Harm Reduction Coalition of York Region


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The Harm Reduction Coalition of York Region participated in a day long harm reduction conference at York Support Services Network in Newmarket. Patti Bell Executive Director of Blue Door Shelters and Lori Kerr from LOFT Crosslinks Street Outreach Program presented to the sold out audience.

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  • Lori introduction of self and work; Patti introduction of self and work;
  • ******* Give out handout *******Harm Reduction Coalition of York Region Terms of Reference Philosophy  - The Harm Reduction Coalition of York Region acknowledges its support of the following definition and basic principles of harm reduction: Definition “Harm reduction can be defined as a set of practical strategies with the goal of meeting people ‘where they are at’ to help them reduce harm associated with risk taking behaviour.” Basic Principles of Harm Reduction: Harm reduction philosophy considers risk taking behaviour as a natural part of our world and suggests that our work should be focused on minimizing the harmful effects of the behaviour rather than focusing on the cessation of the behaviour. Harm reduction philosophy supports the involvement of individuals in the creation and/or delivery of programs and services that are designed to serve them. These programs and services must be offered in a non-judgmental and non-coercive manner.Harm reduction philosophy recognizes the impact of issues such as poverty, classism, racism, homophobia, social isolation, past trauma, and other social inequities on both people’s vulnerability to and capacity for effectively dealing with risk taking behaviour. This definition and the basic principles of harm reduction come from research of the AIDS Committee of York Region which acknowledges the definition currently used by the Canadian AIDS Society.Mandate To promote, advocate for and support best practice policies, programs and initiatives that aim to reduce harms associated with risk taking behaviours, including substance use.Membership A Working Group of community members, groups and organizations representative of the diversity of York Region who are committed to harm reduction and Principles noted in these Terms of Reference.A Steering Committee of agency representatives with decision-making authority, supportive of harm reduction philosophy, whose role is to advise and support the Working GroupGoals/Objectives To develop and strengthen partnerships between organizations and/or individuals who believe in harm reduction.To increase the awareness of harm reduction philosophy of the public, service providers, politicians and legislators.To increase the awareness of and accessibility to harm reduction strategies, approaches and programs in York Region. To identify and act on harm reduction priorities is identified by the community.
  • This is a sample only of harm reduction activities in the Region, not a comprehensive list.
  • Because it is the law to not discriminate.
  • What is a Needle Exchange Program (NEP)?Needle exchange programs help reduce the harms associated with injection drug useNeedle  Exchange Programs (NEPs) are a form of harm reduction, as they aim to reduce the spread of HIV/AIDS and Hepatitis B and C among injection drug users. Sharing needles and other equipment water, filters, etc) are high risk activities for transmitting HIV/AIDS, Hepatitis B/C, and other blood-borne infectionsAll Health units in Ontario are mandated to provide needle exchange programsYork Region’s Community & Health Services needle exchange program is called Project YES – York Exchange ServicesProject YES offers:Needle distribution/safe disposal of used needles Injection suppliesInformation on safer injectionReferrals to addictions, health and social servicesCondoms & lubeAll Services are Free and Confidential Distribute project YES cards
  • ***** Give out handout *********
  • *** Give out handout ****
  • Survey done across province, York Region participated in the first 2 of 3 waves.
  • Reinforce importance of Harm Reduction
  • Identifies that injected drug use is a significant issue in York Region and across the Province.
  • Highlights need for safer disposal
  • In Toronto many harm reduction practices are supported by the City of Toronto, Public Health and Police Services.
  • Except for Crystal Meth, York region has a higher utilization rate of non-injected drugs than the province of ontario
  • They focused on youthExample of a comprehensive report from our neighbours. Trends identified here are also common to York Region.
  • Do we think it is similar in York Region???
