harm reduction

Naloxone As Overdose Prevention

"The heart of the challenge is the possibility that things could be different: overdose is a public health problem that can be solved. Unlike many of the other leading causes of death, death from opioid overdose is almost entirely preventable,21 and preventable at a low cost.22 Opioids kill by depressing respiration, a slow mode of death that leaves plenty of time for effective medical intervention.23 Overdose is rapidly reversed by the administration of a safe and inexpensive drug called naloxone.

Drug Consumption Rooms in Operation Around the World

"Breaking this down further, as of February 2017 there are: 31 facilities in 25 cities in the Netherlands; 24 in 15 cities in Germany; five in four cities in Denmark 13 in seven cities in Spain; two in two cities in Norway; two in two cities in France; and one in Luxembourg (Luxembourg is preparing to open a second facility in 2018); and 12 in eight cities in Switzerland. In Slovenia following a change in the penal code that created an enabling environment for the opening of supervised consumption facilities, a planned pilot project is pending.

Cost Effectiveness of Harm Reduction

"Prevention of HIV is also cheaper than treatment of HIV/AIDS. For example, in Asia it is estimated that the comprehensive package of HIV-related harm reduction interventions costs $39 per disability-adjusted life-year saved,14 whereas antiretroviral treatment costs approximately $2,000 per life-year saved. Such figures demonstrate that harm reduction is a low-cost, high-impact intervention."

Supervised Injection Facilities (SIFs), Sanitary Consumption Facilities (SCFs), and Drug Consumption Rooms (DCRs)

"Drug consumption rooms are professionally supervised healthcare facilities where drug users can consume drugs in safer conditions. They seek to attract hard-to-reach populations of users, especially marginalised groups and those who use on the streets or in other risky and unhygienic conditions. One of their primary goals is to reduce morbidity and mortality by providing a safe environment for more hygienic use and by training clients in safer use.

Historic Development of Naloxone Programs

"Naloxone distribution programs in the US are ongoing in Chicago, Baltimore, San Francisco, New Mexico and New York City. Additional community-based organizations interested in minimizing the adverse consequences of drug use in several cities in the US, including Los Angeles, Providence, Pittsburgh and Boston, are in the process of planning and developing naloxone administration programs for drug users."

Effectiveness and Benefits of Supervised Consumption Facilities

"Generally speaking, it is reasonable to conclude, on the basis of the available knowledge, that to a large extent DCFs [Drug Consumption Facilities] achieve the objectives set for them, and that the criticisms made of them are rarely justified. In fact, DCFs help to:
"• reduce risk behaviour likely to lead to the transmission of infectious diseases, particularly HIV/AIDS, among the population of the worst affected drug users;
"• reduce the incidence of fatal overdoses and, therefore, the mortality rate in this population;

Feasibility of Naloxone Distribution to People Who Use Injection Drugs

"This pilot trial is the first in North America to prospectively evaluate a program of naloxone distribution to IDUs [Injection Drug Users] to prevent heroin overdose death. After an 8-hour training, our study participants' knowledge of heroin overdose prevention and management increased, and they reported successful resuscitations during 20 heroin overdose events. All victims were reported to have been unresponsive, cyanotic, or not breathing, but all survived. These findings suggest that IDUs can be trained to respond to heroin overdose by using CPR and naloxone, as others have reported.

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