Harm reduction

[rpn]

The Lord isn't into "less bad" (if it is not too presumptuous to say). He is into setting standards and expected people to meet them. Consequences always follow choices. No point in helping people avoid consequences, that only enables them to continue in their path.

[elguanteloko]

The Lord isn't into "less bad" (if it is not too presumptuous to say). He is into setting standards and expected people to meet them. Consequences always follow choices. No point in helping people avoid consequences, that only enables them to continue in their path.

Therefore, we should not help drug addicts unless they show sings of wanting to repent. If I see a drug addict unable to breath because his vomit blocks his airway, then I should let him die since there is "no point in helping people avoid consequences that only enables them to continue in their path".

We should also not let drunk drivers who cause accidents into hospitals, any driver who caused an accident, fat people with heart problems because of bad eating habits, etc.

[Deborah]

How do you know I haven't been there too?

Because you talked about your mom and dad as if you are still their little girl.

[birdgirl]

CFR please. If it's the quote I think it is, that's not really what he was saying.

In a letter to Nancy Rigdon after she declined his marriage proposal, Smith wrote:

"That which is wrong under one circumstance, may be, and often is, right under another.

[Deborah]

Therefore, we should not help drug addicts unless they show sings of wanting to repent. If I see a drug addict unable to breath because his vomit blocks his airway, then I should let him die since there is "no point in helping people avoid consequences that only enables them to continue in their path".

Now that is extrapolating something that wasn't even suggested. Of course if you see someone who is in such immediate need you will do all that you can to help him. This is not at all the same argument as handing out needles in hopes they use them while indulging in highly risky activity that you yourself said they don't care if they use clean or dirty needles.

[elguanteloko]

Now that is extrapolating something that wasn't even suggested.

The poster who wrote that may no have thought his ideas can lead to such disastrous results but it indeed does take you to those results if you follow it. Think about it.

Of course if you see someone who is in such immediate need you will do all that you can to help him.

I would but if I were to follow the poster's advice I would have to say that those people in need have to suffer the consequences of their actions.

This is not at all the same argument as handing out needles in hopes they use them while indulging in highly risky activity that you yourself said they don't care if they use clean or dirty needles.

Many studies indicate handing over clean needles reduces diseases and does not increase drug use.

[nicolasconnault]

Thanks everyone for your thoughtful replies. After reading them all, I have one particular wish: please, please, before you express opinions, read up on the topic! I suggested a wikipedia article in my OP, and some of the first replies were "I have no idea what you are talking about". That is sad, and shows a lack of willingness to learn anything related to drugs.

Harm reduction is a broad term and can be misinterpreted. It was never meant to replace therapies and substance use reduction strategies, but to complement it. While we help people break out the cycle of abuse, let's also help them avoid fatal and transmittable diseases such as HIV and Hepatitis C. Overcoming drug addiction is not only dependent on willingness to stop, willpower or faith in Christ. If you're addicted, you most likely need outside help and a lot of time. During that time, receiving clean needles helps you avoid additional damage.

This is similar to providing people with nicotine patches. We maintain their addiction to nicotine, but we greatly reduce the harm done by smoking it, including the harm to surrounding people. In time, this also helps them to discontinue their habit.

Study after study has shown that harm reduction, when properly implemented, leads to a reduction in use. The needle exchange services are always paired with use reduction services and positive messages, the few governments that allow harm reduction approaches are very cautious that no messages that condone drug use are given out.

I perfectly understand some of the gut-feeling reactions I've read here, but once you get more information, you will see that this is not necessarily a strategy of the devil to keep addicts addicted.

Furthermore, it makes a lot of sense from a public health perspective, and saves a heck of a lot of money on the care of people infected with HiV and HepC.

[dianaiad]

The point is that you are not enabling sin. You are not enabling teens to have sex by giving them condoms. You are not enabling the heroin addict to use heroin but you are helping him (and probably his family) not get HIV. You are giving him the option of using a needle 5 other people have used or use a clean needle.

That's hard...because you are, in fact, enabling sin.

