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Azrael Mae Ní Mháille (Azzy-Mae) (@pro_lapsed_catholic) • Instagram photos and videos

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1,936 Followers, 1,973 Following, 372 Posts - See Instagram photos and videos from Azrael Mae Ní Mháille (Azzy-Mae) (@pro_lapsed_catholic)

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Nurse M (@theharmreductionnurse) • Instagram photos and videos

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1,476 Followers, 486 Following, 123 Posts - See Instagram photos and videos from Nurse M (@theharmreductionnurse)

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Over the Influence The Harm Reduction Guide to Controlling Your Drug and Alcohol Use (Patt Denning, Jeannie Little) 

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Over the Influence The Harm Reduction Guide to Controlling Your Drug and Alcohol Use (Patt Denning, Jeannie Little) (Z-Library)

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Health and safety nonprofit dedicated to ending the drug war, providing on-the-ground services, distributing drug checking materials, and more.

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Visionaries, mentors and teachers

Dan Bigg, whose vision and tenacity started it all. Holly Bradford, for your radical and no-bullshit self, always pushing us to be better. Dr. Nabarun Dasgupta, our advisor, and friend. Alice Bell, who has done the lion's share of coordination for 13 years. All of the activists, advocates, radical doctors, and researchers who have worked for 25 years to get naloxone into the hands of people who use drugs.

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National Harm Reduction Coalition works to increase access to evidence-based harm reduction strategies like overdose prevention and syringe access programs.

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PsychonautWiki is a community-driven online encyclopedia that aims to document the emerging field of psychonautics in a comprehensive, scientifically-grounded manner. Our primary motivations include:

documenting all aspects of psychonautic theory and practice (including meditation, lucid dreaming, psychoactive substance use, sensory deprivation, ritual, etc.) from an evidence-based, academic perspective

providing accessible education, encouraging safe practices, and reforming cultural taboos around the use of psychoactive substances, using both expert and crowd-based sources

promoting a culture of secularism, free thought, and personal autonomy by safeguarding the information needed to make informed decisions over one's body and mind

PsychonautWiki is an open content platform, meaning anyone can get involved. Contributions of any kind are always appreciated - don't hesitate to ask a fellow contributor or the team for help getting started. Our primary methods of collaboration include:

creating new articles, in accordance with the community guidelines

improving upon existing articles by adding content, removing errors, checking grammar and spelling, and finding missing citations from reliable sources (please refer to our style guide)

engaging in constructive discussion with community members and staff by contacting us through our Telegram support channel, user profiles, or by emailing us directly

helping our project grow through donations

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PsychonautWiki is a community-driven online encyclopedia that aims to document the emerging field of psychonautics in a comprehensive, scientifically-grounded manner. Our primary motivations include: documenting all aspects of psychonautic theory and practice (including meditation, lucid dreaming, psychoactive substance use, sensory deprivation, ritual, etc.)

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Erowid is a non-profit educational & harm-reduction resource with 60 thousand pages of online information about psychoactive drugs, plants, chemicals, and technologies including entheogens, psychedelics, new psychoactive substances, research chemicals, stimulants, depressants and pharmaceuticals.…

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StreetCheck is an innovative community-partnered project to develop and standardize sample collection, analysis, and reporting for community drug checking programs. As the street drug supply is unregulated and unpredictable, community drug checking helps people who use drugs better understand what substances are in the drugs they use. The vision of StreetCheck streamlines community illicit drug sample collection through a free, web-based platform and app service, speeds up analysis of the samples, and makes it easier to communicate results back. The project began in Massachusetts, connects sites in the Northeast, and welcomes community partners throughout the country.

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StreetCheck is an innovative community-partnered project to develop and standardize sample collection, analysis, and reporting for community drug checking programs. As the street drug supply is unregulated and unpredictable, community drug checking helps people who use drugs better understand what substances are in the drugs they use.

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Street drug chemical analysis for public health. Drug outbreak alerts. A service of Univ. of North Carolina.

