Interventions: Harm reduction
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| Global State
of Harm Reduction 2008 [May 2008] |
| Mapping the response to drug-related HIV and hepatitis
C epidemics. Full
report 6MB PDF [IHRA] |
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| Public
Order and Supervised Injection Facilities [April 2008] |
| Vancouver’s SIS. 29-page OPDF [Neil Boyd, J. Bryan
Kinney, Carla McLean, Jon Heidt and Isabel Otter, Canada] |
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| Harm
Reduction Developments 2008 [April 2008] |
| Countries with Injection-Driven HIV Epidemics. 84- page
PDF [Open Society Institute] |
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Monograph
#6 A systematic review of harm reduction [December 2005] |
| This monograph (No. 06) reports on the systematic review of harm reduction.
Harm reduction was defined as policies and interventions that focus on
reducing the harms associated with drug use, not the amount of drug used.
The following interventions were reviewed: needle syringe programs; supervised
injecting facilities; non-injecting routes of administration; outreach;
HIV education and information and HIV testing and counselling; brief interventions
(aimed at harm reduction); overdose prevention interventions and legal
and regulatory frameworks. There is substantial evidentiary support for
NSP – as an efficacious, effective and cost-effective intervention.
There is also good evidentiary support for outreach. The other harm reduction
interventions (supervised injecting facilities, non-injecting routes of
administration, overdose prevention, and brief interventions) do not currently
have a sufficiently large body of research knowledge to draw strong conclusions.
There is little evidence for HIV education and information and HIV testing
and counselling as behaviour change interventions. |
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New Zealand Needle
and Syringe Exchange Programme Review [2005]
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The Centre for Harm Reduction was commissioned to review New Zealand's
Needle and Syringe Exchange Programme (NSEP) in March 2002 to assess
whether the NSEP is working in the most effective and efficient way possible
within available resources. The report includes recommendations for action
to improve the effectiveness of needle exchange services in New Zealand
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Burnet Institute
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Harm Reduction
for IDU's in Vietnam [2005]
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A situation assessment detailing the National AIDS Standing Bureau,
Vietnam and the Macfarlane Burnet Centre for Medical Research project
aimed at increasing institutional capacity to respond to the current
HIV epidemic among injecting drug users and to develop effective, sustainable
and culturally appropriate harm reduction interventions.
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Burnet Institute
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The
Vietnamese Harm Reduction Project: Stage 2 [2005]
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Report on the Stage 2 project, undertaken as a continuation of the original
The Vietnamese Harm Reduction and IDU project. Stage 2 provided an opportunity
to build on and expand earlier research findings and respond to some
of the questions and issues raised by the former project. Findings from
the former project indicated that patterns of drug use amongst the heroin
users of Vietnamese ethnicity in the study differed significantly from
Anglo-Australian users, typically found in the literature [Burnet Institute]
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Economic
Evaluation of Hepatitis C [August 2005]
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The Australian Government and State and Territory Governments have committed
to a variety of harm reduction, prevention and education initiatives
in order to mitigate the spread of hepatitis C and other blood borne
viruses. About 90% of incident cases of hepatitis C occur amongst injecting
drug users (IDUs). This report is an economic evaluation of programs
to control the hepatitis C epidemic [The Australian Government Department
of Health and Ageing]
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Needle and
syringe program policy and guidelines for NSW [2005]
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This document outlines the broad operational guidelines for Needle and
Syringe Programs. It is intended as a framework within which Area Health
Services can develop detailed operational guidelines appropriate to their
own setting [NSW Department of Health, Australia]
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Pointing
the Way: Harm Reduction in Kyrgyz Republic [May 2005]
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Unlike many countries in the former Soviet Union, Kyrgyzstan has responded
to the spread of HIV infection with an aggressive plan to reduce health
risks associated with drug use, including measures to protect those unable
or unwilling to stop injecting drugs
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International Harm Reduction Development Program
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Harm
reduction policies and programs for persons involved in the criminal
justice system [May 2005]
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Canadian Centre on Substance Abuse (CCSA), May, 2005
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Protecting
the Human Rights of Injecting Drug Users: The Impact of HIV and AIDS [February
2005]
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Compiling statements given at the 2004 session of the UN Commission
on Human Rights, this IHRD-produced volume argues that unduly strict
interpretation of UN drug control treaties undermines HIV prevention
efforts by discouraging countries from implementing effective, realistic,
and compassionate public health policies
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International Harm Reduction Development Program
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Effectiveness
of sterile needle and syringe programming in reducing HIV/AIDS among
injecting drug users. [2004]
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Providing access to and encouraging utilization of sterile needles and
syringes for IDUs is now generally considered to be a fundamental component
of any comprehensive and effective HIV-prevention programme. [World Health
Organization 2004]
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The
National HIV/AIDS Strategy 1999-2000 to 2003-2004: Changes and Challenges [2004]
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Published by Commonwealth Department of Health and Aged Care
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Evaluation of the
Supervised Injection Site - Year One Summary [2004]
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BC Centre for Excellence in HIV/AIDS, September 17, 2004
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Status Paper on
Prisons, Drugs and Harm Reduction [2004]
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The Status Paper on Prisons, Drugs and Harm Reduction was adopted at
the WHO International Meeting on Prisons and Health in De Leeuwenhorst,
the Netherlands on 22 October 2004.
