HRPO 2255 Substance Use, Drug Policy and Harm Reduction Fall 2024

HRPO 2255: Substance Use, Drug Policy and Harm Reduction FALL 2024 Plan for today Introductions Course overview Class format Course materials Assignments/tests/discussion posts Course expectations Overview of health promotion and drugs  Instructor Info – About me Dal HPRO alumni PhD s...

HRPO 2255: Substance Use, Drug Policy and Harm Reduction FALL 2024 Plan for today Introductions Course overview Class format Course materials Assignments/tests/discussion posts Course expectations Overview of health promotion and drugs  Instructor Info – About me Dal HPRO alumni PhD student in Interdisciplinary Studies –focus is health and criminology Passionate about improving the health outcomes and access points for people who are incarcerated and/or involved in the criminal justice system Interest started by volunteering as a doula Other research interests: doula support, abortion and contraception access, rural health equity Wellness Within: Organization supporting people who are pregnant or parenting and navigating the criminal justice system Fun stuff: biking, hiking, backcountry trips, canoeing, cooking!  Teaching Philosophy Active and collaborative learning Everyone is here to do their best and learn Give you the tools to effectively and critically engage with substance use related topics going forward If there is any way I can support you as a learner, please let me know! Course Info – Class time and location Wednesdays 5:35 – 8:25 PM, CHEB C170 September 25th class will be pre-recorded and uploaded to Brightspace Any further changes to the schedule will be provided with advance notice. Course info - Materials Textbook Recommended Slides will be available on readings Brightspace uploaded on prior to the start Brightspace Note: slides do not contain ofdetail! the Attendance class is all the required. Note: guest lecture slides may not be available prior to the start of the class. Textbook: Drugs, Behaviour and Society (4 rd Canadian Edition) (Hart, Ksir, Hebb, & Gilbert) This is only available as an e-book and will not be available through the Dalhousie Bookstore. The E- book is $67.85 with tax. Link to purchase: https://www.mheducation.ca/product/drugs-behaviou r-and-society-9781265603083-can-group#configurab le-product-options-title or through Brightspace Access code can only be used once… I tried!  The online platform also does not allow downloading. However, you are welcome to print to pdf, screenshot or read together. You are also welcome to use an old edition if you have access. Changes will Course info – Class format In-person lecture Guest lecture – pre-recorded (played in class) and in-person Activities and discussion time Three hours at night is long! We will try to break things up. Safe space for collaborative learning Everyone has unique experiences and knowledge. Lived experience is valuable. Disagree with statements, not people. Aim to use person-first language. Language that acknowledges someone as a person before describing their personal attributes or health conditions. Person-first language does not identify people by secondary or incidental qualities or conditions. Source: Canadian Centre for Substance Ab  To better inform students about the multiple factors that affect society’s views of drugs and how to employ drug education strategies (delivered from a health promotion lens). Some of the content to be covered includes physiology of drugs and drug use; psychological dependence and tolerance; understanding drug policies in Canada and internationally; treatment and prevention options; and content specific to commonly used drugs including marijuana, alcohol, and opioids. Course Learning Outcomes Objectives & By the end of this course, students should be able to: Relate basic terms, concepts, theories, and policies to substance Learning use Outcomes Explain historical events relating to drugs, drug use, and policy Describe how social factors relate to substance use Understand how some drugs interact within the mind and body Appraise commonly used prevention and treatment options for substance use/abuse Demonstrate knowledge of current issues of substance use in local, national and international context Course Policies and Expectations Email me with questions or to make appointments. I will respond to emails with 48 hours (usually faster!) Written assignments submitted via Brightspace by the end of day (11:59 PM) on the due date Students must complete all assignments to receive a grade. No tolerance for plagiarism. Late assignments will receive a late penalty of 1 point per day, unless alternative arrangements are made with me. Please email me if you need support with an assignment. Life happens and I am understanding. I want you to succeed! But if it is right before the deadline, there is little I can do. Late or missed assignments/tests For absences of three days or fewer resulting in missed or late assignments, you must: Email me AHEAD OF THE DEADLINE Submit a student declaration of absence or provide alternate verification (e.g. explain reason via email). If you submit a SDA, you MUST email me as well. The SDA is NOT an automatic extension. For absences greater than three days, please email your Student Services Administrator. This is different depending on your department. Please consult the syllabus. Late assignments with no prior arrangements will be deducted by 1 grade point per day. A note on Chat GPT Appropriate uses: idea generation, synthesis, rephrasing, essentializing and gathering information about the typical understanding of a topic. It should be you that guides, verifies, and crafts your work, so please don't just cut and paste without understanding. Powerful tool – if used correctly! Assessment Discussion Posts (Brightspace) 15% Midterm 20% Final Exam 25% Writing Assignment 1 20% Writing Assignment 2 20% Bonus 5% Discussion Posts Discussion posts on Brightspace (3 total throughout the term, one per month) will be used to engage students with course material. The question will be