Drug+Policy+to+Avert+Abuse

Thanh Ngo Student number: n8307008 Tutor: Mangalam Sankupellay

=** Harm Minimisation **=



Cultural Artefact
The image features a member from the Drug Policy Alliance, an organisation that promotes drug policies. The statement she holds depicts her perspective on harm minimisation in response to drug use. She practices harm minimisation by encouraging individuals to participate in discussions about drug related policies. This aims to promote awareness, which allows one to explore the matter in depth and develop further understanding of its significant contribution to individuals and the community.

**Public Health Issue**
The Australian Government, Department of Health (2013) states “the concept of harm minimisation is not well understood or accepted in the wider community as many people believe that in attempting to reduce the harm associated with drugs, we are condoning drug use.” In the lens of public health, harm minimization aims to prevent the harm of drugs rather than drug use itself. It recognizes that there will be continual drug use amongst individuals who are unable to stop despite their strongest efforts. The public health issue presented is the lack of understanding harm minimisation goals and strategies. As a result the cultural artefact represents the importance of encouraging discussions on drug policies. Without grounding knowledge of harm minimisation, individuals are unable to appreciate the efforts made to minimise the harm of drug use to create a safe society.

**Literature Review**
Policies provide basic guidelines to ensure safety within a society (Harwood, Inciardi, Leukeford, McBride, & Terry-McElrath, 2009). Drug policies in particular aim to keep individuals and the community safe from the negative effects of drug addiction and misuse (Harwood et al., 2009). Without these guidelines, the harm of drugs would affect the health and wellbeing of individuals. The government has an important role in governing drug-related policies. They are continually reviewed and updated to provide beneficial outcomes for society.

Costa (2008) conducted research on the implementation and changes of drug policies in Australia over the years. His research dates back to the 1960’s when illicit drug use was causing major public concern. Initial responses from the government were addressed with law enforcement activities however they were not successful. As a result Australia had one ofthe highest levels of drug use worldwide by the end of the 1990’s (Costa, 2008). The government proceeded to adopt harm minimization approaches and Costa (2008) described this event as “a positive change.” According to the Australian National Council on Drugs (2010), harm minimization has prevented the spread of blood borne viral infections in Australia for over two decades. Furthermore, the level of HIV among injecting drug users in Australia is as low as 1% compared to other countries with levels over 50% (Australian National Council on Drugs, 2010).



Green (2006) states “harm minimisation is designed to prevent and reduce drug related harm through various strategies.” The Australian Government, Department of Health (2013) outlines that harm minimisation strategies are categorised in three areas: supply reduction, demand reduction and harm reduction. The ultimate goal is to reduce drug related harm through these strategies by aiming to reduce the supply of illicit drugs, prevent public desire for drug use and prevent the harm of drug use for individuals and the community (Green, 2006). Costa (2008) states in 1998 there was a strong emphasis on supply reduction, heroin for example was reduced through increased prices followed by lower heroin purity. As a result levels of heroin consumption decreased (Costa, 2008). According to a review on harm reduction strategies published by the Australian Government (2005), several interventions have been major public health success stories. A needle exchange worker states “ harm reduction attempts to intervene where the drug user is, rather than forcing them to adopt an impractical goal of eliminating drug use entirely" (Goldblatt, Webber, Verret, 2007) . Evidently, understanding harm minimisation strategies assists to overlook the misconception that the policy condones drug use.

Statistical reports on harm minimisation interventions support the success of this policy. Between 1991 and 2000 the government invested $130 million in needle and syringe programs. This prevented an estimate 25, 000 cases of HIV and 21, 000 cases of hepatitis C. Additionally, savings to the health care system for treatment costs estimated between $2.4 and $7.7 billion (Australian Government, 2007). Another successful implementation of an evidence-based intervention is the supervised injecting centre located in Sydney. The Sydney Medically Supervised Injecting Centre opened in May 2001 and is staffed by medical and counselling professionals. (Kaldor, Kimber, MacDonald, & Maher, 2005). In the first 12 months of operation, 2279 individuals were assessed and resulted in a total of 31 675 visits. During the first 11 years of operation, staff at the centre has attended to 4375 drug overdoses without a single fatality. On average, there will be 225 visits per day and 700-750 individuals will visit the centre a month (Royal Australasian College of Physicians, 2012).



