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Domain II: Prevention Education and Service Delivery
Published in Nicole M. Augustine, Prevention Specialist Exam Study Guide, 2023
NOTE: Since the development of the continuum of care, there has been an evolution in our field to now include harm reduction. Harm reduction is defined as a set of practical strategies and ideas aimed at reducing negative consequences related to drug use. In theory, harm reduction approaches are not ‘against' abstinence or treatment but rather acknowledge that abstinence may not be achievable or even desired by everyone. Harm reduction focuses on providing folx with the resources (which in clude eudcational resources) necessary for them to make informed decisions on reducing their harms. In the near future, we will see the formal addition of harm reduction into the Continuum of Care.
Set Recovery Goals
Published in Sandra Rasmussen, Developing Competencies for Recovery, 2023
Teens, college students, and other young adults, especially those who meet diagnostic criteria for mild to moderate addiction, are good candidates for harm reduction. Harm reduction is realistic for people who are highly resistant to abstinence: e.g., chronic intravenous drug users, and people who relapse repeatedly. Classic examples of harm reduction include the designated driver program, methadone maintenance programs, needle exchange services, safe legal injection sites, drinking and driving laws, responsible gambling policies, free condoms and, more recently, medication-assisted treatment (MAT).
Substance Use Risk Reduction
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Feasibility and outcomes of harm reduction techniques in alcohol use are mixed and may depend on the degree of consumption. Data analyses from Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) found that the likelihood of maintaining moderate drinking was lower in severely dependent patients (Witkiewitz, 2008). Nonetheless, a recent secondary analysis of the COMBINE study data (N = 1,383) examined heavy drinking patterns up to 16 months and found that two-thirds had a 64% reduction in drinking frequency and a 38% reduction in drinking intensity from pretreatment drinking levels (Witkiewitz et al., 2017).
Evaluation of a brief harm reduction intervention to reduce celebratory drinking among college students
Published in Journal of American College Health, 2023
Christine Arazan, Michael T. Costelloe, Mark T. Willingham
University-based interventions often differ in the administration and program type; however, there is a universally agreed upon notion that prevention efforts are needed if the long- term consequences of risky drinking behaviors in the university setting are to be reduced. Some colleges are introducing programming that aims to reduce the harm related to drinking by focusing on the dissemination of pro-social and educational messages regarding the potential harms and negative consequences associated with risky drinking behaviors to students. This type of intervention frequently utilizes drinking tips, social normative education, a Be Responsible About Drinking (BRAD) approach, or other educational information to minimize risky drinking in college students.10 These strategies aim to reduce heavy drinking, minimize the negative consequences associated with irresponsible drinking, and reduce accidents and deaths from risky drinking behaviors while encouraging students to celebrate responsibly.10 One promising line of inquiry and intervention includes the implementation of harm reduction (also referred to as risk reduction) programs that focus on minimizing the harm at the individual and societal level. These approaches accept that students are likely to drink and therefore a ‘just say no’ abstinence program is largely ineffective for this population.2,11 Furthermore, there is supporting research indicating that targeting a celebratory event with such programs can be successful in changing drinking behaviors for university students.2,10
How the war on drugs impacts social determinants of health beyond the criminal legal system
Published in Annals of Medicine, 2022
Aliza Cohen, Sheila P. Vakharia, Julie Netherland, Kassandra Frederique
At the mezzo- and institutional levels, healthcare providers can advocate to shift hospital and programmatic policies around drug testing, mandatory reporting, and collaborations with law enforcement. As outlined in this paper, drug testing is not an effective monitoring strategy for care and support, but rather, it is more often a punitive tool of surveillance. If drug testing cannot be eliminated, at the very least, patients should have the right to understand the implications of drug testing and provide explicit consent for the test. To the extent possible, providers should not share private patient information with police or state agencies. Healthcare professionals should understand the implications of reporting positive drug tests and suspicion of use and should work to change these policies where possible and inform their patients of them. Providers can ensure that their patients who use drugs have access to evidence-based, non-coercive harm reduction and treatment options in addition to robust and supportive primary healthcare. Healthcare professionals involved with medical education and licensure can work to ensure that all students graduate with a deep understanding of SDOH and the impact of the drug war on individual and community health.
Opioid harm reduction: A scoping review of physician and system-level gaps in knowledge, education, and practice
Published in Substance Abuse, 2022
Emma Gugala, Owanate Briggs, Leticia R. Moczygemba, Carolyn M. Brown, Lucas G. Hill
Data extraction was completed manually by two reviewers and accuracy and completeness was addressed during consensus meetings with four authors. Information collected from the studies included study objective, harm reduction strategy, participants, location, study design, assessment or intervention, outcomes measured, key findings, and gap(s) identified. Harm reduction strategies included overdose treatment and prevention, OUD treatment, and syringe and needle exchange. Overdose treatment and prevention strategies commonly involved the use or distribution of naloxone. OUD treatment referred to the use of MOUD for harm reduction (i.e., buprenorphine or methadone). Gaps explicitly noted by authors were listed, however, the reviewers identified additional gaps as appropriate based on study findings. In cases whereby the study authors did not explicitly specify gaps, the reviewers determined and documented gaps based on the results reported.