Ecstasy-related deaths in B.C., Alberta spark debate over how to fix poisonous problem http://www.nationalpost.com/m/wp/news/blog.html?b=news.nationalpost.com/2012/02/05/ecstasy-related-deaths-in-b-c-alberta-sparking-debate-over-how-to-fix-poisonous-problem a debate and argument can be made to legalize or decriminalize some drugs, regulate them, tax the distribution, etc, similar to alcohol, tobacco, etc. Alcohol and tobacco are the most widely used drugs, and most harmful and expensive to society, and cause the most morbidity and mortality. Harm reduction is useful and necessary http://www.canada.com/Harm+reduction+useful+necessary/6060814/story.html and the rebuttal Harm reduction not the solution to addictions http://www.canada.com/Harm+reduction+solution+addictions/6112458/story.html
http://www.slapupsidethehead.com/tag/tony-clement/ It is easy to blame the person, but as with any philosophy that will not help in the long run, and the effort is momentous.
http://www.health.gov.sk.ca/Default.aspx?DN=d264e5d9-64f4-48a8-8d7b-1d34d08c368a&l=English http://www.health.gov.sk.ca/health-effects-tobacco we have MADD and SADD but we don’t have MATS or SATS (mothers against Tobacco and smoking or Students against tobacco and smoking) alcohol related deaths in Sk we ~75 in 2008, tobacco ~ 1500) http://www.health.gov.sk.ca/Default.aspx?DN=8c8efac8-1f44-43b9-88c9-1173c97fff07&l=English http://changetheconversation.ca/drinking_and_driving_facts/saskatchewan_table.php http://www.saddsask.ca/laws.html http://www.sgi.sk.ca/pdf/TAIS_08_section10.pdf in SK we have a harm reduction program for drinking and driving. It is not an abstinence program, you are allowed to drink some alcohol and then drive, just don’t drink too much, and don’t get caught is what we used to say when I was younger….
http://en.wikipedia.org/wiki/Confirmation_bias Dan Gardner book RISK the science and politics of fear
One man said his HIV positive brother was refused care, said Greg Riehl, president of the Saskatchewan HIV and Hepatitis C Nursing Education Organization. “I feel that these are mostly isolated incidents, in that most nurses give good care, but there are some pockets in some areas where nurses could be doing a better job for sure,” he said. It could be that health staff don’t understand their clients entirely, and don’t understand the choices they have made. It comes from a potential lack of education when it comes to HIV and Hepatitis C, as people train to be health-care providers, he said. “As heath care providers we really need to stop, listen and not really try to fix things right away.” Time is an issue in the health care setting, whether hospitals or clinics, and HIV positive clients are complex, with diverse issues, Riehl said. “Sometimes were suffering from burnout to be honest, but that doesn’t excuse us as health care providers to offer bad services, to not care, to not be empathetic,” he said. “We have an obligation to our clients to act ethically. The (Canadian Nursing Association) basically mandates us to treat everyone with a degree of respect, a degree of empathy.
October 3rd, 2007 CANAC Response to Announcement by Minister Clement, Oct. 2nd, 2007 As you are no doubt aware Minister Clement announced, October 2nd, a 6 month extension for North America's only supervised injection site – Insite, located in the Downtown East side of Vancouver. Health Minister Tony Clement has advised the Vancouver Coastal Health Authority which operates Insite, a supervised injection site that their exemption under Section 56 of the Controlled Drugs and Substances Act has been extended until June 30, 2008. This extension will allow research on how supervised injection sites affect prevention, treatment and crime to be continued for another six months. (http://hc-sc.gc.ca/ahc-asc/media/nr-cp/2007/2007_137_e.html) It appears that health and human rights have become political issues and are especially hot topics with an election looming in the near future. The Canadian Association of Nurses in AIDS Care (CANAC) believes that this exemption is only a short reprieve and that a long-term decision is required to support the work that is currently occurring at Insite. In addition, later this week Minister Clement will announce Canada's new Anti-drug Strategy built on 3 pillars: prevention, treatment and enforcement. Harm reduction has been dropped and strategies to address HIV/AIDS are becoming more and more difficult to locate on Health Canada’s web sites. Harm reduction has been an official policy of Health Canada's since 1996 and was a major focus in the document Leading Together: Canada Takes Action on HIV/AIDS (2005 - 2010) blueprint for Canada-wide action on HIV/AIDS until 2010. CANAC supports a four-pillar approach, which includes harm reduction as a policy, strategy, and approach; we see this reactionary decision to drop harm reduction as immensely shortsighted. CANAC has known, or heard rumours, of this impending anti-initiative for some time. The roll out of the government’s three-pillar approach is a wobbly stool at best and is being met with disappointment. The successes of those working to implement harm reduction practices in the areas of substance use have lead the way for others to use similar approaches to reduce harm associated with other behaviours and circumstances. A four pillar approach, that includes Harm Reduction, has improved care for patients everywhere. It has taught us to measure success in small steps, to not be disappointed with relapse, to see the value in trying, and recognize that the sense of self worth that is so compromised in the most vulnerable of our patients and clients can be re-built with every moment that they experience understanding and acceptance. CANAC is in support of focusing on the need to maintain services (indeed expand services) to our most marginalized citizens. CANAC supports programs of harm reduction as an integral component of supervised consumption sites and these positive human rights initiatives need to be standard health care services for homeless drug using people. “ Understanding harm reduction has made me a better nurse and I use these practices in all areas of my work. We need to protect this.” (DRW RN from Toronto) Greg Riehl President Canadian Association of Nurses in AIDS Care The Federal Initiative (http://www.phac-aspc.gc.ca/aids-sida/fi-if/fa-if/pdf/fed_init_e.pdf0) Leading Together (http://www.leadingtogether.ca/)
http://www.joyofconflict.com/editor_articles/ConflictDrama-VictimVillainHero.htm Often we can be seen as different people within the triangle. And our peers, colleagues, bosses, and clients can see us as different player in this situation.
