Harm Reduction

Question 1

Harm Reduction

Answer 1

interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely

any positive change

Question 2

Principle 1

Answer 2

accepts, for better or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore them or condemn them

Question 3

Principle 2

Answer 3

understands drug use as a complex, multi faceted phenomenon that encompasses a continuum of behaviors from severe use to total abstinence and acknowledges that some ways of using drugs are clearly safer than others

Question 4

Principle 3

Answer 4

establishes quality of individual and community life and well-being as the criteria for successful interventions and policies

Question 5

Principle 4

Answer 5

calls for the non-judgemental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing harm

Question 6

Principle 5

Answer 6

ensures that people who use drugs and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them

Question 7

Principle 6

Answer 7

affirms people who use drugs themselves as the primary agents of reducing the harms of their drug use and seeks to empower them to share information and support each other in strategies

Question 8

Principle 7

Answer 8

recongizes that the realities of povery, class, racism, social isolation, past trauma, sex based discrimination, and other inequalities affect people’s vulnerability to and capacity for effectively dealing with drug harm

Question 9

Principle 8

Answer 9

does not minimize or ignore the real and tragic harm and danger that can be associated with drug use

Question 10

Medications for Opioid Use Disorder

Answer 10

Methadone: agonist
- requires active withdrawal with no opioid 8-10 hours before

Buprenorphine: partial agonist
- requires active withdrawal with no opioid 6-12 hours before

Naltrexone: antagonist

Question 11

How do OUD Medications reduce harm

Answer 11

• safer and regulated products that increase patient survival and decrease infections
• decrease illicit opioid use and criminal activity
• increase ability to gain employment
• decrease drug use triggers

Question 12

What is the evidence based for OUD medications

Answer 12

• all medications show higher retentions in care
• agonist medications show decreased overdose mortality
• better maternal and infant outcomes

Question 13

MAT Act

Answer 13

waiver elimination for the prescribing of medications like buprenorpphine

Question 14

Naloxone

Answer 14

What is it? opioid antagonist that binds to the opioid receptor and kicks off other opioids
- available as nasal spray, IM, subQ, IV

Question 15

How does Naloxone reduce harm

Answer 15

• reverses life threatening respiratory depression
• precipitates opioid withdrawal
• will not cause harm if administered to someone not overdosing

Question 16

What is the evidence based for Naloxone

Answer 16

• saved 27,000 lives
• after naloxone laws in place, decreased 14% of overdose deaths
• only 1 naloxone Rx is dispensed for every 70 opioid medications

Question 17

What two naloxone products are OTC?

Answer 17

Narcan & Rivive

Question 18

Syringe Service Programs

Answer 18

• free and safe places to dispose used needles in exchange for sterile ones

Question 19

How do SSP reduce harm

Answer 19

• decrease needle sharing to reduce HIV, HBV, HCV, and other infections
• increase connections to primary care and SUD treatment
• decrease community presence of needles and needlesticks

Question 20

What is the evidence based for SSP

Answer 20

• 50% reduction in HIV and HCV
• 3x likelier to reduce or stop injection drug use
• 5x likelier to enter SUD treatment
• no evidence of increase illicit drug use or crime
• healthcare cost savings

Question 21

How many SSP in Indiana?

Answer 21

12

Question 22

Sterile Syringes in Pharmacies

Answer 22

pharmacists can dispense sterile syringes without a prescription but must maintain a record book:
- name
- address
- name and quantity of syringes
- date
- initials of RPh

YOU DO NOT NEED TO DOCUMENT REASON

Question 23

Supervised Consumption Sites

Answer 23

• sites where people can bring in and use drugs under supervision of trained personnel who can provide lifesaving measures

Question 24

How do SCS reduce harm

Answer 24

• prevent fatalities from opioid overdoses
• decrease needle sharing to reduce HIV, HBV, HCV, and other infections
• increase connections to primary care and SUD treatment
• decrease public drug consumption

Question 25

What is the evidence based for SCS

Answer 25

• 35% reduction in overdose mortality
• significantly reduced injection risk
• no evidence of increased crime or public drug use
• healthcare cost savings

Question 26

Pharmacist Role

Answer 26

• change your language
• reduce stigma
• SBIRT
• be kind

Question 27

SBIRT

Answer 27

Screening:
- ask about substance use (how often do you drink, how many times in have you used illegal drug)
- assess substance use

Brief Intervention (15-25% require BI):
- understand patients point of view (pros/cons, discrepancies)
- give information & feedback (review health risks)
- enhance motivation (assess readiness and confidence to change)
- help patient set goal (naloxone, sterile syringes, etc)

Referral to Treatment (5% require referral)

Question 28

Standard Approach for Assess Substance Use

Answer 28

AUDIT-C + AUDIT –> Alcohol

DAST-10 –> Drug

Question 29

Quick Approach for Assess Substance Use

Answer 29

CAGE-AID –> Alcohol and Drug