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Young Women's Empowerment Project (Historical)

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Young Women's Empowerment Project (Historical)

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Girls in Charge is the leadership group that makes all of the major decisions at YWEP. This is the meeting where we learn about political education and do collective work
Create a workshop for social workers about how to work with girls in the sex trade
Create zines about drugs, the sex trade, violence against girls and social justice
Girls get paid for their work in GIC! We offer bus fare and money to any girl who stays and works during the meeting!

Youth Activist Krew The Youth Activist Krew meets once per week to build and lead our first citywide campaign. For more information about our Campaign called Street Youth Rise UP click here

Peer Education and Outreach Girls and young women currently or previously in the sex trade learn how to offer one-to-one harm reduction information and support to other girls impacted by the sex trade on issues of sexual and reproductive health, street law, and positive options for health and safety for girls using drugs or active in the sex trade in a 56 hour training course we have developed as experienced trainers. This course is designed to be interactive and builds on the knowledge girls already possess. After graduating from the training, girls are eligible to give harm reduction support, information resources and health supplies like condoms to girls in the sex trade through an outreach plan of their own making. YWEP outreach workers fill out booklets about each outreach time and receive on-going support and development. Girls receive $30 cash stipends for their participation in each 2 ½ hour training session and each 2 ½ hour outreach opportunity a week.

Popular Education and Skill Building Workshops Popular education is more than making sure that everyone participates in workshops. Activists for decades have been using popular education practice to work together as educators and learners to open up problems and ask critical questions like: who benefits, why is it this way and what can be done to change the systems that affect us? Our workshops on the sex trade with girls offer practical information like on myths and realities but mostly we are engaged in a process with young people across the city to question why the sex trade exists, why girls are involved and what can be done about it?

Syringe Exchange The Young Women's Empowerment Project believes that everyone deserves access to clean syringes and safer drug use information. We offer a syringe exchange on THURSDAYS ONLY. But we offer delivery when we aren't open. One of our outreach workers can bring them to you. Just contact naima@youarepriceless.org
This means that any girl between the ages of 12-23 can stop by our offices between 4pm-7pm to pick up clean rigs and works or talk to other girls who get it. If you have questions about HIV, Hep C, Vein Care or general questions about drugs we can answer those when you come to pick up. You don't have to give your name or any other information to access syringes. You don't have to join our project or pay for anything. Everything is free and anonymous and super quick!

YWEP learned how to do our own research! In 2009 we did a massive research study and published the results. Our study's findings even went to the United Nations! Right now we are working on a study about our Syringe Exchange and we are doing Bad Encounter Line (BEL). To see the latest zine with the Bad Encounter Line results click here. We wrote a paper about how to do your own Bad Encounter Line, which will be released soon and we will giving out the final data about all of our BEL findings in September 2011.

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Girls in Charge is the leadership group that makes all of the major decisions at YWEP. This is the meeting where we learn about political education and do collective work Create a workshop for social workers about how to work with girls in the sex trade Create zines about drugs, the sex trade, violence against...

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A Harm Reduction Approach to Psychiatric Drugs

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A Harm Reduction Approach to Psychiatric Drugs

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A Harm Reduction Approach to Psychiatric Drugs (May 2022)

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For Clinicians: Using a Harm Reduction Approach to Address Non-Adherence to Antipsychotics

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For Clinicians: Using a Harm Reduction Approach to Address Non-Adherence to Antipsychotics

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Harm Reduction Guide to Coming Off Psychiatric Drugs

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Harm Reduction Guide to Coming Off Psychiatric Drugs

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Coming Off Psych Drugs Harm Reduct Guide online

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Disease-Centered vs Drug-Centered View of Medications

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Disease-Centered vs Drug-Centered View of Medications

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Medication Optimization, Choice, + Alternatives: A Statement from Peers in the Consumer/Survivor Recovery Movement

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Medication Optimization, Choice, + Alternatives: A Statement from Peers in the Consumer/Survivor Recovery Movement

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No clue why I had to upload this as a pdf I am tech illiterate

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@Transmutationisms Harm Reduction for Eating Disorders

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@Transmutationisms Harm Reduction for Eating Disorders

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Transmutationisms Harm Reduction for Eating Disorders

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Harm Reduction is for Eating Disorders, Too

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Harm Reduction is for Eating Disorders, Too

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There must be all kinds of unexplored applications for harm reduction, but the one I always come back to is bulimia. This is partly because, like drug use, it revolves around a specific behavior-easy to isolate and name-and partly because I've been bulimic for about 12 years now, so it's on my mind a lot. But it turns out that harm reduction maps quite well onto any disordered eating behavior. For a lot of people, it stands to produce better results than conventional treatment. It's just not being offered.