Working with FNIH Health Canada allowed me to explore other ways of looking at what Harm Reduction is and how the work could continue http://www.righttoplay.com/International/Pages/Home.aspx Right to Play for me would help kids get involved in sports, thus increasing self esteem, etc, and generally keeping them busy with healthy choices decreasing the opportunities for risky behaviors.
In April or 2008 I started to speak in public about Harm Reduction, good for the overall cause, not the greatest career move, I started to get letters from the Minister of Health’s office to stop speaking against the governments position on HR. Conferences and press releases need to be planned
http://www.marketwire.com/press-release/canadian-aids-care-nurses-voice-support-for-harm-reduction-846910.htm Use your policies, standards, positions statements, if you have them, if you don’t have them, adopt, adapt, or create statements that reflect your organizations values, mission, goals. Involve your clients. Share the spotlight. Build capacity
http://www.srna.org/rss/index.rss Participate when you can. Find allies. Seek out media
The Code supports visionary nurses and the art of nursing is enhanced through ethical practice. We need to focus on advocacy for our clients and staff and be able to use Harm Reduction models to guide our nursing practice. Holistic approaches are required to address issues and factors that affect HIV/AIDS programming, targeting not just the disease, but also the social determinants of health and economic circumstances. Good Harm Reduction programs strongly support the participation of those living with HIV/AIDS in the process. The Canadian Nurses Association’s Code of Ethics for Registered Nurses is a statement of the ethical values of nurses and of nurses’ commitments to persons with health-care needs and persons receiving care. It is intended for nurses in all contexts and domains of nursing practice and at all levels of decision-making. It is for nurses by nurses. The Code assists nurses in practicing ethically and working through ethical challenges that arise in their practice with individuals, families, communities and public health systems. Harm Reduction and the Code meet people where they are at, improving the quality of people’s lives, especially the disadvantaged or vulnerable. Advocating for our clients is ethical nursing. http://www.cna-aiic.ca/CNA/documents/pdf/publications/Code_of_Ethics_2008_e.pdf
I thought that my clients were the public, I was a public servant afterall. Better to be a service to the public, than a servant of my bosses.
I started to change my language around Harm Reduction, but was conflicted for sure.
MLK Martin Luther King I think this is a very important quote. Once Harm Reduction has been eliminated from our language, what will be next. HIV? I saw the elimination of HR as a slippery slope, and wanted to take a stand.
Working with the Saskatchewan Public Health Association allows me to have another hat and a different voice. It is important to stay current and stay involved. http://www.thestarphoenix.com/health/Needle+exchange+good+health+policy/4653521/story.html
Media and harm reductionthunder bay Ontario
"Exploring Current Harm ReductionScenarios as Depicted in the Media"Greg Riehl December 5th, 2012Thunder Bay District Health Unit
• Hopefully my presentation will give you some ideas on how to work with organizations who do not support Harm Reduction, and how to interpret and use media more effectively.Key Messages
• http://www.youtube.com/watch?v=sHzdsFiBbFcNational Film Board
• Harm Reduction can take many faces• I researched a lot• From HR philosophy, to religion, to policy, to science• Get feedback from your people - Do you really want an ‘official policy’? Maybe not . . .Use media but be sure to educateyourself
• Media plural of me·di·a (Noun)• Noun: • The main means of mass communication regarded collectively: "the campaign won media attention". • An intermediate layer, esp. in the wall of a blood vessel.• The mass media are all those media technologies that are intended to reach a large audience by mass communication.Media
“There is nothing either good or badbut thinking makes it so”William Shakespeare Public Opinion
• What is the purpose of media?• People aren’t killed by earthquakes. They are killed by falling buildingsPublic Safety or FearPromotion
City to change"medical clinic"zoning description
Ecstasy-related deaths in B.C., Alberta spark debate over how to fix poisonous problemHARM REDUCTION IS USEFULAND NECESSARYHarm reduction not the solution toaddictions
“Harm Addition”It isn’t about the person.. . .
