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Sharing drugs in methadone .treatment (Ernest Drucker, 23 October 2013)

In considering patterns of methadone patients "sharing: their doses with others , the authors suggest that "Treatment providers should consider including couples in which both individuals are motivated for starting OMT" . Know that In the early days of methadone treatment in the US ( the 1960s and 70s - when access to methadone treatment was more limited than it is today ) this idea was sometimes a program rule for married couple where both used heroin - with appreciation that one members success in methadone treatment might be undermined by their partners ( or friends) needs. The concept of "diversion" was a DEA trope , inappropriately applied to treatment methadone - with sharing being an understandable response of patients with addicted partners - indeed it was an early and spontaneous... read full comment

Comment on: Havnes et al. Harm Reduction Journal, 10:24

Perspective on current situation regarding drug treatment in Cambodia (Mark Elliot Barrett, 20 June 2012)

I should mention that I participated in the project that is the subject of this article as the research consultant who did the commune survey analysis and report write-up (referenced... read full comment

Comment on: Klein et al. Harm Reduction Journal, 9:11

Other considerations... (Dan Bigg, 05 January 2012)

While the dangers of tobacco abuse are well known I am left wondering if the reduced harm apparent from the Narghile smoking is created through its lower frequency of use, dose and social surroundings.... read full comment

Comment on: Dar-Odeh et al. Harm Reduction Journal, 8:24

Leukoencephalopathy associated with heroin inhalation: a proxy for bad drug policy (Jean-Paul Grund, 16 March 2011)

Dear... read full comment

Comment on: Buxton et al. Harm Reduction Journal, 8:3

Keep up the good work (brett davis best, 01 September 2010)

I would like to say that in my opinion also my hands on experience that Harm reduction is by far the greatest positive factor for the decrease of Hiv/Hep-c in the downtown eastside.Vancouver Coastal Health must continue to fund the these needle exchange programs.A greater focus must be put on arranging needle programs in other parts of the greater Vancouver area!! read full comment

Comment on: MacNeil et al. Harm Reduction Journal, 7:11

Correction by the author (Carl Phillips, 03 July 2010)

It has been called to my attention that one of my conclusions does not match the calculation that is presented. In particular, the statement in the abstract, “for the average smoker, smoking for just one more month before quitting causes greater health risk than switching to a low-risk nicotine source” should read either “for a smoker who is doomed to die from smoking if he does not quit, smoking for just one more month….” or “for the average smoker, smoking for just a few more months….”. The latter is probably better as the take-away message from the analysis.

The explanation is that I ran two different calculations when carrying out this analysis, one for the average smoker and one for those smokers who are... read full comment

Comment on: Phillips Harm Reduction Journal, 6:29

About our work (larry pasco, 03 July 2010)

We in Indiana have always done distribution rather then exchange it much easier , it has caused us some problems with some in the community, but we also provide sharps to users, so for us we direct the states's largest Harm Reduction organization and the largest network of peer to peer exchangers and for 17yrs it has worked.when we did do street exchage it we had so many problems but since allowing users to take care of their needs it is working.It might not be right for all projects . read full comment

Comment on: Small et al. Harm Reduction Journal, 7:1

Author of this article has moved to a new Institution (David Thaler, 16 August 2009)

I am the author of this article and have recently moved.
My new contact mail address and email are:

David Thaler
Price Genetic and Translational Research Center Room 550
Howard Hughes Medical Institute
Albert Einstein College of Medicine
1301 Morris Park Ave
Bronx, NY 10461

new email:

read full comment

Comment on: Thaler Harm Reduction Journal, 6:10

Which vaporizer was used for the studies? (Taylor Murray, 18 July 2009)

I couldn't seem to find any information in this article that describes which vaporizer in particular was used for these studies. I believe this is an important factor, because different vaporizers will produce different results. This question is being addressed in vaporizer articles from a large vaporizer store. read full comment

Comment on: Earleywine et al. Harm Reduction Journal, 4:11

Validating findings of qualitative and quantitative research (Arshad Altaf, 07 July 2009)

Naeem Hasan Saleem, Arshad Altaf

In reference to the article published in June 2009 issue of HRJ by Adnan A Khan and colleagues titled “Large sharing networks and unusual injection practices explain the rapid rise in HIV among IDUs in Sargodha, Pakistan” we would like to bring to your attention and readers certain issues that we believe are pertinent to qualitative research particularly focus group discussions. The authors state that 150 IDUs were interviewed in four focus group discussion (FGD) and 30 out reach workers in another focus group discussion. This is a major methodological flaw of conducting an FGD. While this process provides rich information due to flexibilities in the method however, having about 38 persons in one FGD does not seem right.... read full comment