Mental disorder diagnoses are typically chronic. We don't approach them as things to recover from so much as things to live with; to learn to manage. But because many people do recover from eating disorders (ED) and substance use disorders (SUD), recovery is considered the only acceptable goal. You don't try to live with them; either you die, or you stop.

What they also don't have is harm reduction.

"No one who I've met, in my clinical work or otherwise, says that they are an eating disorder nurse, psychiatrist, clinician, who applies a harm reduction lens. Nobody," Andria Bianchi, a Toronto-based bioethicist who has studied harm reduction for anorexia nervosa (AN ), told .

"They be in existence, so that people can get treatment and still maintain a good quality of life. And that may end up being a quality of life that's good an eating disorder."

This is the prevailing mindset: that harm reduction is not ethically defensible so long as abstinence still has any chance of working.

Harm reduction is not considered a viable option for AN patients who are younger or whose illness presents atypically, nor for anyone with any of the other seven feeding and eating disorders recognized in the , the best-known of which are bulimia nervosa (BN) and binge-eating disorder (BED). (Lots of people engage in behaviors attributed to more than one ED, just as lots of people with SUD use more than one substance. And anyone at any weight can have any ED, the same way people with SUD don't all fit the same physical stereotype. )

"I have to say, the harm reduction model applies much more directly to anorexia nervosa than binge-eating and bulimia nervosa," Michael Strober, editor-in-chief of the International Journal of Eating Disorders and director of UCLA's Eating Disorders Program , told .

Strober, who has held both positions since the early '80s, said this is because "binge-eating, which includes bulimia nervosa, is much more amenable to treatments, generally speaking, than anorexia nervosa. You can have binge-eating for a considerable period of time, after which it can go into remission for long periods of time. So [harm reduction] for bulimia nervosa is not as easy to support as it is in anorexia nervosa-where it is known that if the disorder continues into the third decade the likelihood of a full recovery becomes very, very low. But that's not true in bulimia."

What about people with ED other than refractory AN who aren't ready for, or simply don't want, full recovery-but who do want to address symptoms, and reduce risks? Is there an applicability of harm reduction for them?

"Well, I'm sure there is," Strober said. "But that begs the question, when somebody says they're not 'ready to give it up,' what that means. And whether they've had the appropriate care to address that."

This is the prevailing mindset in the ED field: Harm reduction is not ethically defensible so long as abstinence still has any chance of working. If patient says they don't want full recovery, that's only because they don't really know what they want.

Personally, I think what I want is choice. We should question the validity of a treatment model that goes against the patient's own goals. We should question the ethics of letting anyone spend decades in a cycle of unsuccessful abstinence treatments until they finally hover close enough to death to merit being informed of their other options. We should question the justification for not extending harm reduction to everyone.

"Clinicians sometimes are really uncomfortable if patients make decisions that are 'clinically' harmful," Bianchi said. "But there are also harms to working with someone while they're engaging in those harmful behaviors. There are different types of harms."

What Could ED Harm Reduction Look Like?

"It was quite a new way at the time-and it still is to a large extent-of thinking about treating different types of individuals with eating disorders," Geller told .

Centering someone's readiness for change is a counseling strategy called motivational interviewing (MI). It strengthens autonomy and motivation in ambivalent patients-a term that refers not to being uninterested in treatment, but to simultaneously wanting and not wanting to change.

Each time Linda was admitted, she'd be pushed to gain more weight than she was comfortable with. So rather than recovery, Geller focused on meeting her where she was at.

