We must call out every irresponsible politician that lies to depict otherwise.
What is Harm Reduction?
A Public Health Strategy
Harm reduction is about reducing the health and social harms that drug use can cause people who use drugs (PWUD), without requiring that people abstain from drug use, because saving lives is more important than stopping drug use
Using drugs in safer ways can prevent unwanted consequences, like accidental overdose and acquiring blood-borne diseases
Healthy public policy looks like supporting harm reduction initiatives
A Social Justice Movement
It is also a movement advocating for respect towards PWUD
Not only do outdated drug policies harm PWUD, but these policies are rooted in racism, classism, and colonialism, making drug policy reform an important element of the racial justice movement
An Approach to Care
Harm reduction is all about meeting people where they are at in a non-judgemental manner
Harm reduction accepts that everyone is on their own nonlinear path to healing with unique needs
It requires radical empathy to focus on patient goals rather than imposing your own perception of what recovery should look like
"There is no recovery model for people who are dead." – Mental Health and Addictions Minister Carolyn Bennett
Supporting PWUD
What's so controversial about supporting the needs of PWUD?
Well, Canadian Conservatives have been consistent in their criticism of evidence-informed harm reduction strategies and emphasis on focusing on efforts that continue to fail PWUD.
Pierre Poilievre, the current leader of the Conservative Party of Canada and the leader of the Official Opposition, has made his stance clear: He is adamantly against evidence-informed harm reduction strategies encouraged by public health experts, like supervised injection sites and safe supply. He believes various myths about harm reduction strategies and ignores experts on the issues.
Poilievre's posts or comments on anything related to PWUD demonstrate his misunderstanding of this issue - he spreads misinformation and increases stigma, which is one of the most significant barriers for drug users to access care.
Let's take a look at the two major evidence-informed strategies Poilievre spends his time spreading misinformation about!
Supervised Injection Sites
Supervised injection sites serve as a place in which people can bring their pre-obtained drugs to use while a criminal code exemption is in place. It acknowledges the fact that these people were going to use the drugs anyways, but can do so in safer ways, where people are trained and ready to respond if an accidental overdose occurs.
Sterile equipment is provided to prevent complications and trained staff are present to respond to overdoses. These facilities foster community and connection between users. Some facilities have drug checking services available, which acknowledges the issue of the tainted drug supply that contribute to accidental overdoses.
So, to summarize, the benefits of these sites (proven through the evidence) include:
Prevention of blood-borne illnesses like HIV and hepatitis
Prevention of accidental overdose deaths
Increased access to treatment and referrals
Reduced burden and costs for healthcare systems
Decreased public substance consumption and reduced drug paraphernalia on the street
Decreased stigma of drug use, which encourages users to seek treatment
The benefits of supervised injection sites have been consistently demonstrated by over 100 evidence-based, peer-reviewed studies over the past 30 years. Between 200 sites currently operating across 14 countries around the world, no one has died of an opioid overdose in a supervised injection site. Anyone fighting to defund these sites does not care about the lives of PWUD.
Safe Supply
Safe supply refers to a legal and regulated supply of drugs with mind/body altering properties that traditionally have been accessible only through the illicit drug market. Drugs included are opioids such as heroin, stimulants such as cocaine and crystal methamphetamine, hallucinogens such as MDMA and LSD, and marijuana.
All this means is supplying PWUD with drugs they were already going to use, but ensuring that their supply isn't tainted with other drugs that may contribute to an accidental overdose. The tainted illicit supply of drugs is a major contributor to the opioid epidemic, with people not really knowing what's in their drugs.
We've seen this before - thousands of Americans died every year during the Prohibition from drinking tainted liquor. The criminalization of drug use is not based in evidence, drugs are always going to be more dangerous when they go unregulated. It also adds to stigma and makes treatment less accessible.
And no, of course safe supply alone will not solve all problems faced by PWUD. But it will save lives while the fight continues to address the root causes of addiction.
Poilievre’s Uninformed Approach
In spite of this, Poilievre has said that Alberta’s "recovery-oriented" model of care is the direction that he would take as Prime Minister. What this actually means is supporting abstinence-only recovery, and rejecting evidence-informed harm reduction strategies. A harm reduction approach encompasses abstinence for those it is realistic for, but supporting abstinence-only approaches as the only response to those dying every day ignores the needs of PWUD. The solution of "more beds" is also simply debunked when you look at the fact that B.C. already has more beds available, yet even higher death rates.
Additionally, Poilievre emphasizes his desire to focus on accessibility to treatment, which may sound good in theory, but these programs ignore reality when they require abstinence. If "Just Say No" worked in the 1980s, we wouldn't still be talking about this. We must shift the current approach of criminalization to a public health perspective. Increasing accessibility to treatment is necessary too, but not while ignoring the lived realities of PWUD.
Let's stop listening to people offering old, failed ideas that do nothing but cause harm and instead take a look at what the evidence has to say about the many myths Poilievre and other Conservative MPs perpetuate.
Alberta is Failing PWUD
In the first 9 months of 2022, there were 5,360 apparent opioid toxicity deaths (over half of which also involved a stimulant). 78% of these death involved opioids that were only non-pharmaceutical, highlighting the impact safe supply could have. Over 1,000 of these deaths were Albertans (with the majority of the remaining deaths occurring in B.C. and Ontario).
