Bosque-Prous Marina, Brugal María Teresa
Agencia de Salut Pública de Barcelona, Barcelona; Institut d'Investigació Biomèdica Sant Pau, Barcelona; Universitat Pompeu Fabra, Barcelona, España.
Agencia de Salut Pública de Barcelona, Barcelona; Institut d'Investigació Biomèdica Sant Pau, Barcelona; Universitat Pompeu Fabra, Barcelona, España.
Gac Sanit. 2016 Nov;30 Suppl 1:99-105. doi: 10.1016/j.gaceta.2016.04.020.
Harm reduction encompasses interventions, programmes and policies that seek to reduce the negative consequences of the consumption of both legal and illegal drugs on the individual and public health. Harm reduction looks to mitigate the harm suffered by drug users through drug use monitoring and prevention, and promotes initiatives that respect and protect the human rights of this population. The harm reduction policies that have proven effective and efficient are: opioid substitution maintenance therapy (methadone); needle and syringe exchange programmes; supervised drug consumption rooms; and overdose prevention through peer-based naloxone distribution. In order to be effective, these policies must have comprehensive coverage and be implemented in areas where the target population is prevalent. Resident-based opposition to the implementation of these policies is known as the NIMBY (Not In My Back Yard) phenomenon, which is characterised by being against the implementation of new measures in a particular place, but does not question their usefulness. Given that any NIMBY phenomenon is a complex social, cultural and political phenomenon, it is important to conduct a thorough analysis of the situation prior to implementing any of these measures. Harm reduction policies must be extended to other substances such as alcohol and tobacco, as well as to other conditions beyond infectious/contagious diseases and overdose.
减少伤害包括旨在减少合法和非法药物消费对个人和公共健康产生的负面后果的干预措施、项目和政策。减少伤害旨在通过药物使用监测和预防来减轻吸毒者所遭受的伤害,并推动尊重和保护这一人群人权的举措。已被证明有效且高效的减少伤害政策有:阿片类药物替代维持疗法(美沙酮);针头和注射器交换项目;受监管的药物消费室;以及通过基于同伴的纳洛酮分发预防药物过量。为了有效,这些政策必须具备全面覆盖范围,并在目标人群普遍存在的地区实施。基于居民的对这些政策实施的反对被称为“邻避”(不在我家后院)现象,其特点是反对在特定地点实施新措施,但并不质疑其有用性。鉴于任何邻避现象都是一种复杂的社会、文化和政治现象,在实施任何这些措施之前对情况进行彻底分析很重要。减少伤害政策必须扩展到酒精和烟草等其他物质,以及传染病/传染性疾病和药物过量之外的其他情况。