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Beyond Fentanyl Test Strips: The Need To Decriminalize All Drug Checking Equipment In Tennessee, Jeremy C. Kourvelas Mph

SMART Policy Briefs

KEY POINTS

• In 2022, Tennessee decriminalized fentanyl test strips (FTS) through Public Chapter 764. Thousands have since been distributed by the state and nonprofit coalitions as a key harm reduction strategy. As of the end of 2023, 44 other states and D.C. had also decriminalized FTS.

• Research indicates that people who use drugs are five times as likely to change their behaviors (including reducing drug use overall) in response to a test result that is positive for fentanyl. People who use methamphetamine are especially likely to change their behaviors.

• However, the law only applies to “narcotic testing equipment used to …

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Deconstructing Drugs: Addressing The Stigma, Harm Reduction, And Policy Solutions, Charlotte Theriault

Themis: Research Journal of Justice Studies and Forensic Science

Black and homeless people who struggle with substance use disorder (SUD), especially opioid use disorder (OUD), have experienced unique obstacles due to inequalities relating to their social determinants of health (SDOH). Historical context and peer-reviewed research were used to evaluate racial bias and expand upon the factors that contributed to the opioid crisis, the effects of COVID-19 on drug overdoses, and the presence of fentanyl in illicit drug supplies. Various studies combat the stigma surrounding substance use disorder (SUD) by acknowledging the disease as a chronic health condition. Research showed that the most effective way to combat these inequalities and …

Use Of Syringe Service Programs In Rural Vs Urban Maine: A Harm-Reduction Study, Lisa W. Miller, Kim Murray, Emma Daybranch, Kinna Thakarar

Journal of Maine Medical Center

Introduction: Syringe service programs (SSPs) reduce HIV and viral hepatitis transmission, as well as the prevalence of improperly disposed needles and needle stick injuries among first responders. Infections associated with injection drug use are rising in rural areas, including Maine, leading to concerns that SSP services are difficult to access for rural residents.

Methods: A cross-sectional survey of 101 participants hospitalized with infections associated with injection drug use at 4 hospitals in Maine was collected over a 15-month period. Descriptive analyses were performed. Statistical analyses were completed using Fisher’s exact tests, Pearson’s chi-squared tests, and Student’s t tests.

Results: Of …

Harm Reduction In Undergraduate And Graduate Medical Education: A Systematic Scoping Review, Kelsey R. Smith, Nina K. Shah, Abby L. Adamczyk, Lara C. Weinstein, Erin L. Kelly

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Substance use increasingly contributes to early morbidity and mortality, which necessitates greater preparation of the healthcare workforce to mitigate its harm. The purpose of this systematic scoping review is to: 1) review published curricula on harm reduction for substance use implemented by undergraduate (UME) and graduate medical education (GME) in the United States and Canada, 2) develop a framework to describe a comprehensive approach to harm reduction medical education, and 3) propose additional content topics for future consideration.

METHODS: PubMed, Scopus, ERIC: Education Resources Information Center (Ovid), and MedEdPORTAL were searched. Studies included any English language curricula about harm …

Naloxone Education To Improve Distribution In Primary Care: A Quality Improvement Project, Joanna Boback

DNP Projects

Significance and Background: Opioid overdose is a major public health problem in the United States. The Centers for Disease Control and Prevention (CDC) developed guidelines for prescribing opioids which have not been widely integrated into practice. These guidelines specify co-prescribing naloxone with opioids as a form of harm reduction. A policy to reflect these recommendations was needed to guide prescribing at a Federally Qualified Health Center (FQHC) in Connecticut to increase low naloxone prescribing rates. Evidence supported the use of provider education to increase prescribing rates.

Purpose: Deliver education to providers across the health system on best practices related to …

The Need For Sharps Boxes To Be Offered In The Hospital Setting For People Who Use Substances: Removing Sharps Boxes Puts All Of Us At Risk., Cheryl Forchuk, Michael Silverman, Abraham Rudnick, Jonathan Serrato, Brenna Schmitt, Leanne Scott

Nursing Publications

INTRODUCTION: Substance use can occur in the hospital setting among people with substance use disorder, including intravenous use. However, the provision of sharps boxes is not typically offered in Canadian hospitals. This study set out to explore the current issues due to the lack of harm reduction in the hospital setting.

