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12 - Harm-Reduction, Legal Issues, Drug Court and Other Alternatives to Discipline

from Part III - The Treatment Plan

Published online by Cambridge University Press:  07 October 2023

Ethan O. Bryson  and
Christine E. Boxhorn
Ethan O. Bryson
Affiliation:
Icahn School of Medicine at Mount Sinai, New York
Christine E. Boxhorn
Affiliation:
Medical College of Wisconsin, Milwaukee
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Summary

Harm reduction refers to a set of strategies aimed to limit the negative consequences associated with drug use, but without requiring complete abstinence. Some harm-reduction strategies aim to reduce the risk of overdose, such as the use of naloxone rescue kits, fentanyl testing strips, and implementation of Good Samaritan laws. Other strategies lower the risk of overdose but also the likelihood of contracting infectious diseases such as HIV and hepatitis. Syringe services programs, also referred to as needle exchange programs, and supervised consumption facilities all fall under this category. Medications for opioid use disorder (MOUD), which include methadone, buprenorphine, and naltrexone, have been proven to lower the risk of overdose, improve the likelihood of maintaining sobriety, and therefore lower rates of disease transmission. Finally, harm reduction is utilized in criminal justice system through the use of drug decriminalization, police diversion programs, and drug treatment courts.

Keywords

harm reductionnaloxonegood samaritanfentanyl testing stripssyringe services programsneedle exchange programsneedle and syringe programshepatitisHIVsupervised injection sitessupervised consumption facilitiesmedications for opioid use disordermedication-assisted treatmentMOUDmethadonebuprenorphinenaltrexoneheroinpregnancyneonatal abstinence syndromeNASdecriminalizationjailprisonpolicedrug courts
Type
Chapter
Information
The Opioid Epidemic
Origins, Current State and Potential Solutions
 , pp. 144 - 162
Publisher: Cambridge University Press
Print publication year: 2023

