Lecture 10: Harm Reduction

Harm Reduction

evidence-based, client-centred approach, to reduce health and social harms associated with addiction and substance use, without requiring people who use substances from abstaining or stopping

Common Drugs

fentanyl (downer) and methamphetamine (upper)

Fentanyl

downer; opioid agonist, prescribed for pain management

Fentanyl Use

pain relief, drowsiness//exhaustion, nausea, unconscious, trouble breathing, no eye contact

Methamphetamine

upper; monoamine (DA, 5-HT, NE) agonist; people feel energetic, motivated

Meth Use

high energy, no sleep for days → fatigue, reckless, tremors, appetite loss, seizures, psychosis

Naloxone

used as a fast-acting medication to reverse the effects of opioid overdose/poisoning

Drug Poisoning Signs/Symptoms

breathing slow or gone; tiny pupils, blue lips/nails, cold/clammy, not moving, choking or gurgling sounds or snoring

Drug Poisoning Prevention

stored at 15-25, no known harmful effects; shout/shake, call 911, give naloxone, rescue breathing/chest compressions, is it working? → second dose at 3 minutes, 3rd at 5 mins

Aftercare

onset of action → 3-17 minutes; immediate withdrawal symptoms last 30-90 mins, may return

Withdrawal Symptoms

nausea, vomiting, dizziness, headache, irritability, increased HR, abdominal pain

Safe Supply

clean equipment, legally regulated drugs, withdrawal management treatments (OAT)

Withdrawal Managements

medication with longer half-life; OAT (opioid agonist therapy)

Opioid Agonist Therapy

treatment for addiction to opioid drugs, involves opioid agonists; prevent withdrawal and reduce cravings for opioid drugs

Methadone

methadose; synthetic opioid, 24-36 half-life, precipitated withdrawal, 4x poisoning risk

Suboxone

buprenorphine + naloxone; 37 half-life, less sedation

Sublocade

buprenorphine; 43-60 days half-like, may experience sedation

Abstinence

cannot force someone into it; relapse mechanisms, self motivation, after care

Relapse Mechanism

take your brain over a year to heal dopamine receptors

Self Motivation

may not complete program or relapse after treatment; detoxification required + encouraged prior to treatment; 4-6x in treatment before long-term sobriety; crucial for treatment

Aftercare

programs tend to offer aftercare programs to maintain a connection with community; STC has