METHOD: Thirty-one health care professionals participated in virtual one-to-one interviews and focus groups regarding harm reduction in hospital. The issue of sharps box removal was highlighted as a concern. A secondary ethnographic thematic analysis explored this theme in more detail. A scoping review of the literature observed additional considerations. …

Criterion Validity Of Protective Behavioral Strategies For Alcohol Consumption Among College Students, Abby L. Braitman, Amy Stamates, Melissa Colangelo, Sarah J. Ehlke, Jordan Ortman, Kristin E. Heron, Kate B. Carey

Psychology Faculty Publications

Background: Protective behavioral strategies (PBS), or behaviors used to reduce harm associated with alcohol use, are often associated with lower levels of alcohol consumption, lower engagement in high-risk drinking behaviors, and fewer alcohol-related consequences. Although the majority of studies have found significant associations between higher PBS use and lower consumption or consequences, some studies have found nonsignificant or even positive associations. One explanatory hypothesis is that the mixed findings are due to differential content in PBS measures. Objectives: The current study examined the criterion validity of two widely-used PBS measures, the PBSS and the SQ. In a multi-institution online …

Learning From Lived Experience: Substance Use Policies, Emergency Shelters, And Harm Reduction In London, On, Jesse Cram, Dena Salehipour

Undergraduate Student Research Internships Conference

Since 2018, the number of overdoses reported by London housing and emergency shelter agencies to the city of London has increased by 790%.These agencies currently have inconsistent overdose response policies that lack research-based support, and want to establish comprehensive best practices that support those involved at all levels.

Through a community based course, we initially collected and analyzed survey data from managers and staff from various London housing and emergency shelter agencies with the aim of understanding the limitations of the current approaches to the opioid crisis. Wanting to expand on this, our current project focuses on those who are …

Ethnic/Racial Differences In Alcohol Use: Does Drinking Refusal Self-Efficacy Matter?, P. Priscilla Lui, Savannah M. Krantz, Michael B. Madson

Faculty Publications

Introduction: College students—including those of Hispanic backgrounds—are at risk for hazardous drinking. Research has shown robust group differences between Hispanic and White individuals in alcohol use outcomes. The ability to resist alcohol consumption can be leveraged to reduce hazardous drinking; however, little research has examined Hispanic-White differences and whether drinking refusal self-efficacy accounts for group differences in hazardous drinking. Considering Hispanic individuals make up the largest ethnic/racial minority group in the United States, it is important to identify malleable psychological factors that prevent and reduce drinking problems. Method: Hispanic and White college students at two predominantly White institutions …

Monthly Trends Of Substance Use Among Mainers Receiving Buprenorphine Treatment During The Covid-19 Pandemic, Sarosh Khan

Journal of Maine Medical Center

Introduction: Drug-related deaths in Maine increased by 23% in the first quarter of 2020 compared to the last quarter of 2019. Most of these deaths were accidental overdoses involving at least one opioid, and 65% of these deaths were caused by fentanyl, according to the Maine Center for Disease Control and Prevention.

Methods: This research explored substance use in Maine during 2020. Among the sample of individuals, 46% were homeless and receiving recovery services at a buprenorphine-assisted treatment program at a federally qualified health center in Maine. Charts of 35 patients were reviewed for emergency room visits and urine drug …

Assessing The Feasibility, Acceptability, Appropriateness, Barriers, And Facilitators To Implementing Naloxone Distribution In Residential Areas At Ucf, Isabella S. Arguello-Howe