  • Youth acknowledged what’s working well in regards to services and supports, and identified a number of barriers and gapsPolicy Barriers: Lack of funding and support for harm reductionZero tolerance policiesRestrictive eligibility criteria Structural Barriers: Limited and inconvenient hours of operation Limited and inconvenient locations of service delivery Lack of transportation resources Waiting times and waiting lists Lack of program options and the power to choose No health card or health care coverage Attitudinal Barriers: Social stigma and discrimination Social networks Staffing and interpersonal relationships Knowledge Barriers: Lack of knowledge of services and support Lack of knowledge and concern for risks Complex and Multi-Dimensional Barriers: Homelessness and instability Fear of policeDo we think it is similar in York Region???
  • Reinforce the 90% think Harm Reduction is helpful.
  • #1:After hour services and non-downtown areas, shelters, drop-ins, CHCs and areas where youth use and hang out.#3: Greater access to existing supplies and meth, snorting and drug testing kits#4: Expansion of existing NE, outreach and mobile servicesVending machinesPrograms designed for specific groups (i.e. LGBT)Peer and mentoring programs Individual and political advocacy supportHarm reduction: support groups for people living with mental health issues, HIV/AIDS, and Hepatitis C counselling and crisis intervention supportive housing, shelters and hostels for youth who use drugs #5:A variety of educational mediums (i.e. verbal, internet, brochures, etc)Strong visuals and accessible languageYouth involvement in design/production#6:The list of reasons given by youth for why this is an needed resource is detailed in the report. Research regarding Insite supports this recommendation.
  • Increase options:   Youth-specific programs and treatment options (youth-only detoxification centres or at minimum, youth-specific beds within the current system). Options of residential or out-patient programs, and group or individual counselling. Range in program options that include abstinence as well as harm reductionA holistic approach to supporting youth in reducing or quitting substance use; and in the delivery of after-care need to expand to include assisting youth in re-integrating into the community by securing housing, income, primary health care, and linking youth with employment, educational and recreational opportunitiesEasier Access: Reducing waiting time and increasing the flexibility of programs and services Youth-friendly intake procedures, self-referrals, informal assessments, drop-in services, and flexible hours More local services and programs availableLived Experience:Youth described feeling more comfortable talking about their use of substances and other issues with someone who has been through similar experiences themselves.
  • Policing issues was consistently named as an important issue for youth in the interviews and focus group Bring police on board in regards to harm reduction – four pillar approach Training for police: on working with homeless and street-involved youth and harm reduction Policy reform: police will not confiscate or destroy harm reduction supplies Complaints process – educate youth and service providers re: new independent police complaint process (OIPRD)
  • Proposal is for coordinated response throughout the Region on Harm Reduction practices and to build effective strategiesWe are doing good work, we are learning from our neighbours and other research. We want to expand our knowledge base
  • Harm Reduction Coalition of York Region

    1. 1. November 2011 Presenters:Lori Kerr and Patti Bell
    2. 2. Harm Reduction Coalition in York Region Terms of ReferenceDefinition of Harm ReductionBasic principles of Harm ReductionMandateMembershipGoals/Objectives Harm Reduction in York Region- November 2011
    3. 3. Why Harm Reduction? If you say that I can’t come to your program because I am using, then you’re telling me that I don’t deserve to heal. Until I’m clean, I am not good enough. Harm Reduction in York Region- November 2011
    4. 4. MembershipHarm Reduction in York Region- November 2011
    5. 5. Examples of Harm Reduction Activities in York Region Harm Reduction in York Region- November 2011
