Responsible drug use
Encyclopedia
Responsible drug use is a harm reduction
strategy based on a belief that illegal
recreational drug use
can be responsible in terms of reduced or eliminated risk of negative impact on the lives of both the user and others.
Some critics believe that all illegal recreational use is inherently irresponsible, due to the unpredictable, unregulated nature of the drugs and the risks of addiction
, infection, and other side effects. Nevertheless, harm reduction advocates claim that the user can be responsible by employing the same general principles applicable to the use of alcohol: avoiding hazardous situations, excessive doses, hazardous combinations of drugs, using the smallest dose necessary, avoiding injection, and not using drugs at the same time as activities that may be unsafe without a sober state.
(or "pilot"). They also propose some ethical guidelines, such as; a person should never trick or persuade anyone to use a drug; a person should not allow drug use to overshadow other aspects of their life (i.e. financial and social responsibilities); a person should be morally conscious of the source of the drugs that a person is using.
Duncan and Gold suggested that responsible drug use involves responsibility in three areas: situational responsibilities, health responsibilities, and safety-related responsibilities. Among situational responsibilities they included concerns over the possible situations in which drugs might be used legally. This includes the avoidance of hazardous situations; not using when alone; nor using due to coercion or when the use of drugs itself is the sole reason for use. Health responsibilities include: avoidance of excessive doses or hazardous combinations of drugs; awareness of possible health consequences of drug use; and not using a drug recreationally during periods of excessive stress. Safety-related responsibilities include: using the smallest dose necessary to achieve the desired effects; using only in relaxed settings with supportive companions; avoiding the use of drugs by injection; and not using drugs while performing complex tasks or those where the drug might impair one's ability to function safely.
Responsible drug use is emphasized as a primary prevention technique in harm-reduction drug policies. Harm-reduction policies were popularized in the late 1980s although they began in the 1970s counter-culture where users were distributed cartoons explaining responsible drug use and consequences of irresponsible drug use.
socially and economically. Drug use may affect work performance; however, drug testing should not be necessary if this is so, as a user's work performance would be observably deficient, and be grounds in itself for dismissal. In the case of discriminate use of amphetamines and similar drugs, work capacity actually increases. While some people may be able to use some drugs for many years without serious consequences, others may have an unexpected reaction to the drug, even on first use. While funds are diverted from drug research and testing to law enforcement, the reasons for these discrepancies, and therefore the means to remove or avoid harmful consequences remain elusive.
to drugs, diluting them; when a user, expecting a low dose, procures "uncut" drugs, an overdose can result.
The morality of buying certain illegal drugs is also questioned given that the trade in cocaine
, for instance, has been estimated to cause 20,000 deaths a year in Colombia
alone. Increasing western demand for cocaine causes several hundred thousand people to be displaced from their homes every year, indigenous people are enslaved to produce cocaine and people are killed by the land mines drug cartels place to protect their coca crops. However the majority of deaths currently caused by the illegal drug trade can only take place in a situation in which the drugs are illegal. The illegality of drugs in itself may also cause social and economic consequences for those using them, and legal regulation of drug production and distribution could alleviate these and other dangers of illegal drug use.
as applied to drug use began as a philosophy in the 1980s aiming to minimize HIV transmission between intravenous drug users. It also focused on condom usage to prevent the transmission of HIV through sexual contact.
Harm reduction worked so effectively that researchers and community policy makers adapted the theory to other diseases to which drug users were susceptible, such as Hepatitis C
.
Harm reduction seeks to minimize the harms that can occur through the use of various drugs, whether legal (e.g. alcohol
and nicotine
), or illegal (e.g. heroin and cocaine
). For example, people who inject illicit drugs can minimize harm to both themselves and members of the community through proper injecting technique, using new needles and syringes each time, and through proper disposal of all injecting equipment. Smoking a 700-mg. tobacco cigarette or cannabis joint
(with the attendant heat shock
, carbon monoxide
, and combustion toxins) can be avoided by serving individual 25-mg. "single tokes" in a miniature pipe or using a vaporizer
.
Other harm reduction methods have been implemented with drugs such as crack cocaine
. In some cities, peer health advocates (Weeks, 2006) have participated in passing out clean crack pipe mouthpiece tips to minimize the risk of Hepatitis A, B and C and HIV due to sharing pipes while lips and mouth contain open sores.
The responsible user therefore minimizes the spread of blood-borne viruses such as hepatitis C and HIV in the wider community.
by providing the injection drug user with a clean space and clean materials such as needles, sterile water, alcohol swabs, and other items used for safe injection.