The needle and syringe program as well as the supervised injecting centre provide sterile injecting equipment in addition to a clean and safe environment. Hunt (2008) states, “ some injecting drug users may never quit using drugs, but they are able to take greater control over their lives and their health.” Harm minimization provides drug users with safer options to minimize harmful effects. This essentially promotes health amongst individuals and the community, which is an important aspect in the lens of public health.

To measure the effectiveness of harm minimisation in response to drug use, researchers evaluated numerous research reports. These reports were concerned with drug policies and harm minimisation interventions (Cameron & Ritter, 2005). Qualitative data was also gathered. Data showed the perceptions of staff and clients accessing needle and syringe programs (Carmeron & Ritter). Malloch (2011) notes that there is range of methodological difficulties to assess whether harm minimisation interventions stop drug use permanently. A randomised control trail was conducted within a supervised injecting centre. The sample of individuals was too small and often participants did not show up after the first few visits or their visits were inconsistent (Malloch, 2011). As a result, the evaluation was limited to assessing the impact of health on clients over a period of time. There is little evidence to suggest that harm minimisation has the potential to stop drug use which causes uncertainty of it’s effectiveness and creates misconceptions that the approach condones the use of drugs (Lancaster, 2013).

**Cultural and Social Analysis**
Public health issues affect the wellbeing of individuals in society. When faced with these issues, applying social theory can be useful as it guides us towards a different perspective. For example, the functionalism theory outlines the importance of social structure and stability (Thompson, 2013). Each aspect in society is functional and contributes to the stability of the whole society (Thompson, 2013). From a functionalist perspective, drug control policies are a crucial aspect of society to combat the negative effects of drug use. Without these policies, drug use can be detrimental and affect the stability of society.

Despite some positive outcomes of harm minimisation, there is ongoing public scrutiny surrounding its programs and interventions (Haines, Loxley, Stockwell,& Toumbourou, 2004). This is a public health issue influenced by a lack of education on drug policies to fully understand the goals and strategies. As a result this has a major affect on the general public, as they may not feel safe. They rely on these policies for security within the area they live (Haines et al., 2004). The government plays an important role in implementing drug control procedures. They aim to achieve policies that provide the most benefits for society. However it does not satisfy some individuals, which impacts the government. Finally, this issue also affects drug users. Harm minimisation offers services to these individuals that are not supported within the wider community. As a consequence drug users will feel hesitant to access these services that contributes to a safer society (Australian Government, 2013)

Harm minimisation aims to achieve safety amongst individuals and the community. Some confusion can lie between preventing the harmful effects of drug use by providing safer options such as sterile injecting equipment and having the option to stop drug use permanently. Individuals will opt for a drug control policy that restricts drug use as it may provide a drug-free outcome (Luger, 2003). By providing safer options, individuals develop the belief that harm minimisation condones drug use. Raising awareness of this public health issue will allow one to explore the matter and expand their knowledge. It opens up more opportunities for discussion and inform others of the issue. More importantly it has the potential to change people’s negative perception on harm minimisation so that they are accepting of this approach to drug use. Public health experts have a role in raising awareness of these matters. To effectively help individuals understand the goals and strategies of harm minimisation, there should be a focus on education amongst the general public within numerous areas where possible. These can include media campaigns, schools, work places or shopping centres. Receiving some education in comparison to none will make a big difference.

