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YOUTH AGAINST DRUGS NORWAY International Conference 2005

YOUTH AGAINST DRUGS NORWAY International Conference 2005. Winners of the PRIDE International Award, 2003. www.drugprevent.org.uk. Harm Reduction - Where’s the Harm in it?. Peter Stoker Director, NDPA. Harm Reduction. How did it begin?. Harm Reduction. How does it work ?.

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YOUTH AGAINST DRUGS NORWAY International Conference 2005

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  1. YOUTH AGAINST DRUGSNORWAYInternational Conference 2005

  2. Winners of the PRIDE International Award, 2003. www.drugprevent.org.uk

  3. Harm Reduction - Where’s the Harm in it? Peter Stoker Director, NDPA

  4. Harm Reduction How did it begin?

  5. Harm Reduction How does it work ?

  6. Harm Reduction Is Harm Reduction any better than Primary Prevention?

  7. Harm Reduction Is there any contradiction between Harm Reduction and Primary Prevention?

  8. The DRUG PROBLEM … How BIG is it ?

  9. Europe

  10. Europe’s Legalisers Have Their Eyes On You

  11. Harm Reduction How did it begin?

  12. ‘REAL’ HARM REDUCTION • Used for decades • With known users only • ‘1 to 1’ interface • Part of treatment Aim: Abstinence from use

  13. Normalise Depenalise Glamorise Trivialise Decriminalise Legalise Sympathise The Beast with 7 Eyes

  14. ‘REAL’ HARM REDUCTION • Used for decades • With known users only • ‘1 to 1’ interface • Part of treatment Aim: Abstinence from use

  15. ‘So-Called’ HARM REDUCTION • invented in 1980s • promote to everyone • users or non-users • not linked to treatment Aim: Maintenance of use

  16. The Trojan Horse

  17. Societal Factors • Conspicuous Consumption • Rapid Gratification • ‘Values Clarification’ : • ‘Self’ before ‘Society’ • ‘Rights’ but no Responsibilities • The ‘Right’ to be Happy • Youth are ‘Supreme’ • Political Correctness

  18. ALARM REDUCTION HARM REDUCTION LEGALISATION LAW DESTRUCTION NORM PROMOTION

  19. Germany UK Canada USA Hungary Nederlands Switzl’d Australia

  20. Arnold Trebach

  21. George $oro$

  22. Who said this? …. • “ By making readily available drugs of various kinds … • by giving a teenager alcohol • by praising his wildness … • by strangling him with sex literature … • … there must be continued propaganda to undermine the loyalty of citizens in general and teenagers in particular.”

  23. Josef Stalin

  24. United Kingdom Liverpool Manchester London

  25. O’Hare Zinberg Schmoke Parry

  26. ‘…Liverpool cabal … hijacked Harm Reduction … advocate change … break with … existing policies … unworkable dogmas … abstinence’ ‘…radical kernel … political power.’ Peter McDermott

  27. WHAT DO THEY MEAN BY ‘HARM?’ • Harm to user • Physical harm • Harm because illegal (police) • Harm from disapproval (stress) • Need to commit crime

  28. WHAT HARMS DO THEY IGNORE? • Harm to the users themselves • Harm to other people, and • Harm to all, in pre-addiction stages

  29. IT AFFECTS ALL OF US , DIRECTLY/ INDIRECTLY • Workplace • Justice Systems • Police • Therapists +++ • Family • Health services • Schools • Religion • Physical • Mental • Intellectual • Social • Emotional • Spiritual • Environmental ONLY THE USER WHO DOES DRUG MISUSE AFFECT? Costs start from just day of use ONLY THE PHYSIQUE ONLY THE ADDICT Regular user greatly Outnumber addicts and Cost society more IT AFFECTS ALL OF US , DIRECTLY/ INDIRECTLY

  30. WHOLE HEALTH Spiritual SOURCES: WHOAncient Greeks Buddhism, Judaism… Christianity… Environmental Physical Mental – Intellectual Social

  31. COST TO SOCIETY FROM DRUG MISUSE COST TO SOCIETY NOVICE REGULAR HABITUAL OCCASIONAL NO USE HEAVY ADDICTED

  32. Harm Reduction How does it work ? (…. and does it ?)

  33. NEEDLE EXCHANGE

  34. NEEDLE EXCHANGE

  35. NEEDLE GIVE-AWAY

  36. CONDOM ISSUE

  37. METHADONE MAINTENANCE

  38. PRESCRIPTION HEROIN

  39. MODERATION

  40. SHORT BREAKS

  41. SUBSTANCE TESTING

  42. Bridgeport, Connecticut - 1997Kit to use crack “safely”

  43. Excerpts from “Safe” Crack Kit Brochure • “If you smoke indoors, make sure it is ventilated. Poorly aired rooms can be risky for tuberculosis (TB). Cover your mouth when coughing.” • “If you have problems breathing or are coughing up dark stuff, slow down or stop smoking for a while. See a doctor is [if] it continues!”

  44. Needle Exchange Programs Do Not Reduce HIV and Hepatitis C Montreal Study:Bruneau J. et al: “High Rates of HIV Infection Among Injection Drug Users in Needle Exchange Programs in Montreal: Results of a Cohort Study.”Am. J. Epidemiology 1997; 146:904 – 1002. Seattle Study:Hagan H, et al. “Syringe Exchange and Risk Infection with Hepatitis B and C Viruses.”Am. J. Epidemiology 1999; 14-:203 – 218. Vancouver Injection Drug Study

  45. NEP Review - Shortcomings of Studies • Inadequate outcome measures. Few measure HIV incidence. Most often self reported change of risk behaviour • Often systematic control for covariates is lacking • NEP use vs. non-use often poorly defined. Sometimes “ever used” vs. “never used”

  46. Needle History • 131 NEP programs identified • 107 reported a total of 19,397,527 handed out with 62% returned • i.e. 7,371,060 not returned MMWR CDC May 18, 2001

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