Abstract:
BACKGROUND:Ongoing legal and social discrimination, and stigmatization of people with lived experience of drug use (PWLE) continues to contribute to overdose-related deaths in Canada. The involvement of PWLE working in harm reduction services has proven effective in decreasing drug-related harms among PWLE; however, there exist unintended negative impacts. PWLE working in harm reduction services risk overextending themselves beyond employment parameters (e.g., emotional labor) with few systems in place (e.g., employment advocacy) for support. While meaningful participation of PWLE in harm reduction programs is critical to addressing the overdose crisis, their labor in Canada's overdose response commands further investigation and recognition. This paper examines some of the benefits and negative aspects of working in harm reduction among PWLE. METHODS:Fifty qualitative surveys were completed by PWLE working in harm reduction services from across Canada at the National 2018 Stimulus conference held in Edmonton, Alberta. The surveys focused on the benefits and negatives of 'peer' employment and recommendations for organizational transformation through short answer written sections. Surveys were analyzed thematically using NVivo, informed by critical perspectives on substance use, with attention to key re-occurring themes on employment equity. RESULTS:While participants described multiple benefits of working in harm reduction services, such as the valuing of their expertise by fellow 'peers,' growing skill sets, countering stigma, and preventing overdose deaths, issues of workplace equity were significantly identified. Stigma, tokenism, workplace discrimination, including power and pay inequities, as well as lack of worker compensation and benefits were identified as key factors persisting in the everyday experiences of participants. CONCLUSION:Continued exposure to stigma, workplace discrimination, and/or power imbalances, combined with the impact of high stakes employment (e.g., dealing with overdose deaths), can have significant consequences for PWLE working in harm reduction, including burn out. Policy recommendations include large-scale structural changes that address inequities of hierarchical 'peer' employment for PWLE, including increased leadership roles for diverse PWLE, pay equity and benefits, unionization, as well as more supportive working environments attentive to the intersecting social-structural factors (poverty, criminalization, racism, gendered violence) impacting the everyday lives of PWLE working in harm reduction.
journal_name
Harm Reduct Jjournal_title
Harm reduction journalauthors
People with Lived Expertise of Drug Use National Working Group.,Austin T,Boyd Jdoi
10.1186/s12954-020-00453-5subject
Has Abstractpub_date
2021-01-06 00:00:00pages
1issue
1issn
1477-7517pii
10.1186/s12954-020-00453-5journal_volume
18pub_type
杂志文章abstract:BACKGROUND:Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries. Prison represents a high-risk environment for prisoners, in that it is characterized by high-risk behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing s...
journal_title:Harm reduction journal
pub_type: 杂志文章,meta分析
doi:10.1186/s12954-018-0231-0
更新日期:2018-05-09 00:00:00
abstract::Substance-using women who exchange sex for money, drugs or shelter as a means of basic subsistence (ie. survival sex) have remained largely at the periphery of HIV and harm reduction policies and services across Canadian cities. This is notwithstanding global evidence of the multiple harms faced by this population, in...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-4-20
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abstract::This article examines harm reduction from a novel perspective. Its central thesis is that harm reduction is not only a social concept, but also a biological one. More specifically, evolution does not make moral distinctions in the selection process, but utilizes a cannabis-based approach to harm reduction in order to ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-2-17
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-9-7
更新日期:2012-01-25 00:00:00
abstract:INTRODUCTION:In 2008, one of the oldest fixed site needle exchanges in a large urban city in Canada was closed due to community pressure. This service had been in existence for over 20 years. CASE DESCRIPTION:This case study focuses on the consequences of the switch to mobile needle exchange services immediately after...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-7-11
更新日期:2010-05-25 00:00:00
abstract:BACKGROUND:Community pharmacies are important for health access by rural populations and those who do not have optimum access to the health system, because they provide myriad health services and are found in most communities. This includes the sale of non-prescription syringes, a practice that is legal in the USA in a...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-019-0327-1
更新日期:2019-09-18 00:00:00
abstract:BACKGROUND:There are few studies of mortality amongst people who inject drugs (PWID) in Australia. In this study, we estimate mortality in a cohort of PWID in Melbourne and examine predictors of mortality including health service use, demographic characteristics, drug use and personal wellbeing. FINDINGS:We linked ide...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-015-0089-3
更新日期:2015-12-09 00:00:00
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journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-8-8
更新日期:2011-04-17 00:00:00
abstract:BACKGROUND:Gambling has quickly emerged as an important global public health issue. With new technologies used to develop high intensity gambling products and promotions aimed at driving consumption, public health organisations and researchers, community groups, and politicians have argued for a range of regulatory and...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-017-0173-y
更新日期:2017-07-25 00:00:00
abstract::With a worldwide prevalence of 15.4%, hepatitis C virus (HCV) has been estimated to be the most prevalent major infectious disease in prisons. The exceptionally high prevalence of HCV in prisons is attributable to common risk behaviors including sharing contaminated tattooing equipment and drug paraphernalia, as well ...
