Toronto Harm Reduction Task Force

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Toronto Harm Reduction Task Force

• Holly Kramer, Project Coordinator

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The THRTF

• is an association of professionals, agencies
  and community members working together to reduce
  the harms to communities and individuals
  associated with drug distribution and use.

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The wisdom of the community will always exceed
the knowledge of the expert.

• -John McKnight

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Harm Reduction

• decreasing the adverse health, social and
  economic consequences of drug use without
  requiring abstinence from drug use.
• Riley et al

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In other words.

• a harm reduction approach does not view or
  promote abstinence as a goal, either in the short
  or the long term.

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The only goal of harm reduction is to reduce or
mitigate harms to

• Individuals (users)
• Families
• Communities
• Society

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Harm Reduction offers

• A social justice response, rather than a
  criminal justice response, to drug use.

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Harm Reduction

• a philosophy,
• a way of thinking,
• a premise,
• an approach,
• a perspective
• NOT a sticker, a buzzword, or a conundrum

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Harm Reduction, AKA

• Risk management or
• or
• Mitigating danger or
• or
• Damage control or
• or
• Injury/death or
• prevention

• Life support
• or
• Health promotion
• or
• Safety endorsement
• or
• REALITY CHECK

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Harm Reduction isa way of thinkinga way of
doing business

• meets people where theyre at in holistic
  way
• respects individuals reasons for using
• acknowledges clients as people deserving of
  dignity and respect

• is non-judgmental does not punish
  use/relapse
• sees use as a symptom, not the problem
• seeks practical ways to reduce harm without
  necessarily eliminating use.

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CRACK PIPE KITSexample of h.r. tool
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Annex Program (Seaton House)example of h.r.
program

• Offers shelter and supports to long term alcohol
  users
• Provides controlled access to consumable alcohol
  (i.e. as opposed to Listerine etc.)
• Residents alcohol use decreases
• Other social determinants of health met e.g.
  improved nutrition, health care needs, hygiene,
  socialization etc.
• AGAIN Alcohol consumption actually decreases!

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Harm Reduction is a continuumall the way from
chaotic use to abstinence

• Recognizes that abstinence may not be
  achievable by everyone
• Understands that using/not using cycle is
  normal
• Meets people where theyre at by
• Encouraging safer use
• Offering alternatives
• A harm reduction approach provides for peoples
  needs regardless of use

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Harm Reduction distinguishes between use and
behaviour

• EG Designated drivers are harm reduction in
  action
• We dont say, dont drink we say dont
  drink and drive.

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Harm reduction

• Understands that drug use is universal
• Recognizes that some people have always used
  drugs usually for a REASON
• Accepts that some people will always use drugs
• Contends that
• No one should be denied service or access to
  service merely because they are using a drug,
  licit or illicit.

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Drug use

• SIGN
• SYMPTOM
• MANIFESTATION
• COPING MECHANISM
• BALM

• UNMET NEEDS
• DESPAIR
• PAIN
• ILL HEALTH
• TRAUMA

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Spot the incongruities!

• Social Determinants
• of Health
• Care in childhood/adolescence
• Education (opportunities)
• Employment/job security
• Food security
• Appropriate housing/stability
• Social inclusion
• Access to health/dental care
• Freedom from discrimination
• persecution/violence/stigma

• Some common experiences among users
• ABANDONED, ABUSED, HOMELESS,
• HUNGRY, ISOLATED,
• NEGLECTED, POOR, SICK, SCARED, SCARRED,
  UNLOVED, UNWANTED, UNEMPLOYED, UNDEREDUCATED

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Providing service from a harm reduction
philosophy

• Recognize the value and necessity of self
  determination and of individual support plans.

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and..

• some people manage well with little support, but
  sometimes have setbacks and need a higher level
  of support, for a while
• people need to be able to move back and forth
  from one level of care fluidity is realistic
• clients should be supported to maintain as much
  independence as they are able
• a spectrum of service is necessary
• BASED ON CLIENT NEED

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Some websites of interest

• www.canadianharmreduction.com
• www.drugpolicy.org
• www.harmreductionjournal.com
• www.ihra.net
• www.habitsmart.com
• www.atkinson.yorku.ca/dce
• www.toronto.ca/health/drugstrategy
• torontoharmreduction_at_yahoo.ca
  647.222.4420