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References

References and Further Reading

Bernard, CL, Rao, IJ, Robison, KK, Brandeau, ML, (2020). Health outcomes and cost-effectiveness of diversion programs for low-level drug offenders: a model-based analysis. PLoS Medicine 17(10): e1003239.Google Scholar
Bond, AJ, Witton, J (2017). Perspectives on the pharmacologic treatment of heroin addiction. Clinical Medicine Insights: Psychiatry 8: 1–10.Google Scholar
Canadian Centre on Substance Use and Addiction (2021). Evidence-based decriminalization (policy brief). www.ccsa.ca/evidence-based-decriminalization-policy-brief.Google Scholar
Centers for Disease Control and Prevention (2019). Summary of information on the safety and effectiveness of syringe services programs (SSPs). www.cdc.gov/ssp/syringe-services-programs-summary.html.Google Scholar
Cropsey, KL, Schiavon, SP (2019). Criminal justice system and addiction treatment. In Johnson, B (ed.) Addiction Medicine: Science and Practice, 2nd ed. Elsevier, pp. 628–637.Google Scholar
Dole, VP, Nyswander, M (1965). A medical treatment for diacetylmorphine (heroin) addiction. JAMA 193(8): 80–84.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (2020) Take home naloxone, factsheet. www.emcdda.europa.eu/publications/topic-overviews/take-home-naloxone_en.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (n.d.). Drug court programmes to reduce recidivism. www.emcdda.europa.eu/best-practice/evidence-summaries/drug-court-programmes-reduce-recidivism_en.Google Scholar
Goldman, JE, Waye, KM, Periera, KA, et al. (2019). Perspectives on rapid fentanyl testing strips as a harm reduction practice among young adults who use drugs: a qualitative study. Harm Reduction Journal 16: 3.Google Scholar
Gugala, E, Briggs, O, Moczygemba, LR, Brown, CM, Hill, LG (2022). Opioid harm reduction: A scoping review of physician and system-level gaps in knowledge, education, and practice. Substance Abuse 43(1): 972–987.CrossRefGoogle ScholarPubMed
Harm Reduction International (2018). Regional overview of the Middle East and North Africa. www.hri.global/files/2018/12/10/MiddleEastNorthAfrica-harm-reduction.pdf.Google Scholar
Indiana State Department of Health (n.d.). Naloxone myths debunked. www.in.gov/health/overdose-prevention/files/47_naloxone-myths-debunked.pdf.Google Scholar
Jaffe, JH (2007). Can LAAM, like Lazarus, come back from the dead? Addiction 102: 1342–1343.Google Scholar
Jesseman, R, Payer, D (2018). Decriminalization: Options and evidence. Canadian Centre on Substance Use and Addiction Policy Brief. 6/2018. www.ccsa.ca/sites/default/files/2019-04/CCSA-Decriminalization-Controlled-Substances-Policy-Brief-2018-en.pdf.Google Scholar
Klaman, SL, Isaacs, K, Leopold, A, et al. (2019). Treatment women who are pregnant and parenting for opioid use disorder and the concurrent care of infants and children: Literature review to support national guidance. Journal of Addiction Medicine 11(3): 178–190.Google Scholar
Kounang, N (2021). This strip of paper can help prevent a drug overdose. CNN Health, December 1. http://edition.cnn.com/2021/12/01/health/fentanyl-test-strip/index.html.Google Scholar
Levengood, TW, Yoon, GH, Davoust, MJ, et al. (2021). Supervised injection facilities as harm reduction: A systematic review. American Journal of Preventive Medicine 61(5): 738–749.CrossRefGoogle ScholarPubMed
Lofwall, MR, Walsh, SL (2014). A review of buprenorphine diversion and misuse: The current evidence base and experiences from around the world. Journal of Addiction Medicine 8(5): 315–326.Google Scholar
Macpherson, D (2001). Framework for action: A four-pillar approach to drug problems in Vancouver. www.researchgate.net/publication/242480594_A_Four-Pillar_Approach_to_Drug_Problems_in_Vancouver.Google Scholar
Mielau, J, Vogel, M, Gutwinski, S, Mick, I (2021). New approaches in drug dependence: Opioids. Current Addiction Reports 8(2): 298–305.CrossRefGoogle ScholarPubMed
Miller, A (2022). As overdoses soar, more states decriminalize fentanyl testing strips. https://khn.org/news/article/states-decriminalize-fentanyl-testing-strips/.Google Scholar
Moaleff, S, Choi, J, Milloy, MJ, et al. (2021). A drug-related Good Samaritan law and calling emergency services for drug overdoses in a Canadian setting. Harm Reduction Journal 18: 91.CrossRefGoogle Scholar
Moosavyzadeh, A, Mokri, A, Ghaffari, F, et al. (2020). Hab-o Shefa, a Persian medicine compound for maintenance treatment of opioid dependence: Randomized placebo-controlled clinical trial. Journal of Alternative and Complementary Medicine 26(5): 376–383.CrossRefGoogle Scholar
National Institute on Drug Abuse (2017). Naloxone for opioid overdose: Life-saving science. https://nida.nih.gov/publications/naloxone-opioid-overdose-life-saving-science.Google Scholar
Noroozi, A, Kebriaeezadeh, A, Mirrahimi, B, et al. (2021). Opium tincture-assisted treatment for opioid use disorder: A systematic review. Journal of Substance Abuse 129: 108519.CrossRefGoogle ScholarPubMed
Rosenstein, RJ (2018). Fight drug abuse, don’t subsidize it. New York Times, August 27. www.nytimes.com/2018/08/27/opinion/opioids-heroin-injection-sites.html.Google Scholar
Rossman, SB, Rempel, M, Zweig, JM, Rempel, M , Lindquist, CH (2011). The Multi-Site Adult Drug Court Evaluation: The Impact of Drug Courts, volume 4. Washington, DC: National Institute of Justice.Google Scholar
Sander, G, Shirley-Beavan, S. Stone, K (2019). The global state of harm reduction in prisons. Journal of Correctional Health Care 25(2): 105–120.Google Scholar
Scott, CK, Dennis, ML, Grella, CE, Mischel, AF, Carnevale, J (2021). The impact of the opioid crisis on U.S. state prison systems. Health and Justice 9: 17.CrossRefGoogle ScholarPubMed
Shulman, M, Wai, JM, Nunes, EV (2019). Buprenorphine treatment for opioid use disorder: An overview. CNS Drugs 33(6): 567–580.Google Scholar
Sofuoglu, M, DeVito, EE, Carroll, KM (2019). Pharmacologic and behavioral treatment of opioid use disorder. Psychiatric Research and Clinical Practice 1(1): 4–15.Google Scholar
Substance Abuse and Mental Health Services Administration (2021). Medications for Opioid Use Disorder. Treatment Improvement Protocol (TIP) Series 63 Publication No. PEP21-02–01–002. Rockville, MD: Substance Abuse and Mental Health Services Administration.Google Scholar
Surratt, HL, Otachi, JK, Williams, T, et al. (2020). Motivation to change and treatment participation among syringe service program utilizers in rural Kentucky. Journal of Rural Health 36(2): 224–233. doi:10.1111/jrh.12388.Google Scholar
United Nations Office on Drugs and Crime (2006). Drug treatment courts work! www.unodc.org/pdf/drug_treatment_courts_flyer.pdf.Google Scholar

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