When I was in high school, I participated in an experimental program (I didn't know it at the time..) where the teacher would give partial credit for wrong answers on tests, in the theory that it would enable learning and self-respect. What it DID, ultimately, is ensure that the average grade for these tests went down. Why? Because students caught on to the idea that they would get just enough points to keep going even if they didn't get the correct answer, so they saw no need to study. It got so bad that many of the tests were answered in ways that were laughable, sometimes insulting, and a complete waste of pencil lead. They were rewarded for making the wrong choices, and only rewarded a little more for making the right ones; they did not see the reward as worth the work.

So...this young heroine addict, being given clean needles, can stop worrying about one of the nastier possible consequences of heroine use; one less reason to stop. It's not that they DESERVE the consequences; it's not about punishment. It's about understanding consequences. Ammeliorating those consequences does not help them change their lives.

ON the other hand, it is very hard to see a loved one suffer. So...if I had the clean needles, would I deny them to my addicted child? I don't know.

What I DID do, though, is, along with my other son, kidnap my oldest, soma addicted son and haul his behind to rehab with the statement that if he didn't get clean, he couldn't come home until he was....and that he had to stay in rehab for nine full months, and for us, that worked. I know other parents for whom such a tactic does NOT work, so again, high flying principles are one thing, but what if?

I'm glad I don't have to make that choice. AT least, not now.

[nicolasconnault]

That's hard...because you are, in fact, enabling sin.

When I was in high school, I participated in an experimental program (I didn't know it at the time..) where the teacher would give partial credit for wrong answers on tests, in the theory that it would enable learning and self-respect. What it DID, ultimately, is ensure that the average grade for these tests went down. Why? Because students caught on to the idea that they would get just enough points to keep going even if they didn't get the correct answer, so they saw no need to study. It got so bad that many of the tests were answered in ways that were laughable, sometimes insulting, and a complete waste of pencil lead. They were rewarded for making the wrong choices, and only rewarded a little more for making the right ones; they did not see the reward as worth the work.

So...this young heroine addict, being given clean needles, can stop worrying about one of the nastier possible consequences of heroine use; one less reason to stop. It's not that they DESERVE the consequences; it's not about punishment. It's about understanding consequences. Ammeliorating those consequences does not help them change their lives.

ON the other hand, it is very hard to see a loved one suffer. So...if I had the clean needles, would I deny them to my addicted child? I don't know.

What I DID do, though, is, along with my other son, kidnap my oldest, soma addicted son and haul his behind to rehab with the statement that if he didn't get clean, he couldn't come home until he was....and that he had to stay in rehab for nine full months, and for us, that worked. I know other parents for whom such a tactic does NOT work, so again, high flying principles are one thing, but what if?

I'm glad I don't have to make that choice. AT least, not now.

Thanks for sharing that, it highlights the ambiguity of a problem which we tend to over-simplify. I have spoken to some recovering drug addicts who said emphatically that, to a hard user, contracting HiV or HepC is just a given, they don't even worry about it. It may be a deterrent for those considering taking up drugs, but it no longer is one for those who have been addicts for a long time. The same goes for the lifetime smokers. They no longer care if they eventually get lung cancer. Is their life not worth living because they have this attitude?

[elguanteloko]

That's hard...because you are, in fact, enabling sin.

When I was in high school, I participated in an experimental program (I didn't know it at the time..) where the teacher would give partial credit for wrong answers on tests, in the theory that it would enable learning and self-respect. What it DID, ultimately, is ensure that the average grade for these tests went down. Why? Because students caught on to the idea that they would get just enough points to keep going even if they didn't get the correct answer, so they saw no need to study. It got so bad that many of the tests were answered in ways that were laughable, sometimes insulting, and a complete waste of pencil lead. They were rewarded for making the wrong choices, and only rewarded a little more for making the right ones; they did not see the reward as worth the work.

So...this young heroine addict, being given clean needles, can stop worrying about one of the nastier possible consequences of heroine use; one less reason to stop. It's not that they DESERVE the consequences; it's not about punishment. It's about understanding consequences. Ammeliorating those consequences does not help them change their lives.

ON the other hand, it is very hard to see a loved one suffer. So...if I had the clean needles, would I deny them to my addicted child? I don't know.

