Lecture reflection

July 15 lecutre 4: soc 387

What is harm reduction?

• Motorcycle safety – having to wear a helmet

The safety belt

Early harm reduction

• Seatbelts weren’t always stock and were aftermarket
• Dr hunter Sheldon made it mandatory in 1950s
• Don’t change ppls behaviour or driving but reduce harm if accident

Harm reduction with regard to drugs is baed on similar principle

Harm reduction defined

The intent of harm reduction, as earlier description implies is to reduce harms

• In this instance, these harms are associated with drug use
• These harms may pertain to health such as prevention of fatal overdoses

• Doesn’t discourage reduction in or cessation of drug use, abstinence is not part of its narrative structure

The first crack pipe stem distribution program in Vancouver: late 1990s in a city operated hotel

• 5 cent parts vs repairs and damaged toilets
• fill tube used to smoke crack

harm reduction is not automatically controversial

• in late 1990s, during period when injection drug use was rampant in public areas of vancouver’s DTES

needle exchange

• provision of clean syringes for drug addicts began as initiative aimed at combating the spread of infection

needle exchange

• 1^st needle exchange in n/a was program in Vancouver in 1989
• city initative and supported by Gordon Campbell
• the specific narratives and cultural values associated with the hypodermic needle will be reviewed in depth in a forthcoming section

• funding ban on needle exchanges effectively lifted

harm reduction, housing and housing first

• harm reduction in housing began in early 1990s Canada
• in 93, a no-eviction policy was established

• harm reduction was further established in housing

• first needle exchange in supported housing was launched in early 1990s

drug users resource centre and cultural opposition to harm reduction

• one of the most controversial of hr initiatives in bc began in 1990s as arealtively simple plan to provide a welcoming place for steet involved and homeless addicts tot attend a centre for engagement where they could receive coffee, nurtrion as awell as shower and laundry facilities

drug users resource centre and cultural opppostion to harm reduction

• lots of public hearings and sad stories

this opposition reflects the deeply cultural nature of harm reduction

narcan and policing

• police officers participate in training to administer narcan in two disstrcits
• in all of n/a to prevent heroin overdoses

harm reduction vending machine

• syringe vending machine exist in number of jurisdictions like france, asutralia, and Canada
• was not until 2013 it was implemeneted
• related controversies associated with this vending machine?

Harm reduction in clinical settings

• broadly speaking, harm reduction in clinical settings takes on 3 forms
• firstly it pertains to harm reduction policy with regard to encouraging professioanls to engage in harm reduction practices
• secondly, it relates to an organizational approach with regard to the engagement of its client group that allows for harm reduction as a compromise in order to retain theme in healthcare
• finally it might involves the development and operation of an actual harm reduction program (e.g. supervised injection, supervised consumption, needle distributuion)

harm reduction in clinical setting: G.f.

likewise, the policy allowed for the clients to use while engaged in the program:

the staff here, in my view, did a masterful job of contemplating about and focusing on their fundamental priority for the program

• these types of ideas sometimes leave people wondering whether they result in complete anarchy,

– culturally tuned initiaitves aimed at contemporary social problems require, in myy view

1. sociocultural accounting: an examination of values and narrative freamework for approaching a contemporary

they are built on idea that

• peter was physician had tv show where he introduced his lfie world
• gay man, HIV positive,

• would they be liable if died in facilitly

• answer is yes

• nursing association did something culturally unheard of

• yes it is their responsibility to monitor somebody using drugs

• supervised injection facility known as insite, aimed at reaching wider public audience

• around 80-89 in Europe

• mix methadone with orange juice
• the program began with a recovery narrative but eventually moved

• crack pipe sharing: Crack pipes are frequently shared
• cracked glass pipes: glass pipes present risks in that they crack when heated or dropped. A jagged glass pipe can cut the lips of the dug user thereby exposing

community transitional care team

clinical program in single room occupancy hotel

• the program was created to address the fact that an extremely marginalized group often didn’t complete treatment within hospital setting
• they either left against medical advice or were evicted from the clcinical setting for behavioural issues

community transitional care team

narrative friction

cultural erasures

• the erasure that was uncovered as part of the launceh of this program is that people living with addictice addictions who seek treatement for their infections actively use illicit drugs in the hospital setting
• that is to say, ppl with addicitions are using illicit drugs in the insitituitional setting
• while this was maintained as an erasure (something present and well known to hospital administrators and clinicians) it wasa tolerated
• when it was foregrounded as an explicit fact through the implmenetation of the cTCT,

canada’s first managed alcohol program MAP began in Toronto

• in 96 3 homeless individuals died in Toronto
• severe alcohol

• gave wine instead of drinking paint, hairspray, mouthwash

• begain in Toronto expanded into Ottawa

• Ottawa has 2 managed alcohol initiatives
• Map approach tolerates alcohol use and provides alchohol to residents
• They drink less, safer alcohol

Vancouver station street

• Taxpayer dollars used to let ppl drink
• Results indicted that partcipants health, mental health, and social functioning iimproved

Sociocultural accounting

Media addressing cultural values

• Tout defined: “an attempt to sell something, typically by persteringppl in an aggresvie or bold manner”

Soteriology-  medical interventions are deeply cultural

• More specifically have elements of salvation and redemption within them
• Morally laten goals set in clinic