9.2 What is harm reduction

I did have a family doctor for some time, until I told her I was escorting for work. And she totally turned her nose up at me. I wanted to get a pap smear and a blood test, but she basically sent me out. So I went somewhere else and got it done. My safety and my wellbeing is still, huge. I might be a drug addict, but, like, regardless I want to make sure that I’m healthy and get checked. Because, you know, it’s a dangerous lifestyle. And you would expect your doctor to help you.[1]

Harm reduction, based on the definition by the International Harm Reduction Association is stated as “policies, programmes and projects that aim to reduce the health, social and economic harms associated with the use of psychoactive substances. It is an evidence-based and cost-effective approach – bringing benefits to the individual, community and society”.[2]  In Canada, harm reduction programs are heavily dependent on community-based agencies and reliant on provincial and federal government funding for service provision, so lack consistency.  In 2015, “only two jurisdictions in Canada had current provincial-level, stand-alone harm reduction policies”,[3] which confirms what many individuals working in harm reduction in Canada have suggested, that a harm reduction philosophy is not embedded in policy or funding at any governmental level.

There are a variety of agencies that address substance use, from the Government of Canada, correctional facilities, Public Health, Canadian Centre on Substance Abuse, The Centre for Addiction and Mental Health, National Native Alcohol and Drug Abuse Program, and various health authorities, private agencies, and businesses as well as non-governmental organizations across the country.  Each of these agencies have a mandate to address substance use in some way, from individual treatment through to incarceration.  Each of these agencies focuses on substance use differently, some recognizing the intersectionality of substance use while others do not.  Part of the work of Social Service workers is to address the stigma associated not only with substance abuse but also with harm reduction.  How can this be done?

Activities

  1. Review this Position paper on harm reduction by the International Harm Reduction Association.[4]
  2. What does the term “targeted at risks and harms”[5] suggest?
  3. What are two harm reduction strategies or programs you can identify in your community?
  4. What theories try to address harm reduction?  How do they suggest this be done?
  5. Why do some claim that harm reduction is cost-effective?
  6. How does harm reduction address the intersectionality of substance use?

Why is harm reduction important?  Effective harm reduction programs seek to serve some of the most marginalized individuals in our country.  As we have explored, substance use is frequently misunderstood and stigmatized; therefore it stands to reason that harm reduction strategies that help support individuals who use substances would be concurrently maligned and perhaps not overtly supported in Canada.  Part of your work, as Social Service workers, is to address the stigma associated with not only substance abuse, but harm reduction.  Please watch the video below to further understand harm reduction in Canada.[6]

Harm reduction is a philosophy that can humanize the way we see/engage with and support people who live with a substance use disorder and a way we can reduce stigma and help educate the public.


  1. Torchalla, I., Linden, I. A., Strehlau, V., Neilson, E. K., & Krausz, M. (2014). “Like a lots happened with my whole childhood:” Violence, trauma, and addiction in pregnant and postpartum women from Vancouver’s Downtown Eastside. Harm Reduction Journal, 11, 34. https://doi.org/10.1186/1477-7517-11-34
  2. International Harm Reduction Association. (2021). What is harm reduction. https://www.hri.global/what-is-harm-reduction
  3. Hyshka, E., Anderson-Baron, J., Karekezi, K., Belle-Isle L., Elliott, R., Pauly, B., Strike, C., Asbridge, M., Dell, C., McBride, K., Hathaway, A., & Wild, T. C. (2017). Harm reduction in name, but not substance: A comparative analysis of current Canadian provincial and territorial policy frameworks. Harm Reduction Journal, 14(1), 50. https://doi.org/10.1186/s12954-017-0177-7
  4. International Harm Reduction Association. (2021). What is harm reduction. https://www.hri.global/what-is-harm-reduction
  5. International Harm Reduction Association. (2010). What is harm reduction?  A position statement from the International Harm Reduction Associationhttps://www.hri.global/files/2010/08/10/Briefing_What_is_HR_English.pdf
  6. TedX Talks. (2019, Nov. 6). The merits of harm reduction | Melissa Byers. [Video]. Youtube. https://www.youtube.com/watch?v=qU_MWjIUFmE

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