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APHA Scientific Session and Event Listing

Recorded presentation

Salaam Semaan, DrPH, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, E-02, Atlanta, GA 30333, 404-639-8870, svs5@cdc.gov, Mary Leinhos, PhD, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, A-25, Atlanta, GA 30333, and Don Des Jarlais, PhD, Chemical Dependency Institute, Beth Israel Medical Center, 160 Water St., Rm 2462, New York, NY 10038.

Although interventions with psychoactive drug users have dramatically reduced HIV rates in this population, drug users remain at risk for infection with HIV, STDs, and viral hepatitis. We reviewed the literature on delivery of preventive and curative services to drug users and on the ethical principles of public health and health care. We explored the ideologies of personal and societal responsibility for drug addiction. Placing the onus on individual responsibility alone, without also addressing the social values of equity and distributive justice, can do harm to drug users and to society. While drug addiction affects all aspects of one's being, the societal marginalization of drug users and lack of social and economic opportunities is also responsible for continuation of drug addiction. A summary of 13 principles has been advocated to guide health care relationships with drug users. These principles include informing drug users about the importance of seeking health care and adhering to medical regimens; encouraging health professionals to learn about referral services for drug users; and avoiding common pitfalls such as unrealistic expectations, moralizing and withholding therapy. It is important to make drug treatment available and accessible to drug users, to address the societal causes of addiction, and to reduce the use of incarceration as a means to curb drug addiction. The ethical principles of respect, beneficence, and justice and those of human rights imply that people addicted to psychoactive drugs have the same rights and deserve the same preventive and medical interventions as those with other diseases.

Learning Objectives: At the conclusion of the session, the participants will be able

(
• to articulate the ethical principles in general and those applicable to vulnerable populatioins, especially drug users. (
• to discuss the personal and societal perspetives used in debating who is responsible for the epidemic of drug addiction. (
• to atriculate how to work with drug users in an ethical way in prevention and treatment settings to prevent and control the epidemic of addiction and of infection with HIV, other STDs, and viral hepatitis.

Keywords: Drug Addiction, Ethics

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation