Harm reduction

Needle and syringe programmes (NSP) and Opioid Agonist Therapy (OAT) outlets in some settings offer basic primary health care.

The facilities provide sterile injection equipment, information about substances and basic health care, treatment referrals, and access to medical staff.

Most people who recreationally consume alcohol are now aware of these dangers and safe ride techniques like 'designated drivers' and free taxicab programmes are reducing the number of drunk-driving crashes.

[7] The web forum Bluelight allows users to share information and first-hand experience reports about various psychoactive substances and harm reduction practices.

The programme has been duplicated in other Canadian cities, and a study of Ottawa's "wet shelter" found that emergency room visit and police encounters by clients were cut by half.

Results of the study funded by the Substance Abuse Policy Research Program (SAPRP) of the Robert Wood Johnson Foundation[15] appeared in the Journal of the American Medical Association in April 2009.

[16] This first controlled assessment in the U.S. of the effectiveness of Housing First, specifically targeting chronically homeless alcoholics, showed that the programme saved taxpayers more than $4 million over the first year of operation.

Most people who recreationally consume alcohol are now aware of these dangers and safe ride techniques like 'designated drivers' and free taxicab programmes are reducing the number of drunk-driving crashes.

Many cities have free-ride-home programmes during holidays involving high amounts of alcohol use, and some bars and clubs will provide a visibly drunk patron with a free cab ride.

In New South Wales groups of licensees have formed local liquor accords and collectively developed, implemented and promoted a range of harm minimisation programmes including the aforementioned 'designated driver' and 'late night patron transport' schemes.

[17] Providing medical prescriptions for pharmaceutical heroin (diacetylmorphine) to heroin-dependent people has been employed in some countries to address problems associated with the illicit use of the drug, as potential benefits exist for the individual and broader society.

The Swiss heroin maintenance programme is generally regarded as a successful and valuable component of the country's overall approach to minimising the harms caused by illicit drug use.

[22] A German study of long-term heroin addicts demonstrated that diamorphine was significantly more effective than methadone in keeping patients in treatment and in improving their health and social situation.

Established programs distribute naloxone, as per WHO's minimum standards, to people who use substances and their peers, family members, police, prisons, and others.

[citation needed] Research into the usefulness of piritramide, extended-release hydromorphone (including polymer implants lasting up to 90 days), dihydroetorphine and other substances for OAT is at various stages in a number of countries.

[49] In some countries (not the US, UK, Canada, or Australia),[46] regulations enforce a limited time period for people on OAT/OST programs that conclude when a stable economic and psychosocial situation is achieved.

The provision of accessible, acceptable and opportunistic services which are responsive to the needs of this population is valuable, facilitating a reduced reliance on inappropriate and cost-ineffective emergency department care.

[54][55] Specific harms associated with cannabis include increased crash-rate while driving under intoxication, dependence, psychosis, detrimental psychosocial outcomes for adolescents who use substances, and respiratory disease.

[58] Some people like Ethan Nadelmann of the Drug Policy Alliance have suggested that organized marijuana legalization would encourage safe use and reveal the factual adverse effects from exposure to this herb's individual chemicals.

Research organisation the Burnet Institute completed the 2013 'North Richmond Public Injecting Impact Study' in collaboration with the Yarra Drug and Health Forum, City of Yarra and North Richmond Community Health Centre and recommended 24-hour access to sterile injecting equipment due to the ongoing "widespread, frequent and highly visible" nature of illicit drug use in the areas.

The Burnet Institute's researchers interviewed health workers, residents and local traders, in addition to observing the drug scene in the most frequented North Richmond public injecting locations.

[74] On 28 May 2013, the Burnet Institute stated in the media that it recommends 24-hour access to sterile injecting equipment in the Melbourne suburb of Footscray after the area's drug culture continues to grow after more than ten years of intense law enforcement efforts.

[75] The British public body, the National Institute for Health and Care Excellence (NICE), introduced a new recommendation in early April 2014 due to an increase in the presentation of the number of young people who inject steroids at UK needle exchanges.

The facilities provide sterile injection equipment, information about drugs and basic health care, treatment referrals, and access to medical staff.

"[78] Jürgen Rehm and Benedikt Fischer explained that while evidence show that DCR are successful, that "interpretation is limited by the weak designs applied in many evaluations, often represented by the lack of adequate control groups."

While its usage is "associated with self-reported reductions in injecting risk behaviour such as syringe sharing, and in public drug use" and "with increased uptake of detoxification and treatment services.

Two of the centers, in Sydney, Australia and Vancouver, British Columbia, Canada cost $2.7 million[90] and $3 million per annum to operate respectively,[91] yet Canadian mathematical modeling, where there was caution about validity, indicated just one life saved from fatal overdose per annum for Vancouver,[92][93] while the Drug Free Australia analysis demonstrates the Sydney facility statistically takes more than a year to save one life.

[5] Decriminalisation as a harm-reduction strategy gives the ability to treat substance use disorder solely as a public health issue rather than a criminal activity.

The implementation of harm reduction faced much resistance within the US due to the demonization of particular drugs associated with stigmatized groups, such as sex workers and drug-injecting users.

[107] Drug liberalization as a harm-reduction strategy gives the ability to treat substance use disorder solely as a public health issue rather than a criminal activity.