Vancouver
, British Columbia
opened a SiS called Insite
in its poorest neighbourhood, the Downtown Eastside
. Insite was opened in 2003 and has dramatically reduced many harms associated with injection drug use. The research arm of the site http://www.vch.ca/sis/research.htm, run by The Centre of Excellence for HIV/AIDS has found that SiS leads to increases in people entering detox and addiction treatment without increasing drug-related crime. As well, it reduces the littering of drug paraphernalia (e.g., used needles) on the street and reduces the number of people injecting in public areas. The program is attracting the highest-risk users, which has led to less needle-sharing in the Downtown Eastside community, and in the 453 overdoses which occurred at the facility, health care staff have saved every person.
In the Netherlands
, where drug use is considered a social and health-related issue and not a law-related one, the government has opened clinics where drug users may consume their substances in a safe, clean environment. Users are given access to clean needles and other paraphernalia, monitored by health officials and are given the ability to seek help from drug addiction.
Due to the project's initial success in reducing mortality ratios and viral spread amongst injection drug users, other projects have been started in Switzerland
, Germany
, Spain
, Australia
, Canada
and Norway
. France
, Denmark
and Portugal
are also considering similar actions.
Harm reduction
Harm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
strategy based on a belief that illegal
Drug prohibition law
Drug prohibition law is prohibition-based law by which governments prohibit, except under licence, the production, supply, and possession of many, but not all, substances which are recognised as drugs, and which corresponds to international treaty commitments in the Single Convention on Narcotic...
recreational drug use
Recreational drug use
Recreational drug use is the use of a drug, usually psychoactive, with the intention of creating or enhancing recreational experience. Such use is controversial, however, often being considered to be also drug abuse, and it is often illegal...
can be responsible in terms of reduced or eliminated risk of negative impact on the lives of both the user and others.
Some critics believe that all illegal recreational use is inherently irresponsible, due to the unpredictable, unregulated nature of the drugs and the risks of addiction
Substance use disorder
Substance use disorders include substance abuse and substance dependence. In DSM-IV, the conditions are formally diagnosed as one or the other, but it has been proposed that DSM-5 combine the two into a single condition called "Substance-use disorder"....
, infection, and other side effects. Nevertheless, harm reduction advocates claim that the user can be responsible by employing the same general principles applicable to the use of alcohol: avoiding hazardous situations, excessive doses, hazardous combinations of drugs, using the smallest dose necessary, avoiding injection, and not using drugs at the same time as activities that may be unsafe without a sober state.
Rules
Duncan and Gold argue that to use controlled and other drugs responsibly, a person must adhere to a list of principles. They argue that drug users must understand and educate themselves on the effects and legal status of the drug they are taking, measure accurate dosages and take other precautions to reduce the risk of overdose. If possible (rarely done), chemically test all drugs before use to determine their purity and strength. As well, they argue that drug users should avoid driving, operating heavy machinery, or otherwise situate themselves directly or indirectly responsible for the safety or care of another person while intoxicated. When taking hallucinogenic drugs, they suggest that a user have a trip sitterTrip sitter
Trip sitter is a term used by recreational or spiritual drug users to describe a person who remains sober to ensure the safety of the drug user while he or she is under the influence of a drug; they are especially common with first-time experiences or when using psychedelics, dissociatives and...
(or "pilot"). They also propose some ethical guidelines, such as; a person should never trick or persuade anyone to use a drug; a person should not allow drug use to overshadow other aspects of their life (i.e. financial and social responsibilities); a person should be morally conscious of the source of the drugs that a person is using.
Duncan and Gold suggested that responsible drug use involves responsibility in three areas: situational responsibilities, health responsibilities, and safety-related responsibilities. Among situational responsibilities they included concerns over the possible situations in which drugs might be used legally. This includes the avoidance of hazardous situations; not using when alone; nor using due to coercion or when the use of drugs itself is the sole reason for use. Health responsibilities include: avoidance of excessive doses or hazardous combinations of drugs; awareness of possible health consequences of drug use; and not using a drug recreationally during periods of excessive stress. Safety-related responsibilities include: using the smallest dose necessary to achieve the desired effects; using only in relaxed settings with supportive companions; avoiding the use of drugs by injection; and not using drugs while performing complex tasks or those where the drug might impair one's ability to function safely.
Responsible drug use is emphasized as a primary prevention technique in harm-reduction drug policies. Harm-reduction policies were popularized in the late 1980s although they began in the 1970s counter-culture where users were distributed cartoons explaining responsible drug use and consequences of irresponsible drug use.
Health and social consequences
Drug use and users are often not considered socially acceptable; they are often marginalizedMarginalization
In sociology, marginalisation , or marginalization , is the social process of becoming or being made marginal or relegated to the fringe of society e.g.; "the marginalization of the underclass", "marginalisation of intellect", etc.-Individual:Marginalization at the individual level results in an...
socially and economically. Drug use may affect work performance; however, drug testing should not be necessary if this is so, as a user's work performance would be observably deficient, and be grounds in itself for dismissal. In the case of discriminate use of amphetamines and similar drugs, work capacity actually increases. While some people may be able to use some drugs for many years without serious consequences, others may have an unexpected reaction to the drug, even on first use. While funds are diverted from drug research and testing to law enforcement, the reasons for these discrepancies, and therefore the means to remove or avoid harmful consequences remain elusive.