Honors Undergraduate Theses

With the rise of accidental fentanyl overdoses and recreational opioid use in college-aged populations, the need for campus-based overdose prevention and harm reduction measures is at an all-time high. Naloxone, an opioid antagonist, is an FDA-approved, lifesaving, medication which can be intranasally delivered by laypersons. Naloxone reverses opioid overdose, essentially buying time until an overdosing individual receives emergency medical attention. While some previous studies have examined access to naloxone on college campuses, to my knowledge no study has explored distribution of naloxone in residential college areas, such as dormitories and within Greek housing. Therefore, the purpose of this thesis was …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Implementing Evidence-Based Treatment Of Patients With Opioid Use Disorder In An Inpatient Addiction Treatment Center, Emily Ashley

Doctor of Nursing Practice

Patients with opioid use disorder are at increased risk for overdose and death should they relapse due to reduced opioid tolerance after a period of abstinence. A retrospective chart review was performed at an inpatient drug and alcohol treatment center to identify areas in need of improvement. The global aim of this project was to promote patient adherence to treatment, as well as increase the prevention of patient overdose and death after inpatient treatment. Project objectives include improving provider management of opioid use disorder through standardizing patient education, increasing prescription of relapse prevention medication, initiating prescription of naloxone at discharge …

Understanding Polarizing Community Perspectives On Harm Reduction Strategies: Challenges To Addressing The Opioid Crisis In Appalachian Pennsylvania, Stephanie L. Creasy Mph, Jessica R. Thompson Med, Christina F. Mair Phd, Jessica G. Burke Phd

Journal of Appalachian Health

Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide …

Opioid Use And Harm Reduction, Elise Bourassa, David Lee, Jason Rogers, Christian Silverthorne

Thinking Matters Symposium

Calls for various harm reduction approaches to the opioid epidemic are increasing in activist communities (Chapkis, 2020; Kennedy-Hendricks et al., 2019; Sederer & Marino, 2018). Given that harm reduction approaches, if implemented, will be provided by people in various helping professions, the current study investigates the relationship between choice of human service-focused college major and level of support for harm reduction interventions for people who use opioid drugs. A quantitative survey that aims to measure knowledge and perceptions of harm reduction strategies has been disseminated to students in social work, counseling, public health and nursing departments at the University of …

The Boilerworx Project: Mobile Public Health Advocacy, Carolanne Wartman, Kevin Fekete, Fatima Khan, Carrie Kovacik, Carol Ott, Nicole Noel, Catherine Scott

Purdue Journal of Service-Learning and International Engagement

BoilerWoRx is a mobile health initiative that was created in response to Indiana's opioid public health crisis. This College of Pharmacy program is multidisciplinary with students from engineering, nursing, liberal arts, and medicine. BoilerWoRx offers education to both students and community members. There is a comprehensive training for students who volunteer with the BoilerWoRx team, which include various educational Ted Talks, naloxone training, along with assessment tool trainings. For the community members at the events, drug disposal kits, wellness education, syringe service assistance, naloxone distribution, mental health assessments, and community resources are available.

Currently, BoilerWoRx is working with engineering students …

Harm Reduction In Prison Settings: A Relevant Approach To Reduce Hiv Transmission?, Amine Ghrabi

English Language Institute

Harm reduction defines a set of policies and interventions aiming to address the adverse health consequences associated with drug use. Compared to the general population, prisoners are disproportionally affected by HIV. Thanks to its strong emphasis on public health and human rights principles, harm reduction can effectively reduce transmission of HIV inside prison settings.

Group Treatment Effectiveness For Substance Use Disorders: Abstinence Vs. Harm Reduction, Jill D. Parramore

Counseling & Human Services Theses & Dissertations

The purpose of this systematic review and meta-analysis was to compare group treatment effectiveness for substance use disorders within the U.S. across treatment philosophies as it relates to the primary research question, Is there a significant difference of group treatment effectiveness between Abstinence and Harm Reduction treatment philosophies? It was hypothesized that group treatment will remain an effective intervention to treat substance use disorders between treatment philosophies and that no significant differences exist between-group comparisons. The aim of this study is to provide evidence of treatment effectiveness that will ultimately improve treatment outcomes for substance use disorders, provide guidance for …