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WHO
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Lessons Not Learned:
Human Rights Abuses and HIV/AIDS in the Russian Federation [2004]
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This 62-page report documents how harsh drug policies and routine police
harassment of injection drug users—the population hit hardest by AIDS
in Russia—impedes their access or makes them afraid to seek basic HIV-prevention
services such as syringe exchange, which is available in other countries
around the world
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Human Rights Watch
HRW Index No.: D1605 April 28, 2004
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A review of the
evidence-base for harm reduction approaches to drug use [2003]
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This overview addresses both understandings of harm reduction and summarises
its key principles before going on to consider the strength and nature
of the evidence of the effectiveness of various forms of ‘harm reduction’ intervention.
In doing so, some consideration is also given to criticisms of harm reduction
that are occasionally encountered
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Neil Hunt, contributions from Mike Ashton, Simon Lenton, Luke Mitcheson,
Bill Nelles and Gerry Stimson
Forward Thinking on Drugs 2003
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Manual for Reducing
Drug Related Harm in Asia (2003) [2003]
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This Manual contains the accumulated experience of over decade of attempts
to change policy and implement programs to stop HIV and other harms among
drug users, collected over several years from many countries in Asia
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Burnet Institute
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Injecting Reason:
Human Rights and HIV Prevention for Injection Drug Users California:
A Case Study [2003]
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Government interference with sterile syringe programs is thwarting HIV
prevention efforts in California
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Human Rights Watch
HRW Index No.: G1502 September 9, 2003
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Fanning the Flames:
How Human Rights Abuses are Fueling the AIDS Epidemic in Kazakhstan [2003]
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Human rights abuse against injection drug users and sex workers in Kazakhstan
is fueling one of the fastest growing AIDS epidemics in the world
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Human Rights Watch
HRW Index No.: D1504 June 30, 2003
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Locked Doors: The
Human Rights of People Living with HIV/AIDS in China [2003]
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Widespread discrimination against people with HIV/AIDS is fueling the
spread of the epidemic in China. This 94-page report is based on more
than 30 interviews with people with HIV/AIDS, police officers, drug users,
and AIDS outreach workers in Beijing, Hong Kong, and Yunnan province
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Human Rights Watch
HRW Index No.: C1507 September 3, 2003
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Abusing the User: Police Misconduct,
Harm Reduction and HIV/AIDS in Vancouver [2003]
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An anti-drug crackdown by the Vancouver Police Department has driven
injection drug users away from life-saving HIV prevention services, raising
fears of a new wave of HIV transmission in the city that is already home
to the worst AIDS crisis in the developed world
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Human Rights Watch
HRW Index No.: 1502B May 7, 2003
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Reducing
the harm of drugs [2003] |
| Some have perceived a contradiction between drug prevention and treatment
on the one hand and efforts to reduce the negative health and social consequences
of drug use on the other. However, in a new discussion paper,
UNODC says that these are in fact complementary rather than contradictory
[UNODC] |
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International
law tackles harm reduction [2002]
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It has emerged from a legal study published by the Pompidou Group (1),
some extracts of which are given below, that harm reduction strategies
can sometimes be in contradiction with the international drug control
laws. Two experimental harm reduction strategies have come up against
legal barriers in this way: drug testing at rave parties and the medical
prescription of heroin for relapsed drug users
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Professor Brice de Ruyver University of Gand, Belgium 2002
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Dependent
on Rights: Assessing Treatment of Drug Dependence from a Human Rights
Perspective
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Social attitudes toward, and criminalization of, people who use illegal
drugs have apparently influenced the practice and policy of treatment
for drug dependence in many countries. The already precarious human rights
situation of people who use drugs is compounded by the inability of a
large percentage of them to receive humane, effective, timely and affordable
treatment for their addiction. 46-page PDF [Canadian HIV/AIDS Legal Network]
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Sticking
Points: Barriers to Access to Needle and Syringe Programs in Canada
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Barriers persist that prevent people who use drugs from free access
to sufficient sterile injection equipment. 47-page PDF [Canadian HIV/AIDS
Legal Network]
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Harm
Reduction Policies and Programs for Persons of Aboriginal Descent
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A 20-page document created to inform the implementation of policies
and programs for reducing harm associated with substance abuse by people
of aboriginal descent [CCSA/CCLAT, Canada]
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International
Human Rights Jurisprudence on Issues Relating to Drug Use and Harm
Reduction
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Commissioned by the Open Society Institute Law and Health Initiative,
