In light of the recent opioid crisis, many public health entities have called for an expansion in syringe exchange programs (SEPs), which provide access to sterile syringes and facilitate safe needle disposal for injection drug users. This paper investigates the effects of recent SEP openings on HIV diagnoses and drug-related overdoses in the wake of the opioid crisis. I find that SEP openings decrease HIV diagnoses by up to 18.2 percent. However, I present new evidence that SEPs increase rates of opioid-related mortality and hospitalizations, suggesting that needle exchanges alone may be less effective than other interventions at stimulating recovery.
This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.
One doctor's courageous fight to save a small town from a silent epidemic that threatened the community's future--and exposed a national health crisis. When Dr. Will Cooke, an idealistic young physician just out of medical training, set up practice in the small rural community of Austin, Indiana, he had no idea that much of the town was being torn apart by poverty, addiction, and life-threatening illnesses. But he soon found himself at the crossroads of two unprecedented health-care disasters: a national opioid epidemic and the worst drug-fueled HIV outbreak ever seen in rural America. Confronted with Austin's hidden secrets, Dr. Cooke decided he had to do something about them. In taking up the fight for Austin's people, however, he would have to battle some unanticipated foes: prejudice, political resistance, an entrenched bureaucracy--and the dark despair that threatened to overwhelm his own soul. Canary in the Coal Mine is a gripping account of the transformation of a man and his adopted community, a compelling and ultimately hopeful read in the vein of Hillbilly Elegy, Dreamland, and Educated.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
A NEW YORK TIMES BESTSELLER More people than ever before see themselves as addicted to, or recovering from, addiction, whether it be alcohol or drugs, prescription meds, sex, gambling, porn, or the internet. But despite the unprecedented attention, our understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as brain disease, and in equally outdated treatment. Challenging both the idea of the addict's "broken brain" and the notion of a simple "addictive personality," The New York Times Bestseller, Unbroken Brain, offers a radical and groundbreaking new perspective, arguing that addictions are learning disorders and shows how seeing the condition this way can untangle our current debates over treatment, prevention and policy. Like autistic traits, addictive behaviors fall on a spectrum -- and they can be a normal response to an extreme situation. By illustrating what addiction is, and is not, the book illustrates how timing, history, family, peers, culture and chemicals come together to create both illness and recovery- and why there is no "addictive personality" or single treatment that works for all. Combining Maia Szalavitz's personal story with a distillation of more than 25 years of science and research,Unbroken Brain provides a paradigm-shifting approach to thinking about addiction. Her writings on radical addiction therapies have been featured in The Washington Post, Vice Magazine, The Wall Street Journal, and The New York Times, in addition to multiple other publications. She has been interviewed about her book on many radio shows including Fresh Air with Terry Gross and The Brian Lehrer show.
From “one of the bravest, smartest writers about addiction anywhere” (Johann Hari, New York Times bestselling author)—the untold story of harm reduction, a surprisingly simple idea with enormous power Drug overdoses now kill more Americans annually than guns, cars or breast cancer. But we have tried to solve this national crisis with policies that only made matters worse. In the name of “sending the right message,” we have maximized the spread of infectious disease, torn families apart, incarcerated millions of mostly Black and Brown people—and utterly failed to either prevent addiction or make effective treatment for it widely available. There is another way, one that is proven to work. However, it runs counter to much of the received wisdom of our criminal and medical industrial complexes. It is called harm reduction. Developed and championed by an outcast group of people who use drugs and by former users and public health geeks, harm reduction offers guidance on how to save lives and improve health. And it provides a way of understanding behavior and culture that has relevance far beyond drugs. In a spellbinding narrative rooted in an urgent call to action, Undoing Drugs tells the story of how a small group of committed people changed the world, illuminating the power of a great idea. It illustrates how hard it can be to take on widely accepted conventional wisdom—and what is necessary to overcome this resistance. It is also about how personal, direct human connection and kindness can inspire profound transformation. Ultimately, Undoing Drugs offers a path forward—revolutionizing not only the treatment of addiction, but also our treatment of behavioral and societal issues.
The EMCDDA's 10th scientific monograph, entitled Harm reduction: evidence, impacts and challenges provides a comprehensive overview of the harm reduction field. Part I of the monograph looks back at the emergence of harm reduction approaches and their diffusion, and explores the concept from different perspectives, including international organisations, academic researchers and drug users. Part II is dedicated to current evidence and impacts of harm reduction and illustrates how the concept has broadened to cover a wide range of behaviours and harms. Part III addresses the current challenges and innovations in the field. The core audience of the monograph comprises policymakers, healthcare professionals working with drug users, as well as the wider interested public -- EU Bookshop.
This book reports on research on and experience with needle exchange and bleach distribution programs and their effects on rates of drug use, the behavior of injection drug users, and the spread of HIV and other infectious diseases among injection drug users. It discusses U.S. needle exchange data, international evaluations of needle exchange programs, legal issues and drug paraphernalia laws, evaluation methods, and bleach distribution programs.
