harm reduction harm reduction harm reduction
Harm reduction refers to “policies, programs and practices that aim primarily to reduce the adverse health, social and economic consequences of [drug use] without necessarily reducing drug consumption.” Advocates describe harm reduction as “meeting people where they’re at.”
Harm reduction services do not require abstinence or reduced substance use and they acknowledge that despite even the strongest efforts to get someone to end their drug use, many people will not because they are unable to stop at a given time and enter treatment, or because their use is not problematic. Harm reduction services often also include advice on safer injecting; access to drug treatment programs, including opioid substitution therapy; and vital connection with peers that builds a sense of community and purpose, increasing the likelihood of recovery.
Benefits & Positive Outcomes
Harm reduction services have been very well-studied in Canada and globally, and the evidence is clear that harm reduction
- Saves lives by preventing fatal overdose, helps people avoid arrest, prevents disease transmission (HIV, hepatitis C), improves access to drug treatment, and improves public safety by reducing needles in the community
- Is cost effective due to savings from prevented disease transmission, plus the increased productivity of people using harm reduction services far outweigh the cost of the programs themselves
- Does not encourage increased drug use and has been demonstrated to have no negative impact on public safety around locations where services are provided
Examples of Harm Reduction
- Needle syringe programs (NSP) – Programs providing sterile equipment to people who inject drugs. NSPs can be in fixed locations or mobile sites, such as a van or person with a backpack handing out supplies. Some programs operate through pharmacies or automated dispensing machines. NSPs exist in many communities across Canada.
- Supervised consumption services (SCS) – Federally sanctioned fixed or mobile sites where people can use substances in a monitored, hygienic environment. Supervision is typically done by a medical professional who intervenes if a person experiences a medical complication such as an overdose. No one has ever died from an overdose in an SCS despite thousands of injections and/or inhalations in these facilities. SCSs provide many other services in addition to supervision, such as referrals to treatment and drug checking. Supervised consumption services do not provide the drugs, only a safe setting and support services for individuals.
- Overdose prevention sites (OPS) – These are similar to supervised consumption sites, but they operate under different authority from the government (or at times without government sanction), and with a simpler application process for service providers. Overdose prevention sites are often initially run by volunteers and are crowdfunded. They are a direct response to an urgent and specific community need wherever they are set up.
- Drug checking – A service that allows people to test what is in their drugs. Drug checking can use technology that varies widely in cost and accuracy. For example, Fourier transform infrared (FTIR) spectroscopy, which can cost tens of thousands of dollars, can rapidly and accurately identify a wide range of compounds in a sample. Fentanyl immunoassay testing strips, which are less expensive, can only detect whether fentanyl (and sometimes analogues) are present in a sample. Increasingly, drug checking is available alongside harm reduction services (such as an SCS or OPS) and at festivals, and also by mailing a sample to a lab in some places.
- Safe supply – A program that provides pharmaceutical-grade drugs for people who are currently purchasing them from the illegal market. This program can be operated in tandem with an SCS and provides many other supportive services. These substances may also be distributed through low-barrier housing providers or automated dispensing machines. Safe supply includes interventions such as opioid agonist therapy (OAT) and injectable OAT (e.g. heroin-assisted treatment).
- Naloxone distribution – A program that distributes free or inexpensive naloxone to people who use drugs as well as to their friends and family for rapid intervention to prevent death by overdose. Naloxone can be administered through a syringe or nasal spray.