Harm Reduction

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Harm Reduction

• G. Alan Marlatt, Ph.D.
• University of Washington
• Addictive Behaviors Research Center
• abrc_at_u.washington.edu
• [phone]

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Harm Reduction History

• U.K. Model
• Medicalization Approach
• Netherlands
• Normalization Approach
• Junkie bond

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Dutch Model

• Realistic and pragmatic
• Social/health approach
• Openness, Normalization leads to access,
  control
• Distinction between soft and hard drugs
• Low threshold treatment policies

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Dutch vs. American Drug Policies

• Low vs. High threshold access to prevention and
  treatment programs
• Public health vs. Criminal justice approach
• Tolerance vs. Zero-tolerance
• Normalization vs. Denormalization policies

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Harm Reduction Central Assumptions

• Public health alternatives to moral/criminal and
  disease models of drug use and addiction
• Recognizes abstinence as an ideal outcome, but
  accepts other alternatives
• Often partners with the group to obtain input on
  programs

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Harm Reduction Overview

• Harmful consequences of drug use can be placed on
  a continuum
• Goal to move along this continuum by taking
  steps to reduce harm

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Harm Reduction

• Habit is habit and not to be flung out of the
  window by any man, but coaxed downstairs a step
  at a time.
• Mark Twain,
• Puddnhead Wilsons Calendar,
• Chapter 6

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Harm Reduction Methods

• Safer route of drug administration
• Alternative, safer substances
• Reduce frequency of drug use
• Reduce intensity of drug use
• Reduce harmful consequences of drug use

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Harm Reduction Behavior Change

• Individual
• Environment
• Policy

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How was I supposed to know that the apple was a
controlled substance?
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Thank You.