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  1. After reading the case studies at home, have the students participate in a class discussion of each case study by responding to the following questions.

    Case Study: Insite-North America's First Supervised Injection Site
    • What are the benefits of having a supervised injection site (SIS) available for injection drug users?
    • What are the potential drawbacks of an SIS?
    • What are some of the attitudes that community residents display towards a local SIS.
    • What do you think? Is an SIS a good idea or not?
    • What would happen if a group of injection users organized and requested an SIS in our community?


    Case Study: Forcing a woman to take substance-abuse treatment to protect her unborn child (the case of Ms. G)
    • What argument does the article make as a reason for legally requiring the woman in question to enter treatment?
    • What are the benefits of requiring a pregnant woman to enter treatment?
    • What are the drawbacks of making it possible to force a pregnant woman into drug treatment, whether she wants to go or not?
    • What do you see as the legal rights of a long-term drug user?
    • How do you think people in your community would respond if the woman in question lived here and was well known?


    Case Study: North American Opiate Medication Initiative Project-Prescription Heroin for Drug User Treatment
    • What argument does the article make as a reason for offering heroin by prescription to heroin addicts?
    • What are some of the attitudes that community residents display towards prescription heroin?
    • What do you think? Is prescription heroin for drug users who are trying to get off drugs a good idea or not?
    • What would happen if a treatment service in our community wanted to offer prescription heroin?


  2. Wrap up the discussion by noting that each of these cases reflects a harm-reduction approach to dealing with substance-use problems. Harm reduction is an approach that is concerned with reducing the various harms (e.g., overall health of the person, public disorder) associated with substance use without necessarily requiring abstinence. Harm reduction is now considered one of the four pillars of drug policy in this country (along with prevention, treatment, and enforcement) and, although controversial in some respects, represents the most significant shift in public attitudes and government policies witnessed in this country in the past 10 years.

    Extension Opportunity
    All of these case studies work well in the form of a class debate.