Rebecca Haines-Saah, associate professor at the University of Calgary's School of Medicine, describes the issue well: "People are dying because we're fixated on recovery, we're fixated on abstinence, and we're fixated on things that work for some people in the long term. Those are things that address addiction. They don't address the public health emergency."
The Data Supports Harm Reduction
Evidence-informed harm reduction strategies actually increase the likelihood of a drug user seeking treatment
The benefits of supervised injection sites have been consistently demonstrated by over 100 evidence-based, peer-reviewed studies over the past 30 years
There have been 0 overdose deaths in any supervised injection site around the world
And they have reversed tens of thousands of overdoses
Handing out clean needles does not result in more drug paraphernalia on the street - the rate at which needles are turned in is often the same as or higher than the rate at which they are handed out.
For example, a needle exchange program operated in the City of Vancouver reported that across 3 separate years, more needles were turned in than were handed out
Harm reduction means reducing harms for everyone
Drug criminalization is not based in evidence, but rather in racism
Current literature demonstrates that drug use generally doesn’t change with decriminalization, but it does allow for increased access to treatment
See drugpolicy.ca/resources/evidence/ for more!
Stay Informed
Canadian Resources
The Canadian Drug Policy Coalition
Moms Stop the Harm
The Canadian Association of People Who Use Drugs (CAPUD)
Ontario Harm Reduction Network
Harm Reduction Toronto
American Resources
Drug Policy Alliance
National Harm Reduction Coalition
Find harm reduction services in Canada:
www.canada.ca/en/health-canada/services/substance-use/supervised-consumption-sites.html
If you are at all curious about anything discussed here, you need to read Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction by Maia Szalavitz
References
Bailey, I. (2022). Former Harper adviser denounces Pierre Poilievre drug policy unveiled in video. The Globe and Mail. Retrieved from https://www.theglobeandmail.com/politics/article-former-harper-adviser-denounces-poilievre-drug-policy-unveiled-in/
Canadian Association of People Who Use Drugs (CAPUD). (2019). Safe supply concept document. Retrieved from https://vancouver.ca/files/cov/capud-safe-supply-concept-document.pdf
Canadian Drug Policy Coalition. (n.d.). Evidence around harm reduction and public health-based drug policies. Retrieved from https://drugpolicy.ca/resources/evidence/
Drug Policy Alliance. (n.d.). Overdose prevention centers. Retrieved from https://drugpolicy.org/issues/supervised-consumption-services
Government of Canada. (2023). Opioid- and Stimulant-related Harms in Canada. Retrieved from https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants
Government of Canada. (n.d.). Supervised consumption sites and services. Retrieved from https://www.canada.ca/en/health-canada/services/substance-use/supervised-consumption-sites.html
Homeless Hub. (n.d.). Harm reduction. Retrieved from https://www.homelesshub.ca/about-homelessness/substance-use-addiction/harm-reduction
Johal, R. (2022). Why Pierre Poilievre’s video attacking safe supply is misleading and dangerous. Retrieved from https://pressprogress.ca/why-pierre-poilievres-video-attacking-safe-supply-is-misleading-and-dangerous/
Junker, A. (2023). Alberta opioid deaths surpass 1,000 in 2022. Edmonton Journal. Retrieved from https://edmontonjournal.com/news/local-news/alberta-opioid-deaths-surpass-1000-in-2022#:~:text=More%20than%204%2C150%20occurred%20in,39%20age%20group%2C%20with%20221.
Lambert, T. (2023). Despite soaring death rate from opioids, Alberta steers away from harm-reduction approach. CBC. Retrieved from https://www.cbc.ca/news/canada/edmonton/alberta-approach-opioid-crisis-1.6750422
Lerner, M. (n.d.). Unintended consequences of prohibition. PBS. Retrieved from https://www.pbs.org/kenburns/prohibition/unintended-consequences#:~:text=As%20the%20trade%20in%20illegal,effects%20of%20drinking%20tainted%20liquor.
Markov, K. (2022). Is Alberta's approach to addiction truly behind the declining number of drug-poisoning deaths? CTV Edmonton. Retrieved from https://edmonton.ctvnews.ca/is-alberta-s-approach-to-addiction-truly-behind-the-declining-number-of-drug-poisoning-deaths-1.6171969
Smith, A. (2023). Alberta lacks data about how many people need addiction treatment services. The Globe and Mail. Retrieved from https://www.theglobeandmail.com/canada/article-alberta-lacks-data-about-how-many-people-need-addiction-treatment/
Star Editorial Board. (2022). Pierre Poilievre’s wrong-headed drug policy. Toronto Star. Retrieved from https://www.thestar.com/opinion/editorials/2022/11/29/pierre-poilievres-wrong-headed-drug-policy.html
Van Dyk, S. (2022). 'Irresponsible populist nonsense': Addictions minister calls out Poilievre over drug policy. CTV News. Retrieved from https://www.ctvnews.ca/politics/irresponsible-populist-nonsense-addictions-minister-calls-out-poilievre-over-drug-policy-1.6163989
Wright, T. (2022). Poilievre defends safe supply criticisms, says programs ‘perpetuating’ addiction. Global News. Retrieved from https://globalnews.ca/news/9365189/poilievre-criticism-safe-supply-opioids/
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