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Harm Reduction Pragmatic Strategies for Managing High-Risk Behaviors

by: Marlatt, G. Alan

9781572308251

Harm Reduction Pragmatic Strategies for Managing High-Risk Behaviors

by: Marlatt, G. Alan

ISBN 13:
9781572308251
ISBN 10:
1572308257
Edition: 1st
Format: Paperback
Copyright: 07/25/2002
Publisher: The Guilford Press
Newer Edition

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Summary

Harm reduction principles and strategies are designed to minimize the destructive consequences of illicit drug use and other behaviors that may pose serious health risks. The first major harm reduction text, this provocative and timely volume examines a wide range of current applications¿from needle exchange and methadone maintenance programs, to alternative alcohol interventions and HIV/AIDS prevention campaigns. Insight is also offered into the often contentious philosophical and policy-related debates surrounding this growing movement.

I. OVERVIEW OF HARM REDUCTION

Highlights of Harm Reduction: A Personal Report from the First National Harm Reduction Conference in the United States

3

(27)

G. Alan Marlatt

My Arrival: Lessons from a T-Shirt

4

(2)

Opening Addresses

6

(4)

The Politics of Harm Reduction

10

(2)

Harm Reduction within Recovery/Abstinence Cultures

12

(2)

Substance Use Management

14

(4)

Medicinal Marijuana

18

(1)

Drug-Using Youth as Harm Reduction Providers

19

(2)

Integrating Harm Reduction and Drug Treatment

21

(1)

Integrating Harm Reduction and Psychotherapy

22

(3)

Other Topics Covered

25

(1)

The Closing Ceremony

26

(4)

Harm Reduction around the World: A Brief History

30

(19)

G. Alan Marlatt

The Dutch Model

31

(6)

The U.K. (Merseyside) Model

37

(4)

Policies and Programs in Other European Countries

41

(2)

Harm Reduction in Canada and Australia

43

(6)

Basic Principles and Strategies of Harm Reduction

49

(20)

G. Alan Marlatt

Basic Principles, Assumptions, and Values

49

(9)

Procedures and Strategies

58

(11)

II. APPLICATIONS TO ADDICTIVE BEHAVIORS AND HIGH-RISK SEXUAL BEHAVIORS

Harm Reduction for Alcohol Problems: Expanding Access to and Acceptability of Prevention and Treatment Services

69

(53)

Mary E. Larimer

G. Alan Marlatt

John S. Baer

Lori A. Quigley

Arthur W. Blume

Elizabeth H. Hawkins

Alcohol Use: Prevalence, Problems, Risks, and Benefits

70

(2)

History of Approaches to Alcohol Problems in the United States

72

(2)

Advantages of Harm Reduction as an Alternative to Traditional Abstinence Models

74

(1)

The Controlled-Drinking Controversy

75

(4)

Moderate-Drinking Goals for Alcohol-Dependent Individuals

79

(6)

Clinical Interventions: Advances in the Alcohol Harm Reduction Field

85

(13)

Pharmacological Interventions for Alcohol Problems

98

(3)

Harm Reduction Policies

101

(6)

Environmental Harm Reduction

107

(1)

Conclusion

108

(14)

Harm Reduction, Nicotine, and Smoking

122

(23)

John S. Baer

Heather Brady Murch

Overview

122

(3)

Harm Reduction and Smoking: Conceptual Issues

125

(2)

Harm Reduction Strategies

127

(11)

Summary and Limitations

138

(7)

Harm Reduction Strategies for Illicit Substance Use and Abuse

145

(73)

Susan F. Tapert

Jason R. Kilmer

Lori A. Quigley

Mary E. Larimer

Lisa J. Roberts

Elizabeth T. Miller

Overview

145

(3)

Opiates

148

(27)

Cocaine

175

(8)

Cannabis

183

(7)

Hallucinogens

190

(4)

Prescription Drugs

194

(2)

Risk Reduction Efforts with Other Substances: Keep the Door Open to Injectors

196

(3)

Conclusion

199

(19)

Harm Reduction and HIV/AIDS Prevention

218

(83)

Peggy L. Peterson

Linda A. Dimeff

Susan F. Tapert

Martin Stern

Mike Gorman

Overview

218

(2)

HIV Risk Reduction for Injection Drug Users

220

(11)

Reducing HIV Risk among Men Who Have Sex with Men

231

(13)

Reducing HIV Risk for Women

244

(11)

Reducing HIV Risk among Adolescents

255

(10)

HIV Harm Reduction Approaches in Prison Populations

265

(11)

Conclusion

276

(25)

III. MATCHING STRATEGIES TO DIVERSE ETHNIC COMMUNITIES

Bringing Harm Reduction to the Black Community: There's a Fire in My House and You're Telling Me to Rearrange My Furniture?

301

(26)

Imani P. Woods

Personal History: How I Came to Support Harm Reduction

301

(4)

Historical Barriers to Harm Reduction in the Black Community

305

(2)

Unemployment as an Issue in the Black Community

307

(3)

Effects of the Presence of Illegal Substances in Black Communities

310

(3)

Unrealistic Expectations and Unfulfilled Dreams

313

(3)

Philosophical Differences among African American Leaders

316

(1)

Issues in Developing Harm Reduction Efforts for the Black Community

317

(10)

Alcohol Use and Harm Reduction within the Native Community

327

(26)

Fransing Daisy

Lisa R. Thomas

Charlene Worley

Historical Antecedents

328

(1)

The Direct Impact of Alcohol upon Native Health

329

(1)

Diversity of Factors Affecting Alcohol/Other Substance Use

330

(1)

Alcohol/Other Substance Use among Native Youth

331

(1)

Effects of Gender and Residence

332

(21)

The Importance of Native Identity

333

(1)

Prevention

334

(1)

Current Treatment Approaches

335

(2)

The Need for Alternative Treatment Approaches

337

(2)

The Role of Harm Reduction in the Native Community

339

(6)

Conclusion

345

(8)

IV. CAN HARM REDUCTION PLAY A ROLE IN U.S. DRUG POLICY?

Harm Reduction and Public Policy

353

(2)

Kenneth R. Weingardt

G. Alan Marlatt

The 1997 National Drug Control Strategy: Evaluating the Effectiveness of Current Drug Control Policy

355

(24)

Supply Reduction, Demand Reduction, Use Reduction, and Harm Reduction

362

(5)

Harm Reduction Is Not Legalization

367

(3)

Needle Exchange Programs: A Case Study in Resistance to Harm Reduction Policy

370

(4)

Conclusions

374

(5)

Index

379

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