Her first patient was Linda*, a woman with AN known as a "revolving-door" admission; she ended up there about once a month, year after year. "She was really upset and unhappy with the care system," Geller said, "because she did not want a full recovery."

Each time Linda was admitted, she'd be pushed to gain more weight than she was comfortable with. So rather than recovery, Geller focused on meeting her where she was at.

Linda loved to ride her bike. She loved to ski. She was a runner. A huge proportion of her joy, and her identity, came from doing these activities and being good at them.

"It was only after she heard me reflect that I understood the importance of those things in her life that she was willing to talk about how hard it was when, after a giant ride, she couldn't get out of bed," Geller said. "And how much she disliked having to come into hospital."

They developed a harm reduction plan with a shared goal: Linda being able to eat restrictively, and still ski and bike, without ending up in the hospital. Geller called it their "closet plan." After consulting with a dietician, they put Linda's bike, ski boots, running shoes and roller blades into her closet. When she wanted to go in and get them, they agreed, she would eat her way in. Not a huge amount of food; just some.

"And she never came back to hospital," Geller said. "She actually never returned to what would be considered a 'normal' weight, but she continued doing the things that she liked, and she was able to work, and she was able to have many of the things in her life that she wished for. And it wasn't using a full-recovery model." Linda was in her 40s at the time.

MI has been a pillar of harm reduction counseling for years. Peer workers take courses in it on their way to certification. ED specialists, primary care providers and nutritionists could easily employ it too, utilizing the same toolkit of basic skills like the open-ended questions, affirmation and reflective listening that led Geller and Linda to their closet plan.

Strober saw those recommendations as palliative ones for hopeless cases, unrewarding work that wouldn't satisfy anyone involved. Geller saw them as revelatory. With a few adjustments to make it scalable for the broader ED population (such as trading weight "gain" to "change," to account for the fact that most people with ED aren't underweight) there's a blueprint here for any provider willing to use it. Whether it would produce success stories depends on whether your definition of success includes any positive change or is exclusive to abstinence and recovery-but nobody's denying that it works.

EATING DISORDER HARM REDUCTION STRATEGIES (CLICK TO EXPAND)

Low-Threshold, Whole-Person Care

In my long-running bid to find a decent provider for my treatment-resistant depression, I've been bounced many times on the grounds that I'm exhibiting "drug-seeking behavior"-which is true, as I am seeking the drugs I use to manage the treatment-resistant depression. But providers have also passed on me because they felt iffy about taking on a patient with a comorbid ED.

ED and SUD are both specialty fields in which clinicians receive no training unless they specifically seek it out . Despite the ubiquity of comorbidities among psychiatric patients-and between ED and SUD specifically -the two are often taken as mutually disqualifying from traditional mental health services, rather than as issues that inform one another and are perhaps best addressed concurrently.

Eventually, all the access barriers to the prescription stimulants meant that I just switched to meth. And I might have had better luck with my ED by now had I not been consistently rejected from primary and mental health care, which are usually the first-line recommendations for ED treatment anyway .

This is because SSP workers offer more than just syringes. They offer stems, socks, condoms, wound care, insurance enrollment and blood-borne disease testing. They connect people to housing, food stamps, counseling, medications for opioid use disorder and whatever other services they've figured out how to tap into. They do this because they understand people holistically, and know that issues like SUD and HIV/AIDS and sex work and food insecurity and homelessness don't exist in isolation and cannot be extricated from one another, at least not responsibly.

"By having a harm reduction lens and being willing to offer treatment to people who are still engaging in eating disorder behaviors, it's very possible that they might be able to access other supports," Bianchi said. "Like psychosocial support. If they're not seen by an eating disorder treatment team because they're not 'allowed' ... they might not be able to access other really valuable supports that could improve their quality of life."

It's not particularly helpful to insist patients aren't allowed to have harm reduction because it's not as good for them as a different treatment, which they are also not allowed to have.