this research paper reviews jurisprudence from treaty-monitoring bodies
of the United Nations and selected regional and national human rights
courts that can be used to advocate for the human rights of people who
use drugs. 24-page PDF [Open Society Institute, USA]
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HIV/AIDS
Prevention, Care, Treatment and Support in Prison Settings
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A Framework for an Effective National Response. 50-page PDF [WHO/UNAIDS]
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Deadly
Denial
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This 57-page PDF report found that routine police harassment and arrest – as
well as the lasting effects of former Prime Minister Thaksin Shinawatra’s
2003 drug war – keeps drug users from receiving lifesaving HIV information
and services that Thailand has pledged to provide [Human Rights Watch]
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AIDS
in South Asia: Understanding and Responding to a Heterogeneous Epidemic
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A 131-page PDF report analyzing South Asia's HIV/AIDS epidemic and offering
recommendations for halting its spread [World Bank, UNODC]
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Return
on Investment in Needle and Syringe Programs in Australia - Report
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The study updates and expands a study previously undertaken by Hurley,
Jolley and Kaldor which investigated the effectiveness and cost effectiveness
of needle and syringe programs in relation to HIV/AIDS
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The
Vietnamese Injecting Drug Use & Harm Reduction Study: Stage 1
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In 1995, the Centre for Harm Reduction conducted a collaborative, exploratory
study, the VIDU study, as the beginning of a program of research, specifically
targeting Vietnamese IDUs. The study was the first of its kind in Victoria,
Australia and the first to document extremely high rates of HCV in this
group
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Burnet Institute
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Capacity
Building for IDUs India
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Report on capacity building for HIV prevention among injecting drug
users
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Burnet Institute
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Needle Exchange
Provision in Scotland
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A Report of the National Needle Exchange Survey [NHS - Scotland, UK]
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Needle
and syringe programs
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Position paper - Australian National Council on Drugs
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WHO Releases
Report On Role In Supporting 3 By 5 Initiative
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The report - which follows the release of a 2005 report that says WHO
missed its 3 by 5 Initiative target - identifies future collaboration
opportunities between WHO and partners and gives recommendations for
the "way forward" [WHO]
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Substitution
maintenance therapy in the management of opioid dependence and HIV/AIDS
prevention
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WHO/UNODC/UNAIDS position paper
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Evidence for
Action on HIV/AIDS and Injecting Drug Use
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5 Policy briefs [WHO]
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The Report of
the Independent Working Group on Drug Consumption Rooms
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A detailed examination of whether Drug Consumption Rooms (DCRs) should
be introduced in the UK [JRF, UK]
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Legislating for Health
and Human Rights: Model Law on Drug Use and HIV/AIDS
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Many countries with injection-driven HIV/AIDS epidemics continue to
emphasize criminal enforcement of drug laws over public health approaches,
thereby missing or even hindering effective responses to HIV/AIDS. There
is considerable evidence that numerous interventions to prevent HIV transmission
and reduce other harms associated with injection drug use are feasible,
effective as public health measures and cost-effective [Aidslaw, Canada]
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Preventing HIV Infection
among Injecting Drug Users in High Risk Countries
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An Assessment of the Evidence - a free online publication authored by
the Board on Global Health (BGH) and the Institute of Medicine (IOM)
[National Academic Press, USA]
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Monitoring
Drug Policy Outcomes: The Measurement of Drug Related Harm
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This latest Report from the Beckley Foundation Drug Policy Programme
looks at the various attempts by governments and academic institutions
to develop a methodology for assessing and measuring the level of drug
related harm, in order to better understand the impact of illegal drug
use on society, and of policies and programmes that aim to reduce that
impact
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Closed
to Reason: The International Narcotic Board and HIV/AIDS
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A 37-page report arguing that the International Narcotics Board hampers
efforts to address the HIV epidemic among injecting drug users [Policy
Pointers Worldwide]
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Hepatitis
C in Prisons: Evolving Toward Decency Through Adequate Medical Care
and Public Health Reform
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Hepatitis C in prisons is a public health crisis tied to current drug
policy's emphasis on the mass incarceration of drug users. Prison policy
acts as a barrier to hepatitis C care by limiting medical care for the
infected, especially drug users, and by inhibiting public health measures
addressing the epidemic [SSRN / University of California, Los Angeles
- School of Law, USA]
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How Effective
is Micro Harm Reduction in Reducing Macro Harm?