Harm Reduction In The Emergency Department, Alexa J. Golden

Family Medicine Clerkship Student Projects

The number of overdose deaths in Vermont has been trending up over the past several years. A majority of these fatalities involved synthetic opioid fentanyl. The Emergency Department (ED) at Central Vermont Medical Center delivers medication assisted treatment (MAT) through the Rapid Access to MAT (RAM) program. This program has connected many people in the region to treatment for opiate use disorder. However it was identified that we lacked connection to harm reduction services for those not interested in MAT. Harm reduction education was provided for recovery coaches and ED nursing staff. Harm reduction kits containing life-saving supplies such as …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

Improving Contraception Among Female Syringe Exchange Clients: A Reproductive Needs Assessment, Gena Zollman

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Women with opioid and other substance use disorders have a high rate of unintended pregnancy and a low rate of effective contraceptive use. Integrating family planning (FP) services into medication-assisted treatment (MAT) clinics has increased rates of initiation and adherence to contraception among this population. This study assesses the reproductive health needs of female clients in a syringe exchange program (SEP)to assess if integrating FP services would improve access to contraception.

Methods: Female clients of a SEP voluntarily completed an anonymous survey to determine demographics, FP needs, and barriers to accessing care, and were compensated with $20 gift cards. …

Peer-Delivered Harm Reduction And Recovery Support Services: Initial Evaluation From A Hybrid Recovery Community Drop-In Center And Syringe Exchange Program, Robert D. Ashford, Brenda Curtis, Austin M. Brown

Faculty and Research Publications

Background: Recovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effective in improving SUD outcomes, as well as improving the engagement and effectiveness of harm reduction programs. Methods: This study provides an initial evaluation of a hybrid recovery community organization providing PRSS as well as peer-based harm reduction services via a syringe exchange program. Administrative data collected during normal operations of the …

Smoking And Exercise: Mechanisms And Effects During Simulated And Genuine Quit Attempts, Stefanie De Jesus

Electronic Thesis and Dissertation Repository

Cigarette smoking is a leading agent for premature morbidity and mortality among the global community. Most individuals surrender to tobacco use disorder due to the inability to cope with cravings and withdrawal symptoms. Exercise appears to provide acute relief. Currently, it is unclear how exercise attenuates these reductions. Furthermore, the available evidence has focused on acute outcomes besides smoking behaviour and is limited to simulated quit attempts. Three experimental studies were designed to address these outstanding issues. Not surprisingly, a bout of moderate intensity exercise was found in study 1 (chapter 2) to reduce cravings associated with a temporary period …

Perceived Harms And Benefits Of Parental Cannabis Use, And Parents’ Reports Regarding Harm-Reduction Strategies, Kathleen J. Donoghue

Theses: Doctorates and Masters

This research focussed on families in which at least one parent was a long-term cannabis user; I explored family members’ perceptions of the benefits and harms of cannabis use and the strategies parents used to minimise cannabis-related harm to themselves and their children. In depth, semi-structured interviews were undertaken with 43 individuals from 13 families, producing a series of family case studies that enabled examination of multiple perspectives within each family. In Study 1, I used an interpretive framework guided by Miles and Huberman’s (1994) thematic content analysis technique to analyse interview data, while study 2 yielded detailed descriptive vignettes …

Harm Reduction: Compassionate Care For Persons With Addiction, Robin Bartlett, Laura Brown, Mona Shattell, Thelma Wright, Lynne Lawallen

Mona Shattell

No abstract provided.

Harm Reduction And The American Difference: Drug Treatment And Problem-Solving Courts In Comparative Perspective, James L. Noland Jr.

Journal of Health Care Law and Policy

No abstract provided.

Keynote Speech On The Application Of Harm Reduction To Other Public Health Problems: What Is Similar Or Different About The Issue Of Tobacco?, Cheryl Healton

Journal of Health Care Law and Policy

No abstract provided.

Tobacco Litigation Without The Smoke? Cigarette Companies In The Smokeless Tobacco Industry, Micah L. Berman

Journal of Health Care Law and Policy

No abstract provided.

Tobacco Control And Snus: Time To Take A Stand, Lindsey C. Dastrup, Jacqueline M. Mcnamara

Journal of Health Care Law and Policy

No abstract provided.