    6. 6. Harm Reduction InitiativesStreet OutreachEducation, achievable optionsSupplying condomsModerate/Controlled using strategiesNeedle Exchange & Safe Disposal (Sharps)Safer Inhalation ProgramsTolerance zones (e.g., Supervised InjectionSites)Methadone Maintenance ProgramsPrescription of heroin and other drugsWet shelters, Dry shelters, managedAlcohol Programs (MAP)User groups, peer supportCounselling & Referral Harm Reduction in York Region- November 2011
    7. 7. Why Here? Canadian Human Rights Act (June18, 2008)For all purposes of this Act, the prohibited grounds of discrimination are race, national or ethnic origin,colour, religion, age, sex, sexual orientation, marital status, family status, any previous or existing mental or physical disability and includesdisfigurement and previous orexisting dependence on alcohol or a drug, and conviction for which a pardon has been granted. Harm Reduction in York Region- November 2011
    8. 8. Street Outreach In 2010 the van was approached on 916 occasions by persons withpotential addiction or usage issues. Some of the more common substances used include oxycontin,marijuana, alcohol, crack cocaine, etc. Of the 916 contacts, 390 accessed the needle exchange program. Almost 24,000 clean needles were given out and 192 bio bins. Just over 8,000 needles were turned in for safe disposal. Harm Reduction in York Region- November 2011
    9. 9. Street Outreach Safer sex Food and Shelter and Referralsinformation Health care Counselling clothing sleeping and (condoms information & support distribution bags linkages available) Harm Reduction in York Region- November 2011
    10. 10. York Region Alliance to End HomelessnessHealth Care Supports not Currently Available to Homeless and At-Risk People in York RegionGaps in Existing Health Care Support Specific Needs IdentifiedShelter Needs “Wet” Shelter Year-round Inn from the Cold (emergency shelter) Supportive housingHealth Centres Community Health Centres beyond VaughanSafe Spaces or Supplies More unscheduled drop-in centres (like Krasman Centre) Safer use crack kitsTreatment Needs Residential withdrawal management/ detox Street health care services Mobile foot care Pediatric care Dental care Specialists- reduced waitlists More nurse practitionersQuality of Care Assurance of confidential care and consultations Ethno-cultural support (especially in the north) Harm Reduction in York Region- November 2011
    11. 11. Needle Exchange ProgramWhat is a Needle Exchange Program (NEP)?All Health units in Ontario have needle exchange programsProject YES – York Exchange ServicesServices: •Needle distribution/safe disposal of used needles •Injection supplies •Information on safer injection •Referrals •Condoms & lubeAll Services are Free and Confidential Harm Reduction in York Region- November 2011
    12. 12. Needle Exchange Program Locations Mobile site in partnership with Loft/Crosslinks StreetOutreach van Fixed sites: Rutherford Guardian pharmacy Newmarket Sexual Health Clinic Richmond Hill Sexual Health Clinic Markham Sexual Health Clinic Vaughan Sexual Health Clinic 1-905-955-2471 1-866-553-4053 Harm Reduction in York Region- November 2011
    13. 13. Current Needle Exchange Program York Region Locations Harm Reduction in York Region- November 2011
    14. 14. Future Needle Exchange Program York Region Locations ?? Harm Reduction in York Region- November 2011
    15. 15. Blue Door Shelters Board training on Harm Reduction Board supported and approved formal policy Management completed York University Harm Reduction Certificate Staff received mandatory trainingInternal Harm Reduction Committee to assist with policy implementation and continuing education Acknowledgement and education in Blue Door Shelter’s intake process Estimate over 50% of residents use substances to cope On-site sharps disposal containers Developed and distribute “Harm Reduction” pamphlet for all clients Harm Reduction in York Region- November 2011
    16. 16. Data from Ontario Harm Reduction Distribution Program  First wave data is from 2007 • Surveyed approximately 70 injection drug users • Compared York Region to Ontario  Final report: Ontario Harm Reduction Distribution Program Final Outcome Evaluation April 2009 • http://www.ohrdp.ca/wp- content/uploads/pdf/OHRDP.Prov.Rpt_LLeonard.pdf Note: statistics from the final study are not included in this presentation since the data is not isolated to York Region. Harm Reduction in York Region- November 2011