journal_title:Harm reduction journal
pub_type: 信件
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更新日期:2020-05-24 00:00:00
abstract:BACKGROUND:We have recently published some work on CEA levels in hookah (also called narghile, shisha elsewhere) and cigarette smokers. Hookah smokers had higher levels of CEA than non-smokers although mean levels were low compared to cigarette smokers. However some of them were also users of other tobacco products (ci...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-5-19
更新日期:2008-05-24 00:00:00
abstract:BACKGROUND:In some countries, "Big Events" like crises and transitions have been followed by large increases in drug use, drug injection and HIV/AIDS. Argentina experienced an economic crisis and political transition in 2001/2002 that affected how people use their time. This paper studies how time use changes between y...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-8-2
更新日期:2011-01-20 00:00:00
abstract:BACKGROUND:This study aimed to investigate the development of opioid tolerance in patients receiving long-term methadone maintenance treatment (MMT). METHODS:A region-wide cross-sectional study was performed focusing on dosage and duration of treatment. Differences between racemic methadone and levomethadone were exam...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-016-0095-0
更新日期:2016-02-16 00:00:00
abstract:BACKGROUND:Condom provision is one of the most effective harm reduction interventions to control sexually transmitted infections (STIs) including HIV/AIDS and viral hepatitis in prisons. Yet, very few countries around the world provide prisoners with condoms. The present study aimed to elucidate principles of effective...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-021-00462-y
更新日期:2021-01-28 00:00:00
abstract:BACKGROUND:Prevalence of HIV infection among people who inject drugs (PWID) has been reported to be higher than that of the general population. The present study aimed to estimate the prevalence of HIV infection and associated risk factors among PWID in Dar es Salaam, Tanzania, following the introduction of a comprehen...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00364-5
更新日期:2020-03-24 00:00:00
abstract:INTRODUCTION:The aim of this study is to identify the profiles of young people who use drugs (YPUD) and their exposure to HIV risks in the 3 main cities of Vietnam, Haiphong, Hanoi, and Ho Chi Minh City (HCMC), in order to design a community-based intervention to prevent HIV. METHODS:A survey using respondent-driven s...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00357-4
更新日期:2020-02-24 00:00:00
abstract:BACKGROUND:The HIV epidemic among people who inject drugs (PWID) in Russia continues to spread. This exploratory study examines how HIV-prevention measures are perceived and experienced by PWID in the northwestern region of Russia. METHODS:Purposive sampling was used to obtain a variety of cases that could reflect pos...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-017-0162-1
更新日期:2017-06-05 00:00:00
abstract:BACKGROUND:Methadone maintenance treatment is the most widely prescribed treatment for opiate dependence with proven benefits for patients. In naïve users or in case of recreational misuse, methadone can be a source of potentially lethal intoxications, resulting in fatal overdoses. A few cases of infantile intoxication...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-11-20
更新日期:2014-07-02 00:00:00
abstract:BACKGROUND:Illicit drug users have a high prevalence of HCV and represent the majority of newly infected persons in the U.S. Despite the availability of effective HCV treatment, few drug users have been evaluated or treated for HCV. Racial and ethnic minorities have a higher incidence and prevalence of HCV and higher H...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-10
更新日期:2013-06-20 00:00:00
abstract:OBJECTIVES:The COVID-19 pandemic led to the closure of the IDEA syringe services program medical student-run free clinic in Miami, Florida. In an effort to continue to serve the community of people who inject drugs and practice compassionate and non-judgmental care, the students transitioned the clinic to a model of Te...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00438-4