What I DID do, though, is, along with my other son, kidnap my oldest, soma addicted son and haul his behind to rehab with the statement that if he didn't get clean, he couldn't come home until he was....and that he had to stay in rehab for nine full months, and for us, that worked. I know other parents for whom such a tactic does NOT work, so again, high flying principles are one thing, but what if?

I'm glad I don't have to make that choice. AT least, not now.

This is working under the assumption that, overall, giving people free syringes increases drug use... that is not true. http://drugwarfacts.org/cms/?q=node/66

[Pahoran]

This is working under the assumption that, overall, giving people free syringes increases drug use... that is not true. http://drugwarfacts.org/cms/?q=node/66

According to your pressure group, that is.

Another group that needs a good healthy dose of antioxidants.

Of course if you give a teenager a needle, or a condom, or anything else that enables "risk-free" self-destructive behaviour, the approval implicit in the action will completely overwhelm any verbal message of disapproval. How clueless would you have to be to assume anything else?

Regards,

Pahoran

[Nathair/|\]

Good to see you again, Nick. I was thinking about you the other day. I'm still in touch with Georgie Valcher.

Intuitively, I see no ethical problem with giving out clean needles, etc. If nothing else, it may be the only opportunity they have to experience the pure love of Christ. On the other hand, I would be uncomfortable with any such program being taxpayer funded.

Yours under the charitable oaks,

Nathair /|\

(Ps. Thanks for telling me about this place. It's blessed me a lot.

Samuel Smith)

[nicolasconnault]

According to your pressure group, that is.

Another group that needs a good healthy dose of antioxidants.

Of course if you give a teenager a needle, or a condom, or anything else that enables "risk-free" self-destructive behaviour, the approval implicit in the action will completely overwhelm any verbal message of disapproval. How clueless would you have to be to assume anything else?

Regards,

Pahoran

Another emotional response

1. Needle exchange programs (only one small part of the harm reduction approach) do not call their approach "risk-free"
2. Injecting drug users who share needles probably never come in contact with any health services. Through the needle exchange program, they do, which gives them loads of information about rehabilitation services, in addition to access to nurses and competent medical staff.
3. From experience, injecting drug users who make use of needle exchange facilities do not see it as "approval" of their behaviour.
4. Giving out condoms to teenagers is essentially different from providing needles to injecting drug users, for the following reasons:
   1. Drug users still have to obtain their drugs, which is most likely done illegally
   2. Drug addiction is very different from the sexual experimentation of teenagers. The social environment and repercussions on lifestyle are also fundamentally different between these two behaviours.
   3. Most users of needle exchange programs are not teenagers, but long-term users (I speak from experience)
      
      However, I agree that, if done incorrectly, harm reduction approaches could be detrimental and send out the wrong message. This is why I emphasised that the programs must be implemented appropriately.
      Overall I believe that people's negative responses have more to do with the general idea of giving out an instrument required for committing sin, than with the actual approach of harm reduction/minimisation.

[wenglund]

This is working under the assumption that, overall, giving people free syringes increases drug use... that is not true. http://drugwarfacts.org/cms/?q=node/66

According to Wikipedia article on Needle Exchange Programs: Rise in Drug Use: "However critics have noted that these studies demonstrate only that drug use has not increased for the recipients of needles or other injecting paraphernalia, but not measured whether the aura of acceptability that comes with providing equipment for a still illegal activity has increased initiation to illicit drug use at the population level. While studies designed to assess this concern may not be feasible or too costly, it is conversely clear from 12 month illicit drug prevalence data from Sweden, Australia and the United States indicate that concerted prevention efforts yield significantly lower levels of illicit drug use."

The concern isn't just the possible rise of drug use, but the lack of decline in drug use. A problem isn't considered solved on the basis that the problem doesn't get worse.

That same article also cast doubt on the effectiveness of NEPs and SEP in preventing various infectious diseases.

Thanks, -Wade Englund-

[Flyonthewall]

Thanks for sharing that, it highlights the ambiguity of a problem which we tend to over-simplify. I have spoken to some recovering drug addicts who said emphatically that, to a hard user, contracting HiV or HepC is just a given, they don't even worry about it. It may be a deterrent for those considering taking up drugs, but it no longer is one for those who have been addicts for a long time. The same goes for the lifetime smokers. They no longer care if they eventually get lung cancer. Is their life not worth living because they have this attitude?

