The International journal on drug policy
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Int. J. Drug Policy · Mar 2009
Pain, physical dependence and pseudoaddiction: redefining addiction for 'nice' people?
The undertreatment of pain has increasingly been framed as both a public health problem and a human rights issue. The application of rights-based discourses to the field of pain management has provided an important means of critiquing "opiophobia" amongst healthcare professionals and challenging current criminal-legal and regulatory sanctions on the distribution of opiate medications. This movement would therefore appear to align with harm reduction advocacy and longstanding criticisms of international drug policies. However, discourses on pain management rest on moral as well as medical assumptions about who has pain and who needs drugs. ⋯ Present efforts to secure access to pain relief as a human right are likely to undermine, rather than advance, the rights of so-called 'drug addicts'.
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Int. J. Drug Policy · Mar 2009
Evaluation of the Staying Alive programme: training injection drug users to properly administer naloxone and save lives.
In response to the high rates of opiate-related overdoses and deaths in the United States, a number of overdose prevention programmes have been implemented that include training drug users to administer naloxone, an opiate antagonist. The purpose of this study was to evaluate the Staying Alive (SA) programme in Baltimore, Maryland, which trained drug users to prevent and respond to opiate overdose using techniques including mouth-to-mouth resuscitation and administration of naloxone. ⋯ Results from this study provide additional evidence to support the effectiveness of overdose prevention training programmes that include skills building for drug users to administer naloxone.
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Int. J. Drug Policy · Mar 2009
Qualitative evaluation of a peer-based needle syringe programme in Vietnam.
Harm reduction has been identified as an important HIV prevention strategy for injecting drug users (IDUs) in Vietnam. However, to date only small geographically limited formal needle syringe programmes (NSPs) have been implemented; and little attention has been given to assessing the effectiveness of the piloted models. Using data from a qualitative evaluation of an NSP in northern Vietnam, this paper assesses the effectiveness of the intervention, examines barriers to the NSP, and documents lessons which can be applied to replicate and scale up interventions across Vietnam. ⋯ Programme success is dependent upon community support. Resistance to NSPs can be overcome through a programme of intensive advocacy with community stakeholders including; local government, mass organizations, local residents, IDUs and their families. Garnering the support of law enforcement officials requires a sustained effort.