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reduce risky use

Level of research support: Evidence of effectiveness

What is it?

British Columbia’s strategy for addressing substance use acknowledges that a person's use of alcohol or other drugs ranges from beneficial or non-problematic to problematic use, depending on these factors:

  • mode of administration,
  • intoxication,
  • chronic use, or
  • dependence.

Reducing risky use of alcohol and other drugs, therefore, emphasizes interventions that can impact those patterns and modes of substance use that have the greatest likelihood of causing acute harm (e.g., injury or death due to a fall, fight, accident or overdose) or chronic harm (e.g., cancer or other serious disease, relationship and financial problems). In some cases, the goal is to eliminate or at least reduce use. In other situations, it involves reducing risky patterns of use or promoting an understanding of safer use.

Why do it?

Alcohol consumption by BC residents, particularly by young adults, is at a level which places a significant number of them at risk (Stockwell et al., 2007). Strategies aimed at reducing risks of acute or chronic harms by focusing on risky patterns of use—and encouraging safer levels of use—can be effective.

Tobacco smoking is the single largest preventable cause of death and disease in BC, the vast majority of which is the result of long-term chronic use. Efforts aimed at reducing tobacco consumption do not make tobacco safe, but can reduce the risks associated with its use.

Poly-drug use is a pattern that raises risks for acute harms. People who use multiple substances may use them in combinations that change or amplify their effects, increasing the potential for impairment, overdose and other harms. Interventions aimed at encouraging safer patterns and levels of use can reduce these risks.

Injection drug use is a pattern and mode of use that raises risks for health and social harms. In particular, the practice of sharing equipment continues to be a primary means of transmission for HIV and hepatitis C. Encouraging safer injection practices by providing access to clean equipment and other supports is an effective strategy in reducing the spread of blood-borne diseases and infections.

Use of psychoactive pharmaceutical drugs, such as prescription pain killers, can be of great benefit to patients for whom such treatment is indicated. However, use of such substances can pose potential harm, especially when used in ways other than prescribed, or in combination with other substances. Strategies can be effective in minimizing harms by encouraging safer use of psychoactive medications (CARBC, 2006).

Who is it for?

  • Young people (selected)
  • People displaying risky patterns (indicated)

Who can facilitate it?

  • Interested citizens
  • Community leaders
  • Municipal governments
  • Schools
  • Health services
  • Social services
  • Business community

How can we implement it?

Encourage safer alcohol use

  • Provide opportunities for people to assess their drinking patterns and understand if their drinking is putting them at risk of harm (e.g., feature the Alcohol Reality Check online screening tool at community events).
  • Promote and disseminate low-risk drinking guidelines for BC to help people avoid immediate and long-term health, safety and social problems.

Promote screening, brief intervention and referral related to risky alcohol, tobacco and other drug use

  • Encourage healthcare providers in various settings to screen their clients, utilize brief interventions with individual follow-up, and promote self-management materials as appropriate.
  • Work with employers and unions to encourage the development of clear workplace policies, and supporting these policies with educational materials and training in screening, brief intervention and referrals applicable to workplace settings.
  • Support screening, brief intervention and referral programs in post-secondary schools.

Improve harm reduction supports for injection drug users

  • Improve access to needle and syringe distribution programs in both urban and rural settings.
  • Ensure access to primary response services that provide brief intervention and referral to other services.
  • Work with stateholders to establish multi-faceted support centres for users (e.g. supervised injection sites, sleeping quarters, linkages to services) and a multi-component support system (e.g. wet-dry housing, employability skills training and work experience programs).

Increase awareness of the potential risks of using psychoactive pharmaceutical medications

  • Encourage stakeholders in the health professions to develop programs that encourage safer use of psychoactive pharmaceutical medications.
  • Explore ways to disseminate evidence-based information to improve consumer awareness of medication actions and interactions.

 

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