announced in class and posted on Brightspace. Discussion board will remain open for one week. Students will also be given class time to complete the discussion board. Questions will be related to course content and will be primarily reflection based (e.g. little to no outside research is required). Answers should be thoughtful, appropriate/respectful, and answer the question posed. Answers should be full sentences, 5-7 sentences long, and do not need to be referenced. You can post a new answer or respond to something someone else posted. Due dates are included on the syllabus below and on Brightspace. Discussion board will be open the full week (open on Wednesday and close the following Wednesday). Note: posts cannot be anonymous as we need to assign grades. If you are uncomfortable sharing publicly, you can email me your discussion post directly. Due dates are: Post 1: Open September 18th – 25th Post 2: Open October 9th – 16th Post 3: October 30th – November 6th Midterm and Final Exam Two tests will be administered during the course to test students’ understanding of lecture content and textbook materials. Tests 1 will include multiple choice, true and false, and short answer questions. Test 2 will include multiple choice, true and false, short answer, and one essay question. Tests are not cumulative; however, you may find that content covered earlier in the course is helpful for understanding material covered later in the course. Only the required readings (the textbook) will be covered on the tests. Both lectures and guest lectures are fair game! The test dates are: Midterm: October 23rd Final Exam: November 27th  Written Assignment #1 Assignment 1 (20%) – Due October 13 th at midnight via Brightspace Description of /5 The first assignment is used to introduce your topic. This brief assignment issue should: Be 3-5 pages, double-spaced Description of /5 Include an introductory description of your substance use issue SDOH Describe at least two social determinants of health that might impact your issue Use of /5 Reference at least three reputable sources using APA format. Reputable sources include peer-reviewed journal articles, government reports, and news evidence articles from reliable sources (e.g. CBC News, major newspapers). Course readings and textbook are reputable sources. Grammar, /5 The social determinants of health are to be chosen from one or both of these sources: structure, http://thecanadianfacts.org/the_canadian_facts.pdf https://www.canada.ca/en/public-health/services/health-promotion/population formatting -health/what-determines-health.html Final Mark / Total 20  Written Assignment #2 In the second assignment, you will propose at least one strategy to address the substance use issue you described in Assignment 1. Assume Description of /5 the reader has read your first assignment (and they have!) and do not strategy to copy and paste the entire background on the issue, simply re-introduce your issue with a brief summary. The focus of this assignment is the address issues solutions. This assignment should: Connection of /5 Be 3-5 pages, double-spaced strategy to SDOH Expand on the previous assignment and feedback Use of evidence /5 Share your opinion, but use evidence to support it. There are no right or to support wrong answers – you are allowed to think outside the box – but make argument sure you are using reputable sources to inform your idea. Identify how your solution connects to or addresses the two social Grammer, /5 determinants of health you wrote about in Assignment 1. formatting, Reference at least three reputable sources, including at least one not structure referenced in Assignment 1. Final Mark Total / Because this is an opinion-based assignment, you can use “I” 20 statements e.g. “I think that an overdose prevention site would be an appropriate solution to this issue because….”, but you must cite at least three references that support your ideas. Bonus Points! Throughout the semester, I will post opportunities to get engaged in this topic outside of the classroom (e.g. attend a webinar or in-person lecture, watch a documentary, listen to a podcast, take a naloxone training). If you complete an activity outside of the classroom, you will receive 5% added to your final grade. You do not need to show any proof of attendance, simply send me a brief email outlining what event you attended what you learned (1-2 sentences). E.g. “I attended a seminar on drug policy in Nova Scotia at Dalhousie. I learned about services available in my community.” Bonus point activity must be submitted by December 1st. Volunteer as a note taker A note taker is required to assist one of your peers. If you are interested, please contact the Student Accessibility Centre, [email protected] for more information. Upload electronic copies of the notes to Accommodate At the end of the term, peer note-takers are provided with a minimum $75 honorarium/per course and are recognized through Dalhousie’s Co-Curricular Record (CCR). Questions? ? Introducti on to Drug Use  What is Health Promotion? “The process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well- being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well- being” (World Health Organization, 1986, Ottawa Charter for Health Promotion) Health Promotion Focuses on the social determinants of health (SDOH) Comprehensive strategies include: Building healthy public policy Creating supportive environments Strengthening community action Developing personal skills Re-orienting health care services toward prevention of illness and promotion of health Social Determinants of Health The non-medical factors that influence health outcomes. The conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. Don’t exist in isolation. It is the combined influence of the determinants that determines health status Two comprehensive lists in Canada: Public Health Agency of Canada (PHAC) and the Canadian Facts Determinants of Health PHAC list Employment/ Income and Social Social Support Education and Working Status Networks Literacy