Their life is worth living in spite of this kind of attitude. But the choices one makes in their life contribute to the type of life they will have. It is they, that de-value life, not those that don't contribute. It is not me that doesn't care if they get Hi'V or HepC, it is them. I would not give them the means to continue their habit, as that is the reason they would contract those diseases.

A clean needle quickly becomes a dirty needle, and it did not stop them from using.

[elguanteloko]

According to Wikipedia article on Needle Exchange Programs: Rise in Drug Use: "However critics have noted that these studies demonstrate only that drug use has not increased for the recipients of needles or other injecting paraphernalia, but not measured whether the aura of acceptability that comes with providing equipment for a still illegal activity has increased initiation to illicit drug use at the population level. While studies designed to assess this concern may not be feasible or too costly, it is conversely clear from 12 month illicit drug prevalence data from Sweden, Australia and the United States indicate that concerted prevention efforts yield significantly lower levels of illicit drug use."

The concern isn't just the possible rise of drug use, but the lack of decline in drug use. A problem isn't considered solved on the basis that the problem doesn't get worse.

The point of needle exchange programs is to reduce the spreading of diseases, not to lower drug use; there are other programs for that. As the starter of the OP has mentioned several times, this type of programs are only to attack a part of the problem.

That same article also cast doubt on the effectiveness of NEPs and SEP in preventing various infectious diseases.

Sure, but there are a bunch of more articles from different sources that strongly conclude the opposite. Again, check this link and the sources: http://drugwarfacts.org/cms/?q=node/66

[wenglund]

The point of needle exchange programs is to reduce the spreading of diseases, not to lower drug use; there are other programs for that. As the starter of the OP has mentioned several times, this type of programs are only to attack a part of the problem.

Sure, but there are a bunch of more articles from different sources that strongly conclude the opposite. Again, check this link and the sources: http://drugwarfacts.org/cms/?q=node/66

You didn't read the article I linked to, did you? It raises concerns regarded the studies used in many of the different articles and sources you linked to (and, yes, I read through your link).

Thanks, -Wade Englund-

[sunstoned]

If I were a desperate drug addict and my mom or dad saw that I was going to use an old needle and they had a clean one but withheld it to let me learn a lesson I'd feel like that was a sick and sadistic kind of love.

I believe this is so true. I don't have answers for anyone. My son is a heroin addict. It has destroyed his life, and has almost destroyed the lives of the family members who have tried to help him. My wife is damaged because of his choices. So am I. There are no easy answers. But the one thing I do know, that condescending, self righteous judgment will not help the situation. It turns people away.

A clean needle is better than a dirty needle. I would do that for my son to prevent further damage.

[nicolasconnault]

A pattern emerges from the answers to my OP: people who have first-hand experience with drug users and/or HiV/HepC tend to favour the harm minimisation approach, while those who argue only from logic and conjecture without the benefit of experience tend to dismiss it outright.

[Deborah]

A pattern emerges from the answers to my OP: people who have first-hand experience with drug users and/or HiV/HepC tend to favour the harm minimisation approach, while those who argue only from logic and conjecture without the benefit of experience tend to dismiss it outright.

Have you read anything? I speak from direct experience with drug users and I do not favor the "minimisation" approach.

[elguanteloko]

You didn't read the article I linked to, did you? It raises concerns regarded the studies used in many of the different articles and sources you linked to (and, yes, I read through your link).

Thanks, -Wade Englund-

Although that part in wikipedia has no source, there are sources that conclude that there is no increase in new users after NEPs are introduced. From http://consensus.nih.gov/

Needle Exchange Programs

An impressive body of evidence suggests powerful effects from needle exchange programs. The number of studies showing beneficial effects on behaviors such as needle sharing greatly outnumber those showing no effects. There is no longer doubt that these programs work, yet there is a striking disjunction between what science dictates and what policy delivers. Data are available to address three central concerns:

1. Does needle exchange promote drug use? A preponderance of evidence shows either no change or decreased drug use. The scattered cases showing increased drug use should be investigated to discover the conditions under which negative effects might occur, but these can in no way detract from the importance of needle exchange programs. Additionally, individuals in areas with needle exchange programs have increased likelihood of entering drug treatment programs.
2. Do programs encourage non

[nicolasconnault]

Have you read anything? I speak from direct experience with drug users and I do not favor the "minimisation" approach.

