The Issue of Drug Addiction and the Harm Reduction Approach – The European Sting – Critical News & Insights on European Politics, Economy, Foreign Affairs, Business & Technology

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This article was written exclusively for The European Sting by M. IZERE Salomon, second year medical student at the University of Rwanda. It is affiliated with the International Federation of Medical Students’ Associations (IFMSA), a cordial partner of The Sting. The opinions expressed in this article belong strictly to the authors and do not necessarily reflect the views of IFMSA on the subject, nor that of The European Sting.


Harm reduction can be seen as preventing the harmful consequences of illicit drug use without necessarily reducing their consumption.

In other words, harm reduction can be defined as a concept aimed at preventing or reducing the negative health consequences associated with certain behaviors. it encompasses a range of health and social services and practices that apply to illicit and licit drugs. These include, but are not limited to, drug consumption rooms, needle and syringe programs, non-abstinence-based housing and employment initiatives, drug checking, prevention and overdose reversal, psychosocial support and provision of safer drug use information. Such approaches are cost-effective, evidence-based, and have a positive impact on individual and community health.

Many consequences are associated with drug use, including problems related to the psychological or physical health of the user such as cirrhosis, cancer, overdose, addiction, accidents, depression, paranoia, etc. [1], [2]Problems are related to relationships, family, friends, intimate partners and children. Problems related to the user’s professional life (for example, lack of concentration at work or school) and other non-professional activities such as hobbies.[1] It can also include problems related to the use of illegal drugs, the acquisition and/or trafficking of drugs, including driving under the influence of drugs.

With regard to these consequences mentioned above and many others that I have not mentioned, you understand that harm reduction strategies must be implemented because these strategies save lives and decrease the likelihood of health problems. drug use for an individual, their family and the surrounding community.

General harm reduction strategies

Information, education and communication about the health risks associated with drug use will help drug users avoid or modify their drug-using behavior.

Education Strategies. The first step in harm reduction is to provide accurate information about the consequences and risks of drug use and to promote behaviors that reduce risk. Education should include information about the physical and psychosocial risks of drug abuse, overdose risks, infectious diseases, conduct problems, and cardiovascular, metabolic, and psychiatric disorders.[3]

Brief interventions and advice. Brief interventions focus on changing high-risk behaviors. These interventions may include single-session therapy, cognitive behavioral therapy, and/or motivational interviewing.

Interventions to reduce injury and violence. Drugs such as alcohol have been linked to injury, violence and public disorder. Strategies to change the environment can be helpful, such as changing alcohol containers (from bottles to plastic cups), banning high-alcohol beverages, community mobilization, etc. Other interventions may aim to reduce road accidents by promoting public transport, punishment for drunk driving, etc.[1], [4]

Overdose Prevention. Naloxone, a short-acting opioid antagonist, reverses the immediate effects of heroin and prevents overdoses in injection drug users. Other drugs, such as methadone, which have similar properties to heroin and morphine, help reduce overdoses, the risk of HIV and hepatitis infection and crime, others overdose management strategies include peer education in first aid and resuscitation); establish peer collaborations and encourage peers to seek help and call an ambulance when an overdose is suspected.[1]

Prevention and care services for sexually transmitted infections. It is essential to provide information to people who use drugs about the risk of HIV transmission and the main strategies to reduce this transmission. Strategies may include the use of condoms, reducing the number of sexual partners or being faithful to one partner, treatment of sexually transmitted diseases, abstinence, etc.[1], [2]

Health care for infectious diseases associated with drug abusein addition to offering screenings and interventions for specific infections, offers support, information and education.

Needle exchange programs, which aim to ensure that those who continue to use drugs have access to clean injecting equipment and to safely dispose of used equipment. These programs offer a range of equipment including needles, syringes, filters, cookers/spoons, sterile water, swabs and citric acid.[2]

■ Drug substitution treatment involves the medically supervised treatment of people with opioid addiction based on the prescription of opioid agonists such as methadone.

Affirms that drug users themselves are the primary harm reduction agents of their drug use and seeks to empower users to share information and support each other in strategies that respond to their actual conditions of use .[1], [3]

Harm reduction is a practical approach that employs a range of different strategies to minimize the risk of contradicting infectious diseases, overdoses, or other consequences related to substance use. Strategies may include changing the way people use drugs or ensuring that the environment in which they use drugs minimizes the risk of negative consequences for their health or quality of life. Strategies may vary depending on the drug, the type of harm associated with its use, an individual using the drug, etc.

References

[1] E. Communities, “Strategies to reduce HIV harm and infection among drug-using populations,” 2008.

[2] I. Literature, National Drug Advisory Committee NACD Review of harm reduction approaches in Ireland and evidence from international literature. 2003. [Online]. Available: https://www.drugsandalcohol.ie/5807/1/2347-A_review_of_harm_reduction_approaches._pdf.pdf

[3] FORM Resources, “Harm Reduction Principles,” 2020.

[4] MD Cookson and PMR Stirk, “済無Untitled, Untitled, Untitled”, 2019.

About the Author

IZERE Solomon is a (2n/a) Second year medical student at the University of Rwanda, Faculty of Medicine and Health Sciences In the department of general medicine and surgery, interested in research, surgery, and he is also an advocate for sexual health and reproductive and human rights. He is an active member of Rwanda Medical Students Association, MEDSAR Rwanda NMO of IFMSA. Currently a member of the Standing Committee on Public Health (SCOPH).

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