Support for harm‐reduction among staff of specialized addiction treatment services in Ontario, Canada

Abstract

In a mail survey of staff of specialized addiction treatment services in Ontario, respondents from different types of services varied in their level of support for a variety of harm reduction initiatives. Across all types of services support was common for needle exchange services (82-95% in favour) and for short-term non-abstinence goals for clients with alcohol or drug problems (51-98% in favour). However, mean ratings for the effectiveness of methadone maintenance were negative or near zero, and only in assessment/referral and out-patient samples did the majority (61% in each case) have a positive view of methadone maintenance programmes. Only a minority of respondents (15% to 35%) indicated support for the prescription of heroin to heroin addicts. In multivariate analyses, support for harm-reduction strategies was found to be positively related to belief in the effectiveness of pharmacological and cognitive-behavioural interventions and working in an out-patient treatment service, and negatively related to belief in interventions based on the disease model.

Barriers to the dissemination of four harm reduction strategies: a survey of addiction treatment providers in Ontario

“…Despite the evidence, however, efforts to implement harm reduction strategies have met with resistance from some health care professionals [7-9], especially when dealing with individuals who are considered dependent on rather than just abusing drugs or alcohol [10]. Reasons for this resistance are varied and multifaceted.…”

“…For example, attitudes toward needle exchange were found to be favorable among physicians who treat addictions in Rhode Island [18] and addiction treatment providers in Ontario, Canada [7,19]. In contrast, in their survey of attitudes toward moderate drinking goals among addiction treatment providers in the United States, Rosenberg and Davis [8] found that approximately 75% of reporting agencies considered nonabstinance an unacceptable treatment goal.…”

“…Ogborne and Birchmore-Timney [7] assessed support for three harm reduction strategies among front line staff in addictions treatment agencies in Ontario: nonabstinence goals in the treatment of alcohol and drug abuse, needle exchange, and methadone maintenance. Results indicated that the staff at outpatient and assessment/referral centers had more favorable attitudes toward harm reduction strategies than those in other types of agencies (e.g.…”

Systemic perspective of violence and aggression in mental health care: Towards a more comprehensive understanding and conceptualization: Part 2

“…This pervasive view is effected, if not actually driven, by contemporary societal views and beliefs of mental health, so-called 'mental illness' and the individuals who experience mental health problems. Related research has repeatedly shown that nurses can be thought of as representative of the broader societal group and may well form their opinions about some mental health matters in the same way the general population does; via mass media, theological beliefs, political rhetoric and hyperbole, and other channels of (mis)information (Forman et al 2001;Ford 2010;Ogborne & Birchmore-Timney 1998). Accordingly, given the overarching, media-perpetuated, societal views of people with mental illness as violent per se (see Cutcliffe & Hannigan 2001;Edney 2004;Vermuelen 2008), the clear and documented shift towards more coercive mental health policy in recent years (see Hannigan & Cutcliffe 2002), and how some nurses apparently form their personal constructs, it may not be entirely surprising that some mental health nurses reportedly view clients as the principal cause of A/V in mental health care.…”

Die Akzeptanz von kontrolliertem Konsum als Behandlungsziel unter Suchthilfefachkräften in Bayern

“…Die Versorgungsforschung in diesem Sektor hat neben der Analyse der tatsächlichen Verbreitung von kontrollorientierten Angeboten über die Jahre auch wiederholt die Akzeptanz unter Suchtfachkräften und Entscheidern in verschiedenen Regionen untersucht (vgl. für GB: [19][20][21]; für die USA: [22][23][24]; für die CH: [25]; für NOR: [26]; für AU: [27,28]; für CAN: [29][30][31][32]). Von besonderem Interesse ist hier die aktuelle Studie von Davis und Rosenberg [24], die anknüpfend an frühere Untersuchungen [21,23] Suchtfachkräfte in den USA nach ihrer Akzeptanz gegenüber reduziertem Trinken und reduziertem Drogengebrauch als Behandlungsziel befragt haben.…”