIV amongst IVDU's is down.
2011 PHAC estimated 11, 700 people were living with HIV in BC
HBV
2011
25.2 new chronic cases in BC
15 acute cases
High rates of chronic HBV are mostly due to importation from endemic countries.
"sexual promiscuity" and IVDU are the two most common forms of contraction in Canada
Canadian Journal of Infections Disease
BCCDC
BCCDC
Boundaries
& Self Care
Standards of Practice
Therapeutic interpersonal relationships

Application & integration of theory-based knowledge

Professional responsibility

Professional Ethics
Micro & Macro
"Treat every action as an invitation and an opportunity to foster a relationship of dignity and respect"
Doing Dignity
AIDS Vancouver Island
Capturing the risk of the work
"Many harm reductionists have made a conscious decision to put some of the most difficult feelings and emotions, those of oppression, marginalization, and political disenfranchisement in our personal backpack, and these are heavy loads to carry." (Rafael Torruella, as quoted in Shepard, 2013)
Shepard, B.C. (2013) Between harm reduction, loss and wellness: on the occupational hazards of work. Harm Reduction Journal, 10(1), 1-17.
Pragmatic approach
Focused on human rights
Meeting immediate needs with a variety of interventions
Focus on peer involvement
Full transcript