更新日期:2020-11-17 00:00:00
abstract:BACKGROUND:Patients with opioid use disorder (OUD) frequently present to the emergency department for acute treatment of overdose and withdrawal. CASE PRESENTATION:A 29-year-old male presented to the emergency room after intravenous heroin use followed by accidental ingestion of naltrexone. He was treated with bupreno...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00417-9
更新日期:2020-10-07 00:00:00
abstract:BACKGROUND:Health services globally are struggling to manage the impact of COVID-19. The existing global disease burden related to opioid use is significant. Particularly challenging groups include older drug users who are more vulnerable to the effects of COVID-19. Increasing access to safe and effective opioid agonis...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00394-z
更新日期:2020-07-17 00:00:00
abstract:BACKGROUND:Treatment of hepatitis C (HCV) among people who inject drugs (PWID) is a critical component of efforts to eliminate viral hepatitis. A recent study found high HCV prevalence among PWID in two cities, Pretoria (84%) and Cape Town (44%). Very few (< 5%) HCV-infected individuals attended follow-up appointments....
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00382-3
更新日期:2020-06-10 00:00:00
abstract:BACKGROUND:In response to the opioid epidemic, naloxone distribution programs aim to prevent overdose death by making naloxone available and training people to use it. Peers of individuals at risk of opioid overdose are well-positioned to administer naloxone and prevent overdose death. METHODS:We conducted key informa...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-019-0352-0
更新日期:2020-01-09 00:00:00
abstract:BACKGROUND AND RATIONALE:The HIV epidemic in Vietnam has from its start been concentrated among injecting drug users. Vietnam instituted the 2006 HIV/AIDS Law which includes comprehensive harm reduction measures, but these are unevenly accepted and inadequately implemented. Ward police are a major determinant of risk f...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-9-27
更新日期:2012-07-09 00:00:00
abstract::Young people aged 15-24 years account for fifty percent of all new AIDS cases worldwide. Moreover, half of all new HIV infections are associated with injection drug use. The average age for initiation into injecting drug use is 20 years of age. This paper investigates whether HIV prevention programs have reduced risk ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-2-5
更新日期:2005-03-17 00:00:00
abstract::Alcohol and other drug misuse are significant but neglected public health issues in conflict-affected populations. In this article, we review the literature on the challenges and strategies for implementing substance misuse treatment and prevention services in conflict and post-conflict settings in low- and middle-inc...
journal_title:Harm reduction journal
pub_type: 杂志文章,评审
doi:10.1186/s12954-018-0267-1
更新日期:2018-11-28 00:00:00
abstract:BACKGROUND:To understand the limits of HCV screening programs to reach all drug users (DUs). METHOD:The association of the recruitment of a representative sample of a population of DUs in a specific area with the use of a questionnaire that included 250 items allowed the use of uni- and multifactorial analysis to expl...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-018-0264-4
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Recovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effec...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-018-0258-2
更新日期:2018-10-22 00:00:00
abstract::The findings of our research show that while police play multiple roles in the fight against drug-related crime, they often perceived their tasks - especially preventing and controlling drug use on the one hand, and supporting harm reduction on the other - as contradictory, and this creates tensions in their work and ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-9-25
更新日期:2012-07-09 00:00:00