Year: 1992
Type: article
Abstract: legitimate goal of treatment: intermediate goals (such as stopping injecting) may be more realistic for some drug misusers.It may be a useful early step on the long journey of treatment.'The first needle exchange scheme in the United Kingdom opened in 1987, and there are now more than 130 such schemes in England."There are also extensive over the counter sales of needles in high street pharmacies.'2Main- tenance programmes using oral methadone, popular in other countries, may represent harm reduction in another guise.A prompt response to withdrawal crises-for example, when the normal illicit supply is interrupted or while the user is on remand or in custody'" '4-may be particularly important in avoiding the transition from smoking to injecting a drug.,sWhere does harm minimisation lead?Providing advice on safer injecting (and in some cases needles and syringes) fails to address the fundamental need for behavioural change.Alternative strategies are already being used, such as booklets giving advice on safer drug use'6 17 and the innovative comic for drug users, Smack in the Eye, which weaves health promotion into an alternative cartoon format.'8But orthodox medicine must also take up the challenge and explore these new territories.Why don't we already offer injecting drug users testing and vaccination for hepatitis B infection?'920Perhaps a case can be made for distributing ampoules of the opiate antagonist naloxone.Its potential for abuse is nil, the risks are probably minimal, and considerable benefit may accrue if drug users could give emergency doses of antagonist to fellow injectors who inadvertently overdose.Finally, we need to know more about how risk behaviour is changing.If a prescribing programme is intended to reduce the frequency of injecting or a needle exchange scheme is intended to reduce the frequency of sharing then measures of these behaviours are needed to monitor progress over time.Harm minimisation must now move to a stage where the critical researcher is not outlawed as a heretic but welcomed as a scientist.
Source: BMJ
Author: S. J. Nixon
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2040748177