Harm reduction: Come as you are

Aim To test whether a single session of motivational interviewing (discussing alcohol, tobacco and illicit drug use) would lead successfully to reduction in use of these drugs or in perceptions of drug-related risk and harm among young people

Design  Cluster randomized trial, allocating 200 young people in the natural groups in which they were recruited to either motivational interviewing (n = 105) or non-intervention education-as-usual control condition (n = 95)

Setting  Ten further education colleges across inner London

Participants  Two hundred young people (age range 16–20 years) currently using illegal drugs, with whom contact was established through peers trained for the project

Intervention  The intervention was adapted from the literature on motivational interviewing in the form of a 1-hour single-session face-to-face interview structured by a series of topics

Measurements  Changes in self-reported cigarette, alcohol, cannabis and other drug use and in a range of drug-specific perceptions and other indicators of risk and harm Measurement at recruitment and follow-up interview 3 months later

Findings  A good follow-up rate (895%; 179 of 200) was achieved In comparison to the control group, those randomized to motivational interviewing reduced their of use of cigarettes, alcohol and cannabis, mainly through moderation of ongoing drug use rather than cessation Effect sizes were 037 (015–06), 034 (009–059) and 075 (045–10) for reductions in the use of cigarettes, alcohol and cannabis, respectively For both alcohol and cannabis, the effect was greater among heavier users of these drugs and among heavier cigarette smokers The reduced cannabis use effect was also greater among youth usually considered vulnerable or high-risk according to other criteria Change was also evident in various indicators of risk and harm, but not as widely as the changes in drug consumption

Conclusions  This study provides the first substantial evidence of non-treatment benefit to be derived among young people involved in illegal drug use in receipt of motivational interviewing The targeting of multiple drug use in a generic fashion among young people has also been supported

The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)60315-8.pdf

Evolution of China's response to HIV/AIDS

This article describes the impact of street-level law enforcement on Australia's principal heroin market. Based on three years of research, including interviews and extended ethnographic fieldwork, it uses data on drug-use, risk practices, crime, and policing to examine the relationship between law enforcement and harm minimization. Findings suggest that the 'successes' of police crackdowns and their impact on drug markets (including threats to public health and community safety as a result of geographical, social, and substance displacement) may be won at substantial costs, raising doubts as to their value. This study is concerned with tensions in drug policing between commitments to law enforcement and to harm minimization, and with the harmful consequences to public health of the domination in policing practice of law enforcement. Reporting ethno- graphic research in Sydney's principal street-level drug market, and integrating perspectives from research in policing and in public health, we argue for a shift in policing priorities, rejecting suggestions that the law constrains the ability of police to subordinate law enforcement to other objectives. The focus is on the policing of drug users and user/dealers in public space. Such work is primarily carried out by uniformed patrol officers, although plain clothes officers also contribute. These activities have to be placed in the context of other forms of drug policing. During the study period, the research site was subject to the attention of a considerable variety of other police sections and agencies, including local detectives and drug units, regional and district specialists, transit police, the NSW Drug Enforcement Agency, the Australian Federal Police, and the National Crime Authority. These activities interrelated, overlapped, and sometimes conflicted. 1 Studies of drug policing often fail to discriminate except at a general level, for example between supply-side and demand-side strategies. This study indicates that more speci- ficity is needed because of the under-acknowledged importance of street-level enforce- ment (Pearson 1992). Despite the attention which specialist units attract, 'the current

/pdf/policing-and-public-health-law-enforcement-and-harm-srdpigsa76.pdf

POLICING AND PUBLIC HEALTH Law Enforcement and Harm Minimization in a Street-level Drug Market

OBJECTIVES: This study examined whether networks of drug-injecting and sexual relationships among drug injectors are associated with individual human immunodeficiency virus (HIV) serostatus and with behavioral likelihood of future infection. METHODS: A cross-sectional survey of 767 drug injectors in New York City was performed with chain-referral and linking procedures to measure large-scale (sociometric) risk networks. Graph-theoretic algebraic techniques were used to detect 92 connected components (drug injectors linked to each other directly or through others) and a 105-member 2-core within a large connected component of 230 members. RESULTS: Drug injectors in the 2-core of the large component were more likely than others to be infected with HIV. Seronegative 2-core members engaged in a wide range of high-risk behaviors, including engaging in risk behaviors with infected drug injectors. CONCLUSIONS: Sociometric risk networks seem to be pathways along which HIV travels in drug-injecting peer groups. The...

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.87.8.1289

Sociometric risk networks and risk for HIV infection.

This book gathers together an international group of practitioners who argue persuasively about the paramount importance of harm reduction strategies rather than total abstention in the fight against drugs.

The Reduction of Drug-Related Harm

The reduction of drug-related harm: A conceptual framework for theory, practice and research

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The Reduction of Drug-Related Harm

The reduction of drug-related harm: A conceptual framework for theory, practice and research