Temple University of the Commonwealth System of Higher Education
PROJECT ON HARM REDUCTION IN THE HEALTH CARE SYSTEM
About the Project
The Project on Harm Reduction in the Health Care System investigates the prescribing and dispensing of sterile injection equipment as one strategy for reducing harm to injection drug users who cannot or will not enter drug treatment. It aims to promote effective disease prevention and care among injection drug users, their partners and their children by identifying the legal factors that influence their health. Although many of the same laws apply to needle exchange programs and other harm reduction services, our project has focused on the role of health care providers and pharmacists in reducing harm during the regular course of their professional work.
The Problems We Address
The Public Health Problem
Use of unsterile injection equipment is the main way that drug users get HIV and hepatitis. People who get infected through injection can pass the disease on to their sex partners and their newborn children. Research has shown that drug users will use clean syringes if they can get them, but their ability to get and use them is limited by a web of drug paraphernalia, syringe prescription and pharmacy practice laws.
Physicians and pharmacists can help drug-injecting patients get clean needles and avoid getting or transmitting a fatal disease.
The Health Care Problem
Drug users are a medically underserved population. Injection drug use is fraught with risk, but many users do not ever see physicians, and those that do keep their drug use a secret. Users often do not have the opportunity or the help they need to get into drug treatment.
Prescribing syringes has the potential to draw drug users into medical treatment, and to help them be candid about their drug use with the physician. This gives the physician an opportunity to provide preventive care (like Hepatitis vaccination) and to facilitate entry into drug treatment.
The Political Problem
Despite the strong evidence that links poor syringe access to disease, political opposition to needle exchange programs and the lifting on limits on syringe possession is strong.
Greater physician and pharmacist involvement in preventing blood-borne disease among injection drug users can help reassure policy-makers and the public that changes in needle-access laws are rational and important.
The results of our legal research are presented here. They include:
Results have also been published in an article in the Annals of Internal Medicine: Burris S, Lurie P, Abrahamson D, Rich J. "Physician Prescription of Sterile Injection Equipment to Prevent HIV Infection: Time for Action".
In Phase II of the project, beginning in March 2001, we will be conducting a survey of physician attitudes about providing harm-reduction care for IDUs.
The legal opinions and conclusions expressed on this web site are those of the researchers and cannot be attributed to The Robert Wood Johnson Foundation or the Substance Abuse Policy Research Program, who funded this study.
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