Integrating harm reduction into treatment programs could improve overall patient care. Instead of discharging participants found to be, for instance, purging-"because there are certain expectations"-what if programs were reimagined using elements of safe consumption sites?

"I do wonder if a harm reduction approach-for people, with types of eating disorders-could mean that a clinician could actually be there to supervise. Where they would know that, while under their care, they may binge and purge. They may [harmfully] exercise," Bianchi said. "But maybe, as a harm reduction practitioner, you'd say, 'Okay, we know you're going to try to exercise, so we're going to try to help you exercise in a safe way."

ED treatment being extremely is part of why, culturally, ED are associated with white people. In reality, They're also all less likely to receive institutional care. If they're going to get connected to resources, it will be because people of color as well as people who are queer, trans and/or outside the gender binary and people who are overweight , are all at higher risk for ED than their thin, straight/cis white counterparts. grassroots organizations stepped in.

Rethinking "Relapse"

Substance rehab is basically just a place that forces you to dry out. Similarly, an ED program is basically just a place that forces you to eat, in some sufficiently different way to however you were eating before.

"We call it treatment, but in reality it's refeeding," said Margaret Janse van Rensburg, a registered social worker in Ontario who's been through three ED programs under various diagnoses, including BN. "It's all about fixing and normalizing, instead of naturalizing and making spaces more accommodating."

In one program, Rensburg was not allowed to drink water outside of designated meal times, which only lasted 20-30 minutes. In all three, if she left what was determined to be, say, too much salad dressing on her plate she would have to do a "repair"-extra dressing at the next meal-to not jeopardize privileges such as a day pass home.

She believes an ethical approach to ED would prioritize harm reduction, and that under pandemic conditions many people are increasingly relying on their ED to survive. All ED are associated with increased risk of suicide . The same is true, too.

"Are there administrative discharges? Of course. It's analogous to people who get illicit drugs smuggled into their program. If you're smuggling in drugs while you're in treatment for drug use, there is no point in treatment."

ED programs have a strong culture of recovery and a powerful taboo against "relapse." If abstinence from disordered behavior isn't someone's goal, they probably won't be offered admission. Those who are admitted can be discharged if caught bingeing, vomiting, using laxatives, exercising, water-loading, hiding food, declining food-including condiments-or simply weighing something other than what staff has decided they should weigh.

"I mean, if there are people who are adults and who for whatever reason are not following a sensible treatment plan, and that continues beyond a certain point, are there administrative discharges? Of course," Strober said.

"It's analogous to people who are getting illicit drugs smuggled into their treatment program and when it's found out they're administratively discharged, [or] told 'this has to stop or else your treatment is futile.' If you're smuggling in drugs while you're in treatment that is designed to mitigate drug use, there is no point in treatment."

A harm reduction program wouldn't be like this. It would recognize that recurrence of symptoms doesn't correlate to lack of will, and that it shouldn't be possible for anyone to "fail" health care. Visible illness wouldn't be a justification for withholding treatment.

"Relapse" isn't a real metric of anything. At most, it's a sign that the plan is failing the patient, rather than the other way around. Instead of approaching ED behaviors like bingeing as all or nothing, abstinence or failure, a harm reduction model would reframe them in terms of how chaotic-or not-they are when they happen.

"It may be more relevant to look at life interference," Geller said. Someone who binges and purges, for instance, might only do so once a week, "but maybe it lasts all day long and has a two-day hangover. Versus somebody who, maybe they binge every day but it takes 20 minutes and it really doesn't affect their life at all."

Acknowledging the Good

Most disordered eating doesn't meet criteria for an ED. At the same time, even the most fleeting and least harmful forms of disordered eating probably indicate some sort of underlying fracture. There are times when I can almost think of even my BN as a fun pastime with little correlation to the rest of my life, but this never quite manages to be true.

"There's this idea that we can measure 'recovery' and what's 'recovered enough,' but it's always by someone else's standard," Rensburg said. "Who decides what counts as breakfast, lunch and dinner?"

This is the thing with stigmatized behaviors. If they were only their bad parts, and none of the good, we wouldn't do them.