Analysis of Artefact and Reflection
The cultural artefact represents an individual who believes in the practice of harm minimisation to address to the negative effects of drug use. There are misconceptions surrounding this approach in society. As a result she highlights the importance of drug policy discussions to help individuals explore the matter on a deeper level to gain better understanding. When analyzing this artefact, I believe she has conveyed her message well and I was able to develop more thoughts on the topic. I believe we don't have to be drug users to practice harm minimisation. There are various ways to show others the importance of an issue. Through promotion and education, we can practice harm minimisation.

This assessment piece has given me the opportunity to research a public health issue that affects the society I live in. More specifically, I was able to gain in depth knowledge of drug control policies in Australia and apply a social theory to view the issue from a different perspective. I can understand why others might have negative perceptions towards harm minimisation however the positive outcomes of this approach should be recognised. Being able to view this issue from another perspective might have the potential to create and change negative opinions to more positive ones. Evaluating a matter through differing lens will be useful in my future learning as more thoughts and ideas can be developed. This will change by thinking process and how I approach other issues in the future.

Reflection
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References
ANCD research paper, Drug policy – The Australian approach. (2010). Retrieved from the Australian National Council on Drugs website []

Australian Government (2013). Harm minimisation. Retrieved from Department of Health website []

Australian Government. (2005). Needle and syringe programs: a review of the evidence. Retrieved from the Department of Health and Aging website []

Cameron, J., & Ritter, A. A systematic review of harm reduction. Retrieved from Turing Point Alcohol and Drug Centre Inc website []

Costa, A. (2008). Drug policy and results in Australia. Retrieved from United Nations Office on Drugs and Crime website []

Goldblatt, A., Webber, C., & Verret, C. (2007). //Working with people who use drugs: A harm reduction approach//. Canada: Canadian Liver Foundation.

Green, C. (2006). Minimizing the Harm of Illicit Drug Use: Drug Policies in Australia. Retrieved from Queensland Parliamentary Library website []

Haines, B., Loxley, W., Stockwell, T., & Toumbourou, J. (2004). The prevention of substance use, risk and harm in Australia. In T. Stockwell (Eds.), //Harm reduction// (pp. 222-236). Canberra, ACT: The National Drug Research Institute and the Centre for Adolescent Health.

Harwood, H., Inciardi, J., Leukefeld, C., McBride, D., & Terry-McElrath, Y. (2009). Reflections of drug policy. //Journal of Drug Issues//, //39//, 71-88. doi: 10.1016/j.amepre.2007.12.003

Hunt, N. (2008). A review of the evidence-base for harm reduction approaches to drug use. Retrieved from Forward Thinking On Drugs website []

Kaldor, J., Kimber, J., MacDonald, M., & Maher, L. (2005). Public opinion towards supervised injecting centers and the Sydney Medically Supervised Injecting Centre, //International Journal of Drug Policy//, //16//, 275-280, doi: 10.1016/j.drugpo.2005.03.003

Lancaster, K (2013). Public opinion and drug policy in Australia: engaging the affected community. //Drug and alcohol review//, //32//, 60-78, doi: 10.1016/j.drugpo.2006.11.010

Luger, M. (2003). Drug policy: must we choose between harm minimization and abstinence. //Drug and alcohol review//, //12//, 3-9. doi: 10.1016/j.amepre.2007

<span style="font-family: Arial,Helvetica,sans-serif;">Malloch, M (2011). Interventions for drug users in the criminal justice system. //Criminal Behaviour and Mental Health//, //18//, 47-76, doi: 10.1016/j.pec.2007.06.81

<span style="font-family: Arial,Helvetica,sans-serif;">Medically Supervised Injecting Centre Position Statement 2012. (2012). Retrieved from The Royal Australasian College of Physicians website []

<span style="font-family: Arial,Helvetica,sans-serif;">Thompson, M. (2013). A functionalist theory of social domination. //Journal of political power, 6//, 179-181. doi: 10.0194/CFW-51-0106