9th - Harm Reduction Coalition

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9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE years of research and services with young adults at risk for HCV, HBV and HIV. We have developed a Replication Manual for the UFO Model and training and TA products. The UFO Model is modular and adaptable to communities, and our products are available for free online (www.ufomodel.org). Pamela DeCarlo is the Project Director for UFO Presents! and has over 20 years’ experience as a writer and editor, synthesizing scientific reports and articles into concise and understandable materials for non-academic service agencies and the general public. She uses non-traditional methods such as new media to foster bi-directional communication between scientists and consumers of research. Co-authors: Alice Asher RN MSN CNS, Caycee Cullen, Nickie Tilsner, Giuseppe Cavaleri, Alya Briceno MPH, Kimberly Page PhD MPH Deletis, Robert, Independent, Danbury, CT roberpman@comcast.net The Effects of Exposure Response Prevention on Reducing Addictive Cravings Exposure Response Prevention is a behavior therapy technology that reduces a person’s pre-disposition to respond to a set of stimuli. For example, ERP has been used to treat phobias and compulsions by exposing the person to the phobic situation or thing (stimuli set) and then preventing them from executing their dysfunctional response. ERP has been applied to the problem of substance abuse. One of the key hurdles a person must overcome is to remain substance free is to refrain from using when exposed to stimuli (people, places, & things) formerly conditioned to their substance abuse. Failure to behaviorally ignore such conditioned stimuli is the primary cause of relapse among substance abusers. The range of stimuli conditioned as triggers of substance abuse is varied and individualized. There are, however, common triggers. These are the sensory stimuli associated with the substance of choice, it acquisition and preparation for use. Secondly, there is the typical use setting, such as bars, time of day or special event. Finally emotional stressors while more individualized are another frequent trigger. ERP Therapy helps a client extinguish his substance seeking behavior & impulses by systematically exposing them, in a controlled environment, to a sampling of the three sets of stimuli. It also reconditions the client’s cognitive self-talk over a period of sessions. ERP is an eclectic therapy that is another piece of the recovery process. It is compatible with community support groups like AA, NA, etc. Robert DeLetis, CASAC for the past 15 years. Mr. DeLetis is an international and nationally certified alcohol and drug counselor (CADC). He is also the co-author of Kill the Craving, a book that introduces Exposure Response Prevention (ERP) to professionals and their clients. Mr. DeLetis has been utilizing this process to help the residential and outpatient clients to fight their addictions for the past 14 years. He has developed training seminars, in-service trainings, as well as created a full professional ERP kit. Over the years Mr. DeLetis has been employed in the criminal justice field, as a probation officer, and as a mental health counselor. Denning, Patt, Harm Reduction Therapy Center, Oakland, CA pattdenning@gmail.com The unspoken Politics of Drug Treatment: How Drug Policy Mirrors and Creates Drug Treatment in the United States For too long drug treatment in the United States has hidden under a veil of arrogant self-righteousness. Questioning the principles or practices of the Minnesota Model of treatment constitutes blasphemy and often results in being accused of being an enabler, or worse, a murderer. While public health professionals and policy advocates have pushed an agenda of harm reduction and other pragmatic and humane strategies, drug treatment has been allowed to sit in the shadows doing business as usual…the disease model, 12 Step, abstinence only, confrontational style of getting people “clean and sober”. This workshop will detail the need for a nationwide advocacy and training effort to transform the drug treatment system 30
9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE and bring it in line with evidence-based harm reduction methods. Examples of discrimination, job loss, and other civil rights violations will be given to highlight the problems that can arise after a person “admits” to an alcohol or other drug problems and/or enters traditional treatment or is required to attend 12 Step meetings. Patt Denning has worked in Community Mental Health and private practice as a clinician and program director since 1975. She has written several articles as well as a book for the general public (Over the Influence: The Harm Reduction Guide for Managing Drugs and Alcohol. Guilford Press. ). The 2d edition of her first book, Practicing Harm Reduction Psychotherapy was released in the Fall of 2011 (with co-author Jeannie Little). Patt has completed the Diplomate-Fellow training in Psychopharmacology and also was named to the Drug Policy Resources Directory for the Media in the area of Dual Diagnosis. She is a certified addiction specialist. Perri Franskoviak, has worked in community and teaching settings since the early 1990’s. she has experience with infants and their mothers, seriously disturbed adults in both inpatient and outpatient settings, as well as providing clinical care to people caught up in the criminal justice system. Perri trains and consults with several large organizations, including housing and HIV care agencies. She also trains community police and San Francisco Business District community guides in the management of people with mental illness. She is a senior therapist, supervisor, and trainer for HRTC and will soon take a faculty position at Notre Dames College, teaching substance abuse and counseling students, bringing a much needed harm reduction perspective to an academic setting. She has coauthored articles on community programs as well as supervision. Des Jarlais, Don, CDI-BIMC, NY, NY ddesjarlais@chpnet.org Disparities of HIV infection among racial/ethnic minority people who inject drugs (PWIDs): Results of an international meta-analysis Higher HIV rates exist among racial/ethnic minority PWIDs internationally. A social justice approach to addressing HIV infection among PWIDs requires focusing on these disparities. A systematic review and meta-analysis of the international literature on racial/ethnic HIV disparities among PWIDs was conducted 12/2008-03/2012. Our meta-analysis includes data from various racial/ethnic groups representing 25 countries. Maps were constructed to show the geographic range of minority populations and their HIV-infection rates relative to local majority populations. Researchers screened 43,394 abstracts published from 1985-2010; examined 5,616 full-text articles; 215 were eligible. Analyses conducted to date of 267 R/E comparisons showed 121 (45.3%) comparisons had higher HIV prevalence among minority PWIDs, 137 (51.3%) showed no meaningful difference, and 9 (3.4%) found lower HIV prevalence among minorities. The mean weighted odds ratio (OR) for HIV prevalence in US Black: White comparisons was 2.41 (CI 2.09-2.77). This was greater than the OR for all minorities: majority comparisons, 1.99 (CI 1.84-2.16). There was great heterogeneity in the ORs, I2 = 74.1%. Addressing disparities in HIV infection will require tailoring to local conditions. A large overall effect of minority group membership is associated with higher HIV prevalence; however, great heterogeneity implies that a single solution approach is unlikely to be effective. Don C. Des Jarlais, Ph.D., is Director of Research for the Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center and a Research Fellow with the National Development and Research Institutes, Inc. Dr. Des Jarlais began his research on AIDS in 1982 and HIV/AIDS has been the primary focus of his career. He is currently a Core Group Member of the UNAIDS Reference Group on HIV and Injecting Drug Use and a member of the President’s Emergency Plan for AIDS relief. Co-Authors: Heidi Bramson, Karla Gostnell, Cherise Wong, Kamyar Arasteh, Holly Hagan 31
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