Conditions Personal Health Social Physical Healthy Child Practices and Environments Environments Development Coping Skills Biology and Genetic Health Services Gender Culture Endowment Determinants of Health Canadian Facts List Early Indigenous childhood Gender Disability Housing Status developmen t Income and Employment Social income Education Race and working exclusion distribution conditions Unemploym Food Social safety Health ent and job insecurity net services security Income and Social Status Strong evidence that higher social and economic status is associated with better Income health. and Social Status Arguably these two factors can be said to be the most important determinants of health. Higher income provides: Leisure Post- Choice and Safe Healthy opportunitie secondary Control housing food s education What are drugs? Any substance, natural or artificial, other than food, that has a chemical nature that alters structure or function in a living organism Includes taking Advil for a headache, cough medicine when you have a cold, prescriptions prescribed by your doctors, a glass of wine The words “drugs” and “substances” may be used interchangeably Legal and illegal drugs “Political” factors influences what is concerned legal/illegal Changes over time Social norm Drug Misuse vs. Abuse Misuse: Use of drugs Abuse: Substance use in or chemicals in a manner, an amount, or greater amounts than in situations such that it causes social, prescribed by a occupational, doctor, or for psychological, or physical purposes other than, problems E.g. Missing those intended by the work or classes, or family manufacturer responsibilities Dependence, Tolerance and Withdrawal Dependence: A more precise term than addiction. A state in which an individual uses a drug so frequently or consistently that it would be difficult for the person to stop. May be physiological and/or psychological. Tolerance: A condition that may follow repeated ingestion of a drug. Occurs when a person’s reaction to a drug (such as a painkiller) decreases so that larger doses are required to achieve the Withdrawal: same effect. Symptoms that are abnormal physical or psychological effects that occur after stopping a drug. Example: sweating, tremors, vomiting, anxiety, insomnia, muscle aches and pains Questions to consider when discussing drug use Why is the drug Who is What drug When and being used? where is the E.g. Painkillers taking the are they drug being for medical purposes vs drug? taking? used? painkillers for pleasure How is the How much of Where are we drug being the drug is getting our taken? being used? information? Drugs and Drug Use in Context Drugs are not “good” or “bad” Drugs are substances and many lead to behaviours and/or factors that cause us to be concerned; must consider ‘how’ and ‘why’ Every drug has multiple effects Drugs that act on the brain may also produce effects on other parts of the body Both the size and the quality of a drug’s effect depends on the amount an individual has taken An increased dose usually causes an increased effect. For some substances, different doses cause different kinds of effects The effects of any psychoactive drug depends on the individual’s history and expectations A person’s attitude can affect their perception of a drug experience Drugs and Drug Use in Context Drugs have been used for thousands of years for therapeutic and recreational purposes Many psychoactive drugs are either restricted or tightly regulated through the Controlled Drugs and Substances Act This restriction and regulation has led to growth in illegal trade of substances Attitudes and assumptions about drugs are influenced by many factors: Law/regulation Social norms Treatment  Enforcement: addressing illegal drug production, supply, distribution, and use How does Treatment: providing treatment for those experiencing drug-related issues Canada address Harm reduction: supporting measures substance that reduce the negative consequences of use? drug use Prevention: preventing problematic drug use How do health promotion and substance use fields differ? The substance use field prevents “problem behaviours” and social harms amongst individuals and focuses on delaying, reducing or eliminating alcohol, tobacco and illicit drug use, and reducing risk. Health promotion is a bit broader – focuses on substance use prevention, strengthening health, well- being, resiliency, reducing stigma and targeting root causes of harmful behaviour. Focus is on the social and personal impact of substance use (social determinants of health) How do we promote health in the substance use field? Supply Demand Harm Supply reduction Demand reduction Harm Limited Advertisement hours/prices for restrictions (e.g. reduction alcohol NSLC and cannabis) Safe Increasing cost of Interventions substances (e.g. encouraging people injection sites tobacco & youth) to drink less Needle exchange How do the SDOH interact with substance use? The experience of substance use is different for each individual, and often there is a combination of biological, psychological and social factors that can contribute to why a person may use substances. For example, some of the risk factors for addiction include: a person’s genes, the way a person’s brain functions, previous experiences of trauma, cultural influences, or social issues such as poverty and other barriers to accessing the social determinants of health. Concurrent experience of mental health and substance use rce: Kraft Center for Community Health Harm Reduction Program Next class: Sept 11th Topic: Drugs as Social Problem Required reading: Textbook Chapter 2 Recommended Readings: Canadian Centre on Substance Use and Addiction (2019). Overcoming Stigma Through Language. Available from: https://www.ccsa.ca/sites/default/files/2019-09/CCSA-Language-and-Stigma-in-Substance-U se-Addiction-Guide-2019-en.pdf Crackdown Podcast. Available from: https://www.crackdownpod.com/ (Pick an episode that interests you!) **Get your bonus points early – email me what episode you listened to and what you learned!