WHAT IS HARM Reduction?

To reduce the health and social harms associated with

addiction and substance use, and other risky behaviour. ,
Without necessarily requiring people who use substances
from abstaining or stopping.

Harm Reduction is practical and evidence-based.

(CMHA Simcoe County, 2023)
How does Harm Reduction look like
HR
ONTARIO
• Harm reduction is a part
of the Canadian drugs
and substances strategy
 Philosophy/Principle
Meet the person “where they are”
Client centred approach
to address the unique
Grounded in social
needs of each individual
justice and human
based on their
rights model.
strengths and
limitations.

HR is a non-
Pragmatic: abstinence
judgemental approach
may not be everyone’s
and respects person’s
goal of realistic for
autonomy regardless of
them.
their choices.

(Harm Reduction International, 2023)

History of HR

the 1960s, 1970s, and 1980s 1983 2004

Stems from multiple movements By 1983, PWUD began the distribution Ontario Needle Syringe Programs
emerging across the United States in of sterile syringes to limit the distributed 3.2 million needles and
the 1960s, 1970s, and 1980s:States transmission of HIV/AIDS (McLean, syringes
2011).

CDC human immunodefciency virus The first Needle Syringe Program is

(HIV) is transmissible through the established through Toronto Public Safer crack smoking supplies now
intravenous use of drugs (CDC, 1982). Health available through OHRDP

1982 1989 2014

(Ontario Harm Reduction Distribution Program, 2023)

 Evidence based
30 years of research: Syringe Service Programs
(SSPs) IS:
• Safe, effective, and cost-saving, do not
increase illegal drug use or crime, reduce the
transmission of viral hepatitis, HIV and other
infections.
• Increase Entry Into treatment for substance.
• 5x times more likely to access treatment.
• 3x more likely to stop using drugs.
(Summary of Information on the Safety and Effectiveness of Syringe Services Programs (SSPs) |
CDC, n.d.)
 Education

HR Support
strategies Access

Linkage
 OPIOID CRISIS
• Leading cause of unnatural death in BC since 2016.

• 2016, illegal fentanyl was detected in 60% of deaths.

• In 2018, 4.5 times more overdose deaths than deaths from motor vehicle
crashes.
• For every 10 naloxone kits that are used, one death has been averted.
• Overdose Prevention Sites - 2017, there are 20 OPS across BC. 67,000 visits and
1000 managed overdoses, there have been no deaths at any OPS
• Along with opioid agonist treatment, overdose prevention services, and
supervised consumption services.
• (The BC Public Health Opioid Overdose Emergency, 2017)
Interesting facts
• Tobacco - Nearly two in three lives lost
(46,366 deaths).

• Alcohol and opioid -fewer deaths than

tobacco (17,098 and 6,491 deaths,
respectively).

• In 2020 2X people died in Canada of opioid

since 2007 due to unintentional poisonings
from drug and drug toxicity.

(Canadian Substance Use Costs and Harms, n.d.)

InSite visits Statistics Canada

As of 2023, 38 sites The busiest Supervised

4.17 million
operating, estimated Consumption Sites (SCS)
visits between 2017 and
around 2,600 visits every in Canada sees 400
March 2023.
day. visits each day.

70% of the substances Connected individuals

Around 239,000 referrals
consumed most with health and social
to such services between
frequently were opioids services (medical care,
2017 and March 2023
with fentanyl and mental health support,
(Health Canada, 2023).
hydromorphone. and/or housing services).

(Health Canada, 2023))

 If Insite were closed:

Cost HIV infection annually – Vancouver expected to

increase infection by IDU from 179.3 to 262.8.

Effective These 83.5 preventable infections are associated

with $17.6 million (Canadian) in life-time HIV-
related medical care costs.
Greatly exceeding Insite's operating costs, which are
approximately $3 million per year.

(Pinkerton, 2010)
 Public acceptability: NIMBY

Blue lights in restaurants - installed in public washrooms to

discourage injecting drug use, reduce vein visibility.