Comment on: Khan et al. Harm Reduction Journal, 6:13

Prohibition of Qat (Khat) Chewing and Tobacco Smoking Does Not Work. Harm Reduction and Consistent Drug Education Do (Kamal Chaouachi, 25 June 2009)

Thanks to the Harm Reduction Journal for publishing this very interesting article on Qat (Khat) by Dr Hussein Ageely [1]. The reader may regret however that the author have not sufficiently underscored the importance of the sociologic and anthropologic context of Qat (Khat) use. For instance, 10 years ago, a retired professor of chemical pathology concluded the narration of his own participating experience in a Qat party with these words:

“Every society has its own forms of chemical escape”[2].

Also, unlike most authors, Dr Ageely did not apparently deem relevant to mention the co-occuring use of one of the different local water pipes during the Qat parties. This tall pipe is called Mada'a (whereas it is named... read full comment

Comment on: Ageely Harm Reduction Journal, 6:11

Limitations and fallacies in sex work research (Michael Goodyear, 20 April 2009)

Benoit and Paterson provide a welcome opportunity to discuss the many issues to be considered when designing and interpreting research on sex work. Even the definition of sex worker requires careful consideration, since an act does not define a person. Much of sex work is private, invisible, and a part-time occupation across a very diverse background of education, and professional lives. By default then researchers have focussed on the more visible parts of the spectrum of sex work.

Researchers are influenced by many factors including their own personal and moral values, and privilege, which may also influence the answers obtained from participants. Available funding and sponsor philosophy may be heavily weighted to dominant discourses, and access is likely to be very skewed.... read full comment

Comment on: McInnes et al. Harm Reduction Journal, 6:5

Engendering Knowledge about Sex Workers, Drug Use and HIV/AIDS (Cecilia Benoit, 27 March 2009)

Cecilia Benoit, Centre for Addictions Research of BC & Dept of Sociology, University of Victoria

Jody Paterson, freelance writer, Victoria, BC.

Mikael Jansson, Centre for Addictions Research of BC, University of Victoria

We appreciate the comment of Dr. Goodyear, “Unintended results of research,” and the follow up response from Drs. Druyts, Hogg and Montaner. We are impressed that the authors acknowledged that their original article should have stated their data source for estimates of HIV/AIDS prevalence rates for sex workers was confined to female survival sex workers from Vancouver’s Downtown Eastside, who use addictive substances and live in improvised conditions (i.e., the authors note their “estimate therefore does not... read full comment

Comment on: McInnes et al. Harm Reduction Journal, 6:5

RE: Unintended results of research (Eric Druyts, 14 March 2009)

We thank Dr. Goodyear for his response to our article. We fully agree with his concerns surrounding the recent coverage of our work on HIV prevalence in British Columbia, Canada. Dr. Goodyear has expressed difficulty in seeing how this study will benefit the individuals who participated in the research. Of note, estimates of HIV prevalence among at-risk groups are vital in planning for the development and provision of appropriate policy and programmatic responses. We wish to affirm that it is our overarching goal to ensure that there are adequate services for all individuals living with HIV infection in Vancouver. The WHO has consistently shown that less than 10% of sex workers have adequate access to HIV prevention and care resources.

Our paper did not aim to highlight HIV... read full comment

Comment on: McInnes et al. Harm Reduction Journal, 6:5

Unintended results of research (Michael Goodyear, 07 March 2009)

A fundamental principle of ethics in research is that the object of the research, in this case people infected with HIV, should benefit from the research. Those living in Vancouver will already be familiar with the political fallout from sensationalist media coverage of this article, stressing 'more than a quarter of female sex trade workers in city infected'.

Therefore, although unintended, the research subjects have been harmed, stigmatised and quite probably subjected to increased levels of violence. The health and social problems of Vancouver's Downtown Eastside (DES) are well known in Canada, and it is difficult to see how this research will benefit them.