Illegality
Some drugs are very addictive. Even moderate use may result in a strong physical need for an increased dosage. Illegality causes supply problems, and artificially raises prices. The price of the drug soars far above the production and transportation costs. Purity and potency of many drugs is difficult to assess, as they are illegal. Unscrupulous and unregulated middle men are drawn, by profit, into the industry of these valuable commodities. This directly affects the users ability to obtain and use the drugs safely. Drug dosage is problematic. Drug purity is problematic. Drug purchasing is problematic, forcing the user to take avoidable risks. Profit motivation rewards illegal sellers adding a cutting agentCutting agent
A cutting agent is a chemical used to "cut" illicit drugs with something less expensive than the drug itself.-Overview:The classical model of drug cutting A cutting agent is a chemical used to "cut" (dilute) illicit drugs with something less expensive than the drug itself.-Overview:The classical...
to drugs, diluting them; when a user, expecting a low dose, procures "uncut" drugs, an overdose can result.
The morality of buying certain illegal drugs is also questioned given that the trade in cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
, for instance, has been estimated to cause 20,000 deaths a year in Colombia
Colombia
Colombia, officially the Republic of Colombia , is a unitary constitutional republic comprising thirty-two departments. The country is located in northwestern South America, bordered to the east by Venezuela and Brazil; to the south by Ecuador and Peru; to the north by the Caribbean Sea; to the...
alone. Increasing western demand for cocaine causes several hundred thousand people to be displaced from their homes every year, indigenous people are enslaved to produce cocaine and people are killed by the land mines drug cartels place to protect their coca crops. However the majority of deaths currently caused by the illegal drug trade can only take place in a situation in which the drugs are illegal. The illegality of drugs in itself may also cause social and economic consequences for those using them, and legal regulation of drug production and distribution could alleviate these and other dangers of illegal drug use.
Harm reduction
Harm reductionHarm reduction
Harm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
as applied to drug use began as a philosophy in the 1980s aiming to minimize HIV transmission between intravenous drug users. It also focused on condom usage to prevent the transmission of HIV through sexual contact.
Harm reduction worked so effectively that researchers and community policy makers adapted the theory to other diseases to which drug users were susceptible, such as Hepatitis C
Hepatitis C
Hepatitis C is an infectious disease primarily affecting the liver, caused by the hepatitis C virus . The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years...
.
Harm reduction seeks to minimize the harms that can occur through the use of various drugs, whether legal (e.g. alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
and nicotine
Nicotine
Nicotine is an alkaloid found in the nightshade family of plants that constitutes approximately 0.6–3.0% of the dry weight of tobacco, with biosynthesis taking place in the roots and accumulation occurring in the leaves...
), or illegal (e.g. heroin and cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
). For example, people who inject illicit drugs can minimize harm to both themselves and members of the community through proper injecting technique, using new needles and syringes each time, and through proper disposal of all injecting equipment. Smoking a 700-mg. tobacco cigarette or cannabis joint
Joint (cannabis)
Joint is a slang term for a cigarette rolled using cannabis. Rolling papers are the most common rolling medium among industrialized countries, however brown paper, cigarettes with the tobacco removed, and newspaper are commonly used in developing countries. Modern papers are now made from a wide...
(with the attendant heat shock
Heat shock
In biochemistry, heat shock is the effect of subjecting a cell to a higher temperature than that of the ideal body temperature of the organism from which the cell line was derived.-Heat shock response:...
, carbon monoxide
Carbon monoxide
Carbon monoxide , also called carbonous oxide, is a colorless, odorless, and tasteless gas that is slightly lighter than air. It is highly toxic to humans and animals in higher quantities, although it is also produced in normal animal metabolism in low quantities, and is thought to have some normal...
, and combustion toxins) can be avoided by serving individual 25-mg. "single tokes" in a miniature pipe or using a vaporizer
Vaporizer
A vaporizer or vapouriser is a device used to extract for inhalation the active ingredients of plant material, commonly cannabis, tobacco, or other herbs or blends....
.
Other harm reduction methods have been implemented with drugs such as crack cocaine
Crack cocaine
Crack cocaine is the freebase form of cocaine that can be smoked. It may also be termed rock, hard, iron, cavvy, base, or just crack; it is the most addictive form of cocaine. Crack rocks offer a short but intense high to smokers...
