University of New England, Australia
Cynthia Stuhlmiller is Professor of Rural Nursing at the University of New England School of Health in Armidale Australia. She has been a joint appointment professor for over 17 years at 8 Universities in 5 countries. Her clinical work is in mental health and CBT self-help applications.
Harm minimization is the long standing philosophy underpinning national and state drug strategies in Australia. This public health approach is founded on three pillars of 1) reducing the supply of harmful substances, 2) reducing the demand for their use, and 3) reducing the health-related harm associated with use of drugs. To date, supply reduction has been shown to be complicated, expensive, and ineffective. Demand reduction, or programs aimed to discourage people from wanting drugs, has been shown to work best for those who need them least. There is however strong evidence to support the beneficial effects of harm reduction approaches in decreasing morbidity and mortality by abating spread of HIV and hepatitis C infection. Harm reduction focuses first on reducing the negative consequences of drug use, rather than promoting abstinence. From this paradigm it is argued that programs should be available to help keep addicted people as safe as possible. Yet to what extend has this approach treated addition or reduced the harm created by continuation of addiction and its progression? A “new recovery” approach for addictions is taking hold in United States, United Kingdom and now Australia. New recovery recognises that “interventions to combat complex behavioural difficulties need more holistic responses, and far better co-ordination of a range of government and community services, particularly at grass-roots levels. Recovery pathways are contingent upon matters such as housing, work, access to education, child welfare, protection of vulnerable people, health services more generally and the ability to meaningfully participate in communities”. In Australia, new recovery has been met with controversy by the harm reduction community. This presentation will outline the key issues and concerns of harm reduction and new recovery as they relate to addition therapy and engage the participants in debate. A case example of a needle syringe program in Australia will be used to highlight the relevant points.
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