None of the health care professionals who've told me I should stop doing BN have ever told me anything useful to do instead. But I like to imagine that if I ever found a harm reduction provider, they'd see the issue in pushing someone to drop one of the bedrock routines in their life with nothing to take up the function it served. They'd factor in how a habit supports, alongside how it harms.

BN isn't something I'd say I enjoy. It just brings me release, a way of coping with any number of everyday things that are otherwise unnavigable for me. And it's not that recovery doesn't seem appealing, but when it does it's because I'm imagining a recovery where I get to transcend the parts that hold me back but still keep the ones that push me forward.

I'd prefer it involve less life interference. But I can't see how I'd last the whole rest of my life without needing it at least occasionally, and my mental health gets empirically way worse whenever I try to give it up entirely. At the moment I'd just like to make it more manageable, the way it used to be.

This is the thing with stigmatized behaviors. If they were only their bad parts, and none of the good, we wouldn't do them. In addition to and alongside addiction, people use drugs because they give us something we wouldn't have without them. It could be community, or sleep, or functionality, or a way to kill time, or relief, or adrenaline, or joy. People hold onto disordered eating for similar reasons. If someone wants only a partial recovery, it's because they want to keep the parts that are good. They deserve a provider who sees that, rather than one who believes them confused.

So many of us are told our ED is something we have to kick before we're allowed to start our real lives, even as we keep getting older, even if we know the treatment game is rigged. Few are told that you can live with a stigmatized disorder and still deserve health care, even if you never recover. That there are tools for making the chaotic parts of your life less so, without being forced into a lifestyle that doesn't fit you. That balance is as good a goal as abstinence. That if your particular way of living is how you meet your needs in that moment, then it's valid.
Photograph via Pixabay *Name has been changed

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Harm Reduction Is for Eating Disorders, Too

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Eating disorders and substance use disorders have much in common. Yet except in very rare cases, the ED field isn't willing to try harm reduction.

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Filter - Harm reduction journalism from a dedicated nonprofit

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Filter’s mission is to advocate through journalism for rational and compassionate approaches to drug use, drug policy and human rights.

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We Need A Harm Reductionist Approach to Eating Disorders

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We Need A Harm Reductionist Approach to Eating Disorders

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We Need A Harm Reductionist Approach to Eating Disorders

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People who don’t wish to ‘recover’ still deserve autonomy and care.

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Helping Your Friends Who Sometimes Wanna Die Maybe Not Die

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Helping Your Friends Who Sometimes Wanna Die Maybe Not Die

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Helping Your Friends Who Sometimes Wanna Die Maybe Not Die

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Liberatory Eating Disorder Harm Reduction

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Welcome back to Instagram. Sign in to check out what your friends, family & interests have been capturing & sharing around the world.

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@Librarycards How to Stop Viewing Hospital Videos ED Harm Reduction

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@Librarycards How to Stop Viewing Hospital Videos ED Harm Reduction

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Librarycards How to Stop Viewing Hospital Videos ED Harm Reduction

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@Librarycards ED Harm Reduction for Vegans

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@Librarycards ED Harm Reduction for Vegans

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Librarycards Veganism Harm Reduction EDs

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@Librarycards ED Harm Reduction for Kosher Individuals

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@Librarycards ED Harm Reduction for Kosher Individuals

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@Librarycards ED Harm Reduction, Addressing Internalized Fatphobia

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@Librarycards ED Harm Reduction, Addressing Internalized Fatphobia

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Librarycards ED Harm Reduction Fatphobia

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Harm Reduction- Disorderly Eating

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Screenreader Accessible

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About invisible labor

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The Hurt Yourself Less Workbook (edited to remove some fatphobic language + images of self injury)

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The Hurt Yourself Less Workbook (edited to remove some fatphobic language + images of self injury)

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Microsoft Word - Hurt Yourself Less Workbook (edited version)

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NSPdirect is a great way for UK drug services to deliver an online postal needle exchange service to their clients, via the Exchange Supplies webshop.
>>>CLICK HERE to check if your postcode is covered by NSPdirect, and create a new account<<<