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MacCoun (1996) distinguishes between micro and macro harm reduction
and notes that reducing micro harm (harm per unit of use) may or may
not reduce macro (aggregate) harm depending on its effect on use. We
present a simple model that relates micro and macro harm through five
parameters: price, quantity, elasticity of demand, elasticity of supply,
and the social cost of drug use. Parameterizing the relationship for
the US cocaine market in 1992 suggests that about 75% of the apparent
benefit of reducing micro harm experienced by users would be offset by
increases in use. This suggests that reducing micro harm experienced
by users has merit but that reducing the costs drugs impose on non-users
may merit greater attention, since reducing those costs carries no risk
of being offset by increases in use
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Jonathan P. Caulkins
Carnegie Mellon, Heinz School
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HIV/AIDS and Drug Misuse
in Russia: Harm Reduction Programmes and the Russian Legal System
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Professor Butler’s report breaks new ground in the HIV/AIDS prevention
literature by reviewing harm reduction initiatives and programmes in
the context of Russian and international law.
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International Family Health
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Prison
Needle Exchange
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Lessons from a Comprehensive Review of International Evidence and Experience
109-page PDF [Canadian HIV/AIDS Legal Network]
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Ukraine: Anti-AIDS
Efforts Undermined by Rights Abuses
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The 84-page report, “Rhetoric and Risk: Human Rights Abuses Impeding
Ukraine’s Fight Against HIV/AIDS,” documents how draconian drug laws
and routine police abuse of injection drug users – the population hardest
hit by HIV/AIDS in Ukraine – keep them from receiving lifesaving HIV
information and services that the government has pledged to provide [Human
Rights watch, USA]
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Prescribing
heroin: what is the evidence?
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Until recently, the UK was the only country in the world that allowed
doctors to prescribe heroin for the treatment of opiate dependence. The
Government wants heroin prescribing to increase and to be made available
to all those who have a clinical need for it. This report, by Gerry Stimson
and Nicky Metrebian from the Centre for Research on Drugs and Health
Behaviour at Imperial College, looks at the reasons for international
interest in prescribing heroin. It critically examines the research,
clinical, political and practical challenges to expanding heroin prescribing
in the UK
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Gerry V. Stimson and Nicky Metrebian
Joseph Rowntree Foundation (ISBN 1 85935 082 8)
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Key
documents on HIV prevention and care for Injecting Drug Users
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The (Australian) National Drug and Alcohol Research Centre has recently
assessed the top 50 papers on harm reduction and HIV. Eighteen topics
were covered [International Harm Reduction Association]
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Declaration
of Commitment on HIV/AIDS
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Declaration of Commitment on HIV/AIDS and Political Declaration on HIV/AIDS:
focus on progress over the past 12 months - Report of the Secretary-Genera.
23-page PDF l [United Nations]
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Dependent
on Rights: Assessing Treatment of Drug Dependence from a Human Rights
Perspective
|
|
Social attitudes toward, and criminalization of, people who use illegal
drugs have apparently influenced the practice and policy of treatment
for drug dependence in many countries. The already precarious human rights
situation of people who use drugs is compounded by the inability of a
large percentage of them to receive humane, effective, timely and affordable
treatment for their addiction. 46-page PDF [Canadian HIV/AIDS Legal Network]
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HIV/AIDS
in prisons in Central and Eastern Europe and the former Soviet Union
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This info sheet reviews what is known about HIV/AIDS and hepatitis C
in prisons, with a focus on Central and Eastern Europe and the former
Soviet Union. (28-page PDF) [Aidslaw, Canada]
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Ukraine: Anti-AIDS
Efforts Undermined by Rights Abuses
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The 84-page report, “Rhetoric and Risk: Human Rights Abuses Impeding
Ukraine’s Fight Against HIV/AIDS,” documents how draconian drug laws
and routine police abuse of injection drug users – the population hardest
hit by HIV/AIDS in Ukraine – keep them from receiving lifesaving HIV
information and services that the government has pledged to provide [Human
Rights watch, USA]
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“Unlocking
Potential: Making Prisons Safe for Everyone”
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Report of the 8th European Conference of Drug and HIV/AIDS Services
in Prison 149-page PDF [ENDIPP, Europe]
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Declaration
of Commitment on HIV/AIDS
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Declaration of Commitment on HIV/AIDS and Political Declaration on HIV/AIDS:
focus on progress over the past 12 months - Report of the Secretary-Genera.
23-page PDF l [United Nations]
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Harm reduction approaches
to injecting drug use
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[WHO]
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