MADD SADDWe don’t have MATS or SATS (mothers againstTobacco and smoking or Students against tobaccoand smoking)
• While littering public places like playgrounds with used needles is dangerous, hideous and a source of outrage, the societal impact of addicts sharing used drug needles is just as hideous. http://www.thestarphoenix.com/business/Wall+masters+messaging+skills/7450027/story.html#ixzz2CzbXvoFAConfirmation Bias andMedia
• Confirmation bias (also called confirmatory bias or myside bias) is a tendency of people to favor information that confirms their beliefs or hypotheses.• People display this bias when they gather or remember information selectively, or when they interpret it in a biased way.• The effect is stronger for emotionally charged issues and for deeply entrenched beliefs.Confirmation Bias andMedia
• Because of Confirmation Bias people will have a tough time changing their minds on harm reduction.• It is not the media’s position or job to change peoples’ minds“Seeking to confirm our beliefs comes naturally, while if feels strange and counterintuitive to look for evidence that contradicts our beliefs”Confirmation Bias andMedia
• "Harper has to recognize that if people stop taking drugs, they have to deal with the tsunami of pain underlying their addictions," he said. "Whos going to help them with that? If there were lots of options for people to belong, get affirmation, feel valued, there might be a reason for being abstinent.“David DiewertStephen Harper doesn’t likeHarm Reduction
continued• Knowledge development and knowledge transfer• Coordination, planning, evaluation and reporting integrated approach to program implementation at multi- sectoral levels• Message and program priorities need support through interpersonal and mass media communications and social marketingOverall Goals of HarmReduction
• Everyone here will• The media obviously accept information play a key role inn that supports their getting waves started opinion and ignore or and keeping them reject information that rolling. does not.Media reports
• The media also respond to rising worry by producing • More fear - more more reports – almost reporting. always emotional • More reporting - more stories of suffering and loss – about the fear. thing that has people worriedMedia reports
• First Nations use traditions to tackle oxy problems• Oxy battle rages on• One drug, many problems• Allowing generic oxys a step backwards• Thunder Bay police worry crime and addiction rates will rise• Anishinabek Nation Regional Chief Collins says feds should be blocking generic OxyContinoxycontin
• HIV clients face diverse treatments• Clients report good and bad care given by health professionals• http://www.newstalk650.com/story/hiv-clients-face-diverse-treatments/85685• One-sided info cant contribute to sound policy• http://www.thestarphoenix.com/mobile/opinion/editorial/sided+info+contribute+sound+policy/7550844/story.html• Sask. teenagers testing positive for HIV on the rise• Global Regina | Sask. teenagers testing positive for HIV on the riseWhat do I do?
• Sometimes you are more effective working on the outside• And by working on the outside keep your connections on the inside• Keep current• Be an expert (or at least play an expert on…)• Use the media• Don’t burn bridges or slam doorsWorking from theinside
• Promoting Equity through Harm Reduction In Nursing Practice• February 2008• Keep doing the workSRNA PositionStatement
• Need to be innovative• Meet the needs of the population that you work with• Give and take• Find solutions• Need to find projects and action to keep moving forwardUse media & be prepared
• 16th Annual CANAC Conference • The Power if HIV Nursing: Context and Connections • April 19 – 22, 2008, Ottawa, ON at the Lord Elgin HotelApril 22, 2008 10:30 ETCanadian AIDS Care Nurses VoiceSupport for Harm Reduction CANAC
• OTTAWA, ONTARIO--(Marketwire - April 22, 2008) - Nurses caring for people with HIV/AIDS have a professional obligation to promote the health and well-being of their patients, which includes supporting strategies that reduce harm to patients dealing with addictions, says the Canadian Association for Nurses in AIDS Care (CANAC). At the close of CANACs eighth annual conference, held April 21 - 22 in Ottawa, the association is calling on municipal, provincial and federal governments to immediately implement evidence- based harm reduction programs throughout the country and to continue supporting those already operating. "Nurses are concerned about the lack of support for essential harm reduction programs in Canada," says CANAC President Greg Riehl. "Harm reduction has been dropped from the current governments new Anti-drug Strategy, and many vital programs are being threatened, including needle exchanges, the safer crack kit program in Ottawa, and the supervised injection site (Insite) in Vancouver, despite research showing that these programs work." The City of Ottawa recently withdrew support for the citys safer crack kit program and is now considering imposing a restrictive one-for-one needle exchange policy. "These actions represent a major step backwards," Riehl continues. "We need maximum - not restricted - access to programs that prevent disease and suffering."Harm reduction is part ofprofessional and ethical nursingstandards