True. Hence my use of the words "tend to"

[wenglund]

Although that part in wikipedia has no source:

As expected, you are mistaken. See footnotes 22 to 32.

Thanks, -Wade Englund-

[rodheadlee]

I believe this is so true. I don't have answers for anyone. My son is a heroin addict. It has destroyed his life, and has almost destroyed the lives of the family members who have tried to help him. My wife is damaged because of his choices. So am I. There are no easy answers. But the one thing I do know, that condescending, self righteous judgment will not help the situation. It turns people away.

A clean needle is better than a dirty needle. I would do that for my son to prevent further damage.

Yep, most people here speak from a factual basis of 0. The compassionate ones have been there or a near relative has. I was strung out pretty good 25 years ago. I went to my new bishop (I kept moving to try and run from myself) for help, prayer, a blessing or something. All I got was "come back when you are clean". I was lucky to survive long enough to get clean. Actually, Heavenly Father saved my life several times so it wasn't really luck. Of course harm reduction helps the person live long enough (hopefully) to get clean and not spread disease to innocent victims. Harm reduction can simply be a friend who is addicted to heroine keeping another friend from using that particular drug. My junkie friends would not let use no matter what, we could smoke and snort anything else but no H. I thank them to this day for that.

Enough personal stuff, here are a few points.

1. Most drug addicts don't want to be addicted. They are well aware that they are on a path of destruction but they can't stop anyway.

2. Most drug addicts will only go as far as their moral upbringing to secure the next high. If they are not thieves to begin with, they won't start stealing to pay for it. If they are not promiscuous to start with, they won't start hooking to pay for it, etc..

3.They are among you. They are driving on your hiways to their next score, working in your offices and working on your construction sites. They are regular people with a huge problem. I hid my problem for years.

4.Harm reduction would include flop houses and legally obtained drugs. We are losing the drug war. Making all drugs legal would eliminate the black market and all the gang warfare that goes with it. When is the last time you heard about a smuggling war over booze? All of the law enforcement efforts that are now being used in the drug war could be aimed at border protection and anti terrorism efforts.

5.The money saved from the drug war could be used for rehabilitation for those that desire it. Interventions work, kind of like you see on TV. It has to be family members and friends that care. The person, yes we are people, has to desire to be clean first. The gospel is very important and comes with the 12 step program. I've reviewed the LDS program, I wish we had it back in 1984.

6. It's an endless battle, it may take 2 or 3 interventions until it sticks. The person may channel his addictive behavior towards less damning drugs.

I smoke and drink coffee, I struggle with the coffee and sometimes do well. I wake up every morning and tell myself that cigarettes are going to kill me but I still can't quit. The desire to get a TR will ultimately be my motivator. As bad as it seems, when ever I think of doing a big ol' line of coke or meth it makes me want to puke. I am so thankful for that healing from Jesus Christ that I'd like to help anybody any way that I can. Feel free to PM me.

[species373]

Fascinating discussion. How can we break this down to show influences from Mormon theology...

I think the folks that say consequences are there for a reason, that clean needles equate to enabling drug usage, etc. really connect with Jehovah of the Old Testament. That God is big on punishment and reward. If you slip and touch the Arc of the Covenant, too bad, you're still get zapped. It doesn't matter if it was an accident. This is the God of Tough Love: "Hey, Adam and Eve, go make your way in the cruel wide world. By the way, I made mosquitos just out of spite and you don't get indoor plumbing."

I see the people that lean towards harm reduction, i.e. "People are going to use drugs. Let's at least give them clean needles to minimize their stupidity.", these people tend to go with a Christ of the New Testament "Love the sinner, not the sin" sort of thought.

I see Joseph Smith handing out clean needles, but Brigham Young no. What do you guys think?