This is one of many studies from the B.C. Centre for Excellence in HIV/AIDS, nearly all of which... read full comment

Comment on: McInnes et al. Harm Reduction Journal, 6:5

Substance abuse and pharmacy practice (Bob Sam, 20 September 2008)

This site gives us the information about the Substance abuse and pharmacy practice.University of Maryland School of Pharmacy, which was founded in 1841, is the 4th oldest pharmacy school and the only pharmacy school in Maryland state.=======================================================BobAlcohol Addiction Treatment read full comment

Comment on: Tommasello Harm Reduction Journal, 1:3

Potential Hazards of Aluminium Foil When Inhaling Heroin (Kamal Chaouachi, 24 July 2008)

Smoked heroin users’ concerns over the thickness of the aluminium foil, its coating with oil and even the way to use it (with the dull or shiny side up) are striking when comparing this situation with the modern hookah scene in which, most of the time, kitchen foil is used.In the hookah (shisha, narghile), a burning coal tops the foil which covers a bowl containing the smoking mixture (called “moassel” or “tobamel” and made up, mainly, of tobacco (or a no-tobacco substitute) and molasses. While the temperature of the coal may vary between 350 and 450 °C, that of the tobamel hardly goes in excess of 150 and sometimes 200°C (*).In these conditions, we are still below the melting fusion point of aluminium and I am emphasising on this because I once... read full comment

Comment on: Pizzey et al. Harm Reduction Journal, 5:24

The Most Beautiful Girl in the World Cannot Give More than What She Has and the History of “Tobacco Control” Will Absolve Me (Kamal Chaouachi, 16 July 2008)

A rebuttal to Dr MAZIAK’s Comment (8 July) *************** CONTENT *************** 1) INTRODUCTION2) EPIDEMIOLOGICAL CATEGORISATION3) CAUSALITY IN OUR STUDY4) ETHICS5) ON SCIENCE, PSEUDO-SCIENCE, “LISSENKOIST” SCIENCE AND “JUNK SCIENCE”6) “NICOTINE ADDICTION” DOGMA7) TOBACCO INDUSTRY8) PUBLIC HEALTH AND COOPERATION9) CONCLUSION10) REFERENCES***********************************************1) INTRODUCTIONMy colleagues and I consider, with all due respect, that Dr MAZIAK is doing nothing more than what we call in our country "Bahas baraey bahas", i.e. discussion just for discussion. In Arabic, we would say Tharthara. This is his third comment and we wholeheartedly wished our commentator was able to identify a single error in our study so the discussion... read full comment

Comment on: Sajid et al. Harm Reduction Journal, 5:19

Rewriting history (Wasim Maziak, 08 July 2008)

Dear EditorIn his responses Chaouachi aims to rewrite the history of science and tobacco control. But whatever is said facts cannot be twisted. The study they published in HR is not a cohort study, prospective or retrospective, because in retrospective cohort studies we start from the exposure and go back to the records to look for the outcome (i.e. the outcome has not only occurred but assessed). In their study, they assessed actively both the exposure and outcome at the time of study, a classical cross sectional study. This reflects basic unawareness of research methods. His argument of causality, as synonymous to dependence, reflects another basic unawareness of the concept of causality in science, and in public health in particular, where certain conditions should be present to infer... read full comment

Comment on: Sajid et al. Harm Reduction Journal, 5:19

The Lessons of May 58th. How We Tried to Change the World at the 58th Session of the United Nations INCB (International Narcotics Control Board) - Vienna, 9 May 1995 (Kamal Chaouachi, 08 July 2008)

Canadians are outraged, but also peoples of the world in general and especially South Americans these days. From Caracas, Johanna Levy recently informed us how Bolivia and Peru have strongly rejected some of the recommendations published in the last INCB (International Narcotics Control Board) report. Hugo Chavez, the Venezuelan president, would support Evo Morales, the Bolivian one, and would have gone as far as publicly declaring that he chews coca leaves every morning “to keep fit” [1-2]. Now, here what this document states: "Recommendation 7: […] The Board calls upon the Governments of Bolivia and Peru to initiate action without delay with a view to eliminating uses of coca leaf, including coca leaf chewing, that are contrary to the 1961 Convention [etc.]" [3].The... read full comment

Comment on: Small et al. Harm Reduction Journal, 5:16

Response to Maziak (Reuven Dar, 03 July 2008)