. In some cities, peer health advocates (Weeks, 2006) have participated in passing out clean crack pipe mouthpiece tips to minimize the risk of Hepatitis A, B and C and HIV due to sharing pipes while lips and mouth contain open sores.
The responsible user therefore minimizes the spread of blood-borne viruses such as hepatitis C and HIV in the wider community.
Safe injection sites (SiS)
The provision of safe injection sites operates under the premise of harm reductionHarm reduction
Harm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
by providing the injection drug user with a clean space and clean materials such as needles, sterile water, alcohol swabs, and other items used for safe injection.
Vancouver
Vancouver
Vancouver is a coastal seaport city on the mainland of British Columbia, Canada. It is the hub of Greater Vancouver, which, with over 2.3 million residents, is the third most populous metropolitan area in the country,...
, British Columbia
British Columbia
British Columbia is the westernmost of Canada's provinces and is known for its natural beauty, as reflected in its Latin motto, Splendor sine occasu . Its name was chosen by Queen Victoria in 1858...
opened a SiS called Insite
Insite
Insite is the only legal supervised injection site in North America, located at 139 East Hastings Street, in the Downtown Eastside neighbourhood of Vancouver, British Columbia. The DTES had 4700 chronic drug users in 2000 and has been considered to be the centre of an "injection drug epidemic"...
in its poorest neighbourhood, the Downtown Eastside
Downtown Eastside
The Downtown Eastside is one of the oldest neighbourhoods in Vancouver, British Columbia, Canada and is known as "Canada's poorest postal code"....
. Insite was opened in 2003 and has dramatically reduced many harms associated with injection drug use. The research arm of the site http://www.vch.ca/sis/research.htm, run by The Centre of Excellence for HIV/AIDS has found that SiS leads to increases in people entering detox and addiction treatment without increasing drug-related crime. As well, it reduces the littering of drug paraphernalia (e.g., used needles) on the street and reduces the number of people injecting in public areas. The program is attracting the highest-risk users, which has led to less needle-sharing in the Downtown Eastside community, and in the 453 overdoses which occurred at the facility, health care staff have saved every person.
In the Netherlands
Drug policy of the Netherlands
The drug policy of the Netherlands officially has four major objectives:# To prevent recreational drug use and to treat and rehabilitate recreational drug users.# To reduce harm to users....
, where drug use is considered a social and health-related issue and not a law-related one, the government has opened clinics where drug users may consume their substances in a safe, clean environment. Users are given access to clean needles and other paraphernalia, monitored by health officials and are given the ability to seek help from drug addiction.
Due to the project's initial success in reducing mortality ratios and viral spread amongst injection drug users, other projects have been started in Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
, Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
, Spain
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...
, Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
and Norway
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...
. France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
, Denmark
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...
and Portugal
Portugal
Portugal , officially the Portuguese Republic is a country situated in southwestern Europe on the Iberian Peninsula. Portugal is the westernmost country of Europe, and is bordered by the Atlantic Ocean to the West and South and by Spain to the North and East. The Atlantic archipelagos of the...
are also considering similar actions.
See also
- Counterfeit drug
- EntheogenEntheogenAn entheogen , in the strict sense, is a psychoactive substance used in a religious, shamanic, or spiritual context. Historically, entheogens were mostly derived from plant sources and have been used in a variety of traditional religious contexts...
- Recreational drug useRecreational drug useRecreational drug use is the use of a drug, usually psychoactive, with the intention of creating or enhancing recreational experience. Such use is controversial, however, often being considered to be also drug abuse, and it is often illegal...
- Straight edgeStraight edgeStraight edge is a subculture of hardcore punk whose adherents refrain from using alcohol, tobacco, and other recreational drugs. It was a direct reaction to the sexual revolution, hedonism, and excess associated with punk rock. For some, this extends to not engaging in promiscuous sex, following a...
- Demand reductionDemand reductionDemand reduction refers to efforts aimed at reducing public desire for illegal and illicit drugs. This drug policy is in contrast to the reduction of drug supply, but the two policies are often implemented together...
- Harm reductionHarm reductionHarm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
- Drug educationDrug educationDrug education is the planned provision of information and skills relevant to living in a world where drugs are commonly misused. Planning includes developing strategies for helping children and young people engage with relevant drug-related issues during opportunistic and brief contacts with them...
- Psychoactive drugPsychoactive drugA psychoactive drug, psychopharmaceutical, or psychotropic is a chemical substance that crosses the blood–brain barrier and acts primarily upon the central nervous system where it affects brain function, resulting in changes in perception, mood, consciousness, cognition, and behavior...
- Prohibition (drugs)Prohibition (drugs)The prohibition of drugs through sumptuary legislation or religious law is a common means of attempting to prevent drug use. Prohibition of drugs has existed at various levels of government or other authority from the Middle Ages to the present....