“(Critics) should be taking two steps back and focusing on thehomeless people trying to deal with their pain so they’re usinginjection drugs,” said Greg Riehl, president of the CanadianAssociation for Nurses in AIDS Care (CANAC)“The needles are a symptom of what’s happening in society.”The association, closing its annual conference here, held a pressconference yesterday in which it called on all levels ofgovernment — and for every day Canadians — to support“harm reduction programs” that have come under fire recentlyfor dispensing free drug paraphernalia to addicts.Put focus on addicts: Nurses
“People who use drugs need to be given options andthose options include harm reduction, and they alsoinclude treatment,” said Greg Riehl, CANACpresident.“If we don’t have harm reduction, if we don’t haveInsite, those people will be dead. Dead people cannotenter into treatment.”Harper urged to extend druginjection site agreement
Represent whenever and wherever you can 2008 International AIDS Conference
• Dedication and Action at the Forefront of HIV/AIDS;• Advances and Improved Practices in HIV/AIDS Care: CANAC‘s experience.• August 2nd, 2008 Mentoring, partnership and Collaboration: Respect for Human Rights: Diversity: Participation and Empowerment: Integration: Accountability: Advocacy and leadership:International Nurses‘ Forum
• The Saskatchewan Registered Nurses Association delivers timely information about the nursing industry through regular video podcasts.• Harm Reduction Greg Riehl is the President Canadian Association of Nurses involved in AIDS Care.• He is currently working with Health Canada as the HIV/AIDS/Bloodborne Pathogens/Sexually Transmitted Infections Regional Coordinator for Health Canada First Nations and Inuit Health Programs Saskatchewan. Media files 2008_mar_19.mp4 (Movie Clip)SRNA - The SRNA Podcast Feed
• Harm Reduction asks us to look at ourselves and how we offer services. As nurses, are we really open and accessible to those we want to reach? The intention of Harm Reduction is to help people make informed decisions and empower our clients to reduce the risk of HIV infection.Back to Nursing forsupport
Who are you accountable to?And who do you work for?Do you have a communicationsdepartment
You may have to change the messageRestoring Balance through Harm Reduction Balance Restoration
“Our lives begin to endthe day we become silent about the things that matter” MLK
• Empirical Science Meets Moral Panic: • An Analysis of the Politics of Needle Exchange• DAVID BUCHANAN, SUSAN SHAW, AMY FORD, and MERRILL SINGER“We need to speak with one voice, but this is difficult because we don’t speak with one voice”Research
• Why is everyone talking about Saskatchewan and what is so unique about the epidemiology of this province?• Hear from an RN in Saskatchewan how these numbers can help or hinder communities, agencies and, most importantly, people in the Prairies living with HIV.Use data and epidemiologyto drive your message home
• We need to speak with one voice, but this is difficult because we don’t speak with one voice• Social media can be your friend, and it can be the friend of people opposed to Harm Reduction • Don’t stop• Focusing strictly on empirical evidence has not worked so far.• Don’t get caught in the trap of trying to prove your point (over, & over & over, & over & over…)You need to be heard, or atleast listened to.
Summary• As a Registered Nurse, I care about my profession• As a citizen I care about people• We must support culturally competent care to all people.• Western culture tends to blame the victim.• Harm reduction can improve the quality of people’s lives.• We are all faced with several risk factors, at one time or another, that puts us at risk for ...
• Greg Riehl• email@example.com• I will post this presentation on www.slideshare.net• Thanks again…Thank you for your time
Here is the schedule:8:30 to 9:00am – Registration9:00 to 10:15am – Keynote Speaker (THIS IS YOU!)10:15 to 10:30am – Refreshment Break10:30 to 11:45am – Breakout Session #1 (two concurrentsessions; pick one)11:45 am to 12:40pm – Lunch (a film will be shown)12:45 to 2:00pm – Breakout Session #2 (two concurrentsessions; pick one)2:00 to 2:15pm – Refreshment Break2:15 to 3:30pm – Break Out Session #3 (2 concurrentsessions; pick one) - YOU WILL BE PRESENTINGHERE3:30 to 3:45pm – Wrap up session/evaluationI am here all day today and can answer any questions youmight have!