Government

Quick access to information based on government's structure

Ministry of Health

Harm Reduction

Harm reduction is a pragmatic response that focuses on keeping people safe and minimize death, disease, and injury from high-risk behaviour. At the conceptual level, harm reduction maintains a value neutral and humanistic view of drug use and the drug user. It focuses on the harms from drug use rather than on the use itself. It does not insist on or object to abstinence and acknowledges the active role of the drug user in harm reduction programs. It involves a range of strategies and services to enhance the knowledge, skills, resources, and supports for individuals, families and communities to be safer and healthier.

Specifically for problematic substance use, harm reduction refers to the policies and programs that aim to reduce the adverse health, social, and economic consequences of mood-altering substances to individuals who use drugs, their families, and communities, without necessarily requiring a decrease in drug use. Harm reduction recognizes that individuals may not be ready or able to stop their drug habits and focuses on reducing the harmful effects of drug use and connecting these individuals to health and social services, such as referrals for detoxification and treatment when desired. Harm reduction is an essential part of a comprehensive response to problematic substance use that complements other prevention activities, treatment and enforcement. For further information regarding harm reduction, visit the BC Health File on Understanding Harm Reduction available online.

A range of services is available to reduce harms from substance use, including the distribution of new needles and other injection supplies. For more information on harm reduction and current initiatives please visit the British Columbia Centre for Disease Control (BCCDC).

The BC Harm Reduction Strategies and Services (HRSS) committee launched the inaugural Issue of Strategies in May 2008, its semi-annual newsletter which highlights the latest information on harm reduction principles, policies and programs in British Columbia. The Harm Reduction Supplies Program of the BCCDC purchases and distributes harm reduction supplies to more than 170 sites across the province to support regional health authorities in delivering and expanding harm reduction services for people who use illegal drugs.

NEEDLE DISTRIBUTION

Needle distribution programs, pioneered in the Netherlands in 1980, are perhaps the most well-known harm reduction initiatives because of their success in preventing the spread of diseases and conditions that occur through the sharing unclean needles and non-sterile equipment. This type of program works with people who use injection drugs to make clean needles accessible, remove dirty needles from the community, provide education on safer injection practices and connect clients to other health and social service resources.

Needle distribution is designed to provide clean needles, syringes and other injection related supplies to meet each client's individual need, with or without the return of used needles and syringes. The client should receive enough needles and syringes to be able to use new and sterile supplies for each injection. There are many needle exchange and needle distribution programs around the world. Each has a different policy on the implementation of the program- some programs have a one-for-one exchange policy in which one needle is given for each needle returned while other programs do not require the return of used needles before giving out new ones.

Insite

Insite is North America's first legal supervised injection site (SIS) and has been operating in Vancouver's Downtown Eastside since September of 2003. Insite is operated by Vancouver Coastal Health (VCH), in partnership with the PHS Community Services Society.

Insite has provided a safe and clean environment for individuals to inject drugs, meet with health care professionals and access addiction and treatment services. Vancouver Coastal Health recognizes Insite as a vital component of their continuum of care for people with addiction, mental illness and HIV/AIDS.

To access research regarding Insite and its impact on the community in Vancouver, please visit: http://www.vch.ca/sis/research/

The BC Centre for Excellence in HIV/AIDS is responsible for conducting evaluation of Insite to investigate whether a supervised injection site will reduce harm associated with injection drug use for individuals and the community at large.

Crack Pipe Mouthpieces

People who smoke crack experience chronic cuts, burns, blisters and open sores inside their mouths and on their lips and gums. Pipes used by crack smokers infected with hepatitis C and with oral lesions sometimes test positive for hepatitis C virus. Evidence suggests that if glass pipes for crack smoking are shared, individuals may be at increased risk of exposure to hepatitis C and other communicable diseases. Providing harm reduction supplies such as plastic mouthpieces for people who smoke crack allows them to protect themselves from exposure to communicable disease risks. Furthermore, mouthpiece distribution for safer crack use creates opportunities for engagement with otherwise hard-to-reach populations of marginalized and vulnerable individuals. There is evidence that the majority of crack smokers do not concurrently inject drugs. Therefore, peer-based outreach and mobile services also need to include plastic mouthpiece distribution in order to reach these individuals.