Public safety

CHALLENGES/MYTHS
Increased drug use

Decrease property value

Promote drug use and effects on youth

 In a survey of 557 Peel residents
conducted for the opioid strategy,
61 per cent said “they wouldn't
want a site in their
neighbourhood”.

Another Brampton resident, Gerri-

CONTINUE… Leah Ellery, said “money would be
better spent on mental health
services at Brampton Civic Hospital
or policing drug dealers”.

(Montgomery, 2020)
 Benefit of HR

Access to social and Community safety-

Prevent HIV, hepatitis Reduce overdose deaths
health services without Promote safe needle
and other infections risks
barrier disposal.

Reduce criminal activities

Educate about safer sex Increase referrals to
Prevents transmission of and promote/increase
and sexual health related treatment and other
disease and injury employment
harms. housing support.
opportunities.
The purpose of Supervised Consumption Services (SCSs)
 The purpose of Supervised Consumption Sites (SCSs)

- Clinical spaces for people to consume their own substances, and use
in proximity to trained health professionals. (Injection, intranasally
or orally).
- Pathways to treatment and accessing social services
- Improving the health status of people who use substances by having
trained professionals immediately available in case of an overdose
- Providing access to mental health services, and other healthcare
needs
- Reducing overdose deaths and transmission of infection by
educating on safer practices
10 SCS locations in Toronto:
1. Fred Victor, 159 Jarvis Street
2. Moss Park Overdose Prevention Site, 134 Sherbourne Street
3. Parkdale Queen West Community Health Centre, 168 Bathurst Street
4. Parkdale Queen West Community Health Centre, 1226 Queen Street W.
5. Regent Park Community Health Centre, 465 Dundas Street E.
6. South Riverdale Community Health Centre KeepSIX, 955 Queen Street E.
7. Street Health, 338 Dundas Street E.
8. Kensington Market Overdose Prevention Service, 260 Augusta Avenue
9. Toronto Public Health The Works, 277 Victoria Street
10.Casey House, 119 Isabella Street
 •Criminalization - This PHO Special

HR
Report examines the criminalization of
people who use drugs in BC, Canada
offers a single recommendation:
decriminalization of people who use

Increase
drugs in BC.
•Downtown parts of Vancouver crime
prior to Insite

crime
• Oct 2003-04 - After 2005
•Drug traffic - 124 - 116
•Robberies - 147 - 180
•Vehicle theft - 302 - 227

(Myth) •Barriers for minority groups LFBTQ and

gender -
Stigma and politicization (5:03)
Safer Supply projects

►Pilot projects also known as SUAPs (Substance Use and

Addiction Programs)
►Providing pharmaceutical grade substances, opioids,
stimulants and benzodiazepine’s as an alternative to toxic
drug supplies.
►Currently only being approved for 1-4 years
►List of all SUAPs on Health Canada website. Interactive map
showing Canada's response to the opioid overdose crisis
Approach

Person-first language - Established language…

Placing the person first Addiction and/or
and the diagnosis or Substance use disorder
behavior second helps (SUD). Sam is a person
eliminate stereotypes that with addiction. People with
can form. substance use disorder
Who are Harm Reduction practitioners?

Outreach Workers:
Deliver Medical Supplies
to PWUD

Nurses and Doctors:

Concern are the Health of
PWUD

Educators and community

organizations: Safer Use,
About Naloxone

INDIVIDUALS: Who use

HR as their recovery
pathway to a better life
Harm Reduction Outreach Coordinator/Drug Culture Consultant
Multifaceted responses

Engagement with people with lived experience, family and friends.

Public education and targeted information campaigns,

Enhanced data collection and analyses,

Increased access to evidence-based treatment for opioid use disorder

Rapid distribution of publicly funded naloxone to reverse overdoses,

Enhanced toxicological testing capability, passage of Good Samaritan legislation and other
legislative changes.