    17. 17. Injection Drug Use In the 6 months before the survey... 40 36 35 30 25 19Percentage 20 17 13 Ontario 15 York Region 10 5 0 Injected daily Injected with a shared needle Harm Reduction in York Region- November 2011
    18. 18. Some first wave results: Ontario/York Region Commonly used injected drugs... 44 Crack 43 23 Morphine 53 York Region 41 OntarioOxycodone 53 77 Cocaine 71 Percentage Harm Reduction in York Region- November 2011
    19. 19. Some first wave results: Ontario/York Region Disposal of used equipment... 80 80 70 60 50 37 40 OntarioPercentage 30 26 York Region 20 13 10 6 5 0 Needle Exchange bottle/can Loose Plastic Harm Reduction in York Region- November 2011
    20. 20. Some first wave results: Ontario/York Region 100 80 78 90 80 70 60 50Percentage Ontario 40 30 York Region 20 10 0 Shared drug smoking equipment Harm Reduction in York Region- November 2011
    21. 21. Some first wave results: Ontario/York Region Commonly used non-injected drugs... Crystal 9 Meth 15 Cocaine 75 58 78 York Crack Region 66 Alcohol 78 70Marijuana 82 74 Percentage Harm Reduction in York Region- November 2011
    22. 22. Data from the Shout Clinic Harm Reduction Report, Toronto, 2010 Conducted by: Funded by:Shout Clinic delivers The Wellesley Institute advances urbanprimary, interdisciplinary care to youth health through rigorousages 16 to 24 years through a trauma research, pragmatic policyinformed and harm reduction solutions, social innovation, andphilosophy. community action. Harm Reduction in York Region- November 2011
    23. 23. Dependency and Addiction Issues 47% of respondents were (in the past 6 months) unsuccessfulin trying to cut down or quit their drug of choice; 37% werenot interested50% of respondents used drugs to avoid withdrawal symptomLow use of drug treatment services Harm Reduction in York Region- November 2011
    24. 24. Barriers Youth experienced a wide range of barriers to accessingservices and supports and practicing harm reduction, such as: Policy Structural Attitudinal Knowledge Complex & Multi-dimensional Harm Reduction in York Region- November 2011
    25. 25. Recommendations - Harm Reduction, Public Health ProfessionalsYouth emphasized the importance of 90% of survey respondents think thatprotecting youth with accessible, and harm reduction is an appropriate andappropriate harm reduction services useful approach to substance use and approaches, rather than issues. punishing them for their drug use. Harm Reduction in York Region- November 2011
    26. 26. Recommendations - HarmReduction, Public Health Professionals1. Deliver services where and when youth need them2. Spread the word – better advertisement of services3. Provide supplies that youth need and will use4. Relevant program options that are appealing to youth5. Provide greater access to educational materials and resources6. A safe place to use – safe injection and consumption sites Harm Reduction in York Region- November 2011
    27. 27. Recommendations for Addiction and Harm Reduction Professionals Increase options(for treatment and youth specific programs)Easier accessPeer-workers and people with lived experience Harm Reduction in York Region- November 2011
    28. 28. Recommendations for Police Bring police on board Training for police Policy reform Develop a harm reduction unit as part of TPS Effective complaint process and greater policeaccountability Harm Reduction in York Region- November 2011
    29. 29. Recommendations for Mental Health Professionals Tackle social stigma and promote mental health services More responsive services Program options Positive relationships Harm Reduction in York Region- November 2011
    30. 30. Harm Reduction in York Region- November 2011
    31. 31. Why Harm Reduction? By promoting Harm Reduction we will have safer and healthier communities as a result of our combined effortsHarm Reduction Coalition of York Region Website: http://hrcyr.posterous.com Harm Reduction in York Region- November 2011
    32. 32. The Future for York Region Expansion of needle Safer disposal of used Education! Education! exchange sites in York equipment/sharps Education! Region containers Harm Reduction Making our dreams a Policy and procedure Coalition of York reality, having development for Region expanding everybody “meeting organizations membership and people where they’re activities at” Harm Reduction in York Region- November 2011
    33. 33. Harm Reduction in York Region- November 2011