PUBH 3003 1st Edition Lecture 24Outline of Last Lecture I. Global Drug wara. Drug traffickingb. Impact on societyII. Mexicoa. Key strategiesIII. U.S Prison systemsa. Need for interventionb. Mental Healthc. Mental Health treatmentsIV. Global commission on Drug Policya. Legalize drugs as a solution?Outline of Current Lecture:I. Harm Reductiona. Principles II. Syringe Exchange III. Injection Drug use outreacha. NAXLONE distribution Current Lecture:Harm Reduction: - A range of public health interventions (Programs, policies, etc.) designed to reduce the harmful consequences associated with various human behaviors, both legal and illegal- Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use - Its also a social justice movement built on belief in, and respect for, the rights of people who use drugs- Harm Reduction Principles:o Accepts, for better and or worse, that licit and illicit drug use is a part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them o Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than othersThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.o Establishes quality of individual and community life and well-being not necessarily cessation of all drug use- as the criteria for successful interventions and policies o Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harmo Ensures that drug users and those with a history of drug use routinely have real voice in the creation of programs and policies designed to serve themo Affirms drug users themselves as the primary agents od reducing the harms of their druguse, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of useo Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both peoples vulnerability to and capacity for effectively dealing with drug related harmo Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.Syringe Exchange at MAP- Syringe exchange and disposal - Condoms and safer sex and injection supplies to reduce risk- HIV & Hep C risk reduction- testing and connection to case management/medical services- Referrals for support groups, substance use disorder treatment, and basic needs- A safe space, judgment/ stigma free zone Why Exchange?- Provides education in non-coercive environment- Provides referrals to treatment with a client centered approach- Provides a location for the community to safely dispose of used syringes - Decreases HIV & HEP C transmission- SEP is the most empirically supported strategy for HIV prevention- SEP provides an entry point for clients to access basic needs services - 7% of new diagnoses of HIV in 2012 in the US were attributed to injection drug use- An additional 3% were attributed to male to male sexual contact and injection use Injection Drug Use Outreach- Injection drug use (IDU) accounts for a significant number of HIV infections - In MN: IDU associated risk factor 16% of all people known to be living with HIV- Sharing of syringes and drug injection equipment makes it easy for HIV and Hep C to be passed from one person to another Opiod Replacement Therapy (ORT)/ Opioid Substitution Therapy (OST)- Medical procedure replacing an illegal opioid (such as heroin) with a longer acting but less euphoric opioid, such as methadone- Drug is taken under medical supervision- Medication assisted treatment (MAT)- the use of medications, in combination with counseling and behavioral therapies, to provide a whole patient approach to the treatment of substance usedisorders. Research shows that when treating substance use disorders, a combination of medication and behavioral therapies is most successful. Medication assisted treatment is clinically driven with a focus on individualized patient care Naloxene (Narcan) distribution- Narcan used to counter an overdose from effects of opioids – it reverses the respiratory depression caused by an overdose- Within 2-8 minutes - The world health organization includes naloxone on their list of essential