We read the recent study by Sajid and coworkers [1] and the subsequent comment by Maziak [2] with great interest. We were dismayed, however, by one sentence in Maziak's comment, in which he criticizes Sajid et al. for “the presentation of the issue of nicotine's central role in tobacco dependence as one that is undergoing substantial debate, by citing evidence of associates of the tobacco industry [italics ours]." The evidence cited by Sajid and coworkers, and which Maziak attempts to discredit in the above statement, refers our critique of the nicotine addiction thesis, which was published in a book [3] and in several articles in highly respected journals, including Psychopharmacology and the Journal of Consulting and Clinical Psychology [4-7]. The same derogatory and dismissive... read full comment

Comment on: Sajid et al. Harm Reduction Journal, 5:19

REBUTTAL (KC) to Dr MAZIAK’s (26 June) Remaining Objections (Kamal Chaouachi, 03 July 2008)

************ CONTENT ************ 1) Introduction2) Age Adjustment3) Putting Two Studies Straight4) The Mysteries of Epidemiological Classification5) Narco-Ethics (cont.)6) The World Tobacco Prohibition Agenda7) The Six Actual Filters of the Hookah8) The End of the “Nicotine Addiction” Dogma9) The Emergence of Scientific Integrity Resources in Tobacco Issues10) Harm Reduction11) Conclusion12) References13) Dr MAZIAK’s Reference to KC’s Rapid Response (2 Dec 2004) in Tobacco Control******************************************************1) INTRODUCTIONDr MAZIAK, head of the US-Syrian Centre for Tobacco Studies, feigns to ignore that the detailed rebuttal to which he refers was signed by 2 authors, not by Dr Chaouachi only. In these conditions, I have no problem in... read full comment

Comment on: Sajid et al. Harm Reduction Journal, 5:19

Rhetoric cannot substitute for scientific and ethical standards of human research (Wasim Maziak, 26 June 2008)

Quick response1-Abstract: In research when it is said that a level is lower, that usually means significantly lower. Also in research, the abstract’s conclusions should sum the results of the study at hand not other study. 2-Study design: Chouachi says that this is a cohort study not cross sectional, while in this study the exposure and outcome were measured at the same time, and has no element of a cohort study (i.e. freedom of outcome [CEA] at the beginning, and follow up until the outcome develops). 3-Ethical considerations: in the published study we read that the study was “considered exempt from Pakistani human subjects regulations because the analysis did not expose the volunteers to risk”. Now we know from Chouachi’s response that there is no ethics committee... read full comment

Comment on: Sajid et al. Harm Reduction Journal, 5:19

REBUTTAL: Point-by-Point Response to Purported “Methodological Problems” in Our Study (Kamal Chaouachi, 17 June 2008)

This document is the second part of our rebuttal to Dr Maziak’s commentCONTENT1) Introduction2) Objective and Nature of our Study3) Age Adjustment4) Active and Passive Smoking5) Publication Bias and Overstatements6) Nicotine and “Nicotine Addiction”7) PAH (Polycyclic Aromatic Hydrocarbons)8) SNUS, Cessation and Harm Reduction9) References10) Conclusion***************************************************************************************1) INTRODUCTIONWe wish to thank the Journal of Harm Reduction for allowing Dr Maziak, Head of the US-Syrian Centre for Tobacco Studies, to participate in a free debate on a tobacco issue. This attitude has become rare in scientific journals, particularly those directly related to this theme. We are advocates of scientific controversy. One... read full comment

Comment on: Sajid et al. Harm Reduction Journal, 5:19

REBUTTAL: INTRODUCTORY KEY-POINTS to Our Reply to Purported “Methodological Problems…” (Kamal Chaouachi, 16 June 2008)

HOOKAH COMPARED WITH CIGARETTESWe have described in 2 studies a smoking method used for centuries, particularly in Asia and Africa. In the first one, published in JPMA (Journal of the Pakistan Medical Association), we measured CEA levels in cigarette, hookah (mixed with cigarettes/bidis), and non-smokers [1]. In the second study, published in HRJ (Harm Reduction Journal), we have selected exclusive/ever hookah smokers [2]. This is in contrast with most of the ““waterpipe”” studies of this decade in which unsubstantiated statements about smokers whose career was unclear are frequent [3]. In our 2 studies, the hookah is filled with a quantity of up to 120 g of a tobacco-molasses mixture each (i.e. the tobacco weight equivalent of up to 60 cigarettes of 1 g each) and... read full comment

Comment on: Sajid et al. Harm Reduction Journal, 5:19