Harm Reduction and Supervised Injection Sites in Canada

Harm reduction is a term that Canadians are hearing more and more as the opioid crisis deepens and public health officials look for ways to mitigate the fallout. Supervised injection sites are a key component to a lot of harm reduction policies, and both concepts need to be better understood. Some Canadians think that needle-exchange programs and supervised injection sites are the ‘government giving addicts free drugs’ and don’t understand why this is the government’s response. This blog will explain what these two concepts are, and why they are considered to be both innovative and effective in the fight to save substance users’ lives.

 

What is Harm Reduction?

The Canadian Drug Policy Coalition defines harm reduction as “policies, strategies and services, which aim to assist people who use legal and illegal psychoactive drugs to live safer and healthier lives.” The Coalition believes any person has the right to receive respect, compassion, and the services they require whether they choose to decrease their substance use or not. The BC Centre for Disease Control includes a number of services and strategies under the umbrella of harm reduction, such as: overdose prevention and response training, impaired driving prevention campaigns, needle distribution programs, substitution therapies, supervised consumption facilities, support programs and outreach. This is a good reminder that harm reduction is not just about creating access to clean supplies and space, but also to provide outpatient services like education and peer support programs. These support services make it easier for people to reduce their consumption of substances, and find recovery treatment.

 

What Does Harm Reduction Look Like in Canada?

Despite opposition, in 2007 the Conservative federal government removed harm reduction as an official element of the country’s federal drug strategy. During the same time, Canada opposed harm reduction in international forums, and in 2015 passed Bill C-2 that created unnecessary hurdles to establishing supervised consumption sites. The federal Liberals have not repealed Bill C-2, even in the midst of the opioid epidemic. Bill C-2 requires health authorities to go through many public consultation meetings and extra red tape to get a permit to operate a supervised injection site. Vancouver Coastal Health said that the process to apply for exemptions is “extremely challenging” and involves a large amount of health-care resources that “could be better spent on direct client care and addiction treatment.”

However, due to the dramatic increase in overdose deaths over the last two years provinces are putting in their own protections. For example, in 2016 Alberta implemented a harm reduction strategy with supervised consumption sites at the heart of their plan to save opioid user’s lives. Vancouver, and BC as a whole is also one of the most vocal proponents for nationwide harm reduction policies as the province has seen the most overdose deaths, totaling over 4000 in 2017 alone.

 

Supervised Injection Sites in Canada

In 2003, Insite, the first supervised injection site in North America opened in Vancouver’s Downtown Eastside. Insite has been a testing ground to prove the efficacy of supervised consumption sites, and has provided a kind of blueprint for other provinces looking to increase their services. One of the biggest concerns local residents and city officials usually have about supervised consumption sites is that they will increase the amount of littering, loitering, and drug use in their community. However, Insite and other supervised injection sites have shown that this is not the case and in fact they decrease the amount of public drug use in the area. Substance users are still members of our community, and their health care needs should be just as important as the rest of the community. Keeping substance users healthy and safe through clean supplies and other outpatient services at supervised injection sites ultimately makes the whole community safer and healthier.

 

References:

• BCCDC: Harm Reduction
• CDPC: Harm Reduction
• Bill Adding New Safe-Injection Requirements Receives Royal Assent

JMC 2018.05.24

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