Basic description of harm reduction, bias, and why HR is a good approach for a Hep C clinic

1. B Y : D O N C R O C O C K
HARM REDUCTION

2. SO WHAT IS
HARM
REDUCTION?

3. definition…
“Harm reduction refers to the policies,
programs and practices that aim primarily
to reduce the adverse health, social and
economic consequences of the use of
legal and illegal drugs without necessarily
reducing drug consumption.”
International Harm Reduction Association, 2009.

4. or…
Harm reduction recognizes that there will
always be a percentage of the population who
will engage in higher risk behaviour (e.g.
people that misuse alcohol or other drugs,
have more than one sex partner, smoke)

5. cont.…
…focuses on reducing or minimizing the harm
associated with higher-risk behaviour – the
adverse health, social and economic
consequences

6. cont.…
…can complement, or be an alternative to,
abstinence-based policy and programming

7. Examples of Harm Reduction???

8. Many “shapes & sizes”…
Needle & syringe exchange programs
StreetWorks is a program of Positive Living
Niagara

9. also…

10. Harm Reduction and Abstinence
 Harm reduction and abstinence are highly congruent
goals.
 Harm reduction expands the therapeutic
conversation, allowing providers to intervene with
active users who are not yet contemplating
abstinence.
 Harm reduction strategies can be used at any phase
in the change process.

11. Harm Reduction Initiatives
 Street Outreach
 Education, providing achievable options
 Supplying condoms
 Moderate/Controlled using strategies
 Needle Exchange and Safer Inhalation Programs
 Tolerance zones (e.g., Supervised Injection Sites)
 Methadone Maintenance Programs
 Prescription of heroin and other drugs (e.g., NAOMI)
 User groups, peer support
 Law-enforcement cooperation

12. More HR…
 Sun Screen
 Condoms
 Seat belts
 Bicycle Helmets
 Designated driver
 Blood alcohol levels
 Nicotine patches/gum
 Education & outreach programs
 Sex education for youth

13. Some of the Goals of Harm Reduction
for a “drug user”
 Save lives
 Safer drug use
 Reducing drug use
 Getting off drugs
 Improved emotional state
 Improved health and better
nutrition
 Improved living situation
 Stable income
 Improved social
relationships
 Reducing stigma
 Reducing social isolation
 Increasing validation and
normalization
 Reducing risky or harmful
behaviors
 Intact and better
functioning families
 Reducing violence and
aggression
 Higher self-esteem
 Greater ability to love and
be loved

14. Finally -
Harm reduction is a set of practical
strategies and ideas aimed at reducing
negative consequences associated with drug
use. Harm Reduction is also a movement
for social justice built on a belief in, and
respect for, the rights of people who use
drugs.

15. Benefits of Harm Reduction
● Access To Stigma Free Service
 It's Cost Effective
 Reduction in Communicable Diseases and
Infections
 Positive Community Impact & Reduction In
Crime
 Addicts Need Support, Not Punishment
* With thanks to K. Lanktree – studiolonline.net

16. OK, SO WHY US?

17. The guidelines say…
All Ontarians at risk of/living with HCV
should have equal access to high-quality
treatment, prevention, support, and
education interventions, regardless of where
they live or how they contracted the disease,
individual linguistic or cultural barriers,
socioeconomic or education level.

18. cont…
While assisting people to stop using drugs is
an appropriate long-term goal for some,
harm reduction strategies put the emphasis
on the most immediate, achievable and
positive changes, whether or not they can be
shown to reduce consumption.

19. cont…
People living with HCV face stigma and
discrimination associated with their drug use
which can be a barrier to accessing services.
All HCV programs and services in Ontario are
delivered in a non-judgmental, non-coercive
manner.

20. Last Ministry point - Boundaries
While clinical and support services are
provided to emphasize accessibility and to
develop trusting relationships, personal and
professional boundaries are recognized as
being in the interest of both clients and staff.

21. What is BIAS?

22. Bias is:
Prejudice in favor of or against one thing,
person, or group compared with another,
usually in a way considered to be unfair.
* Can be conscious or unconscious

23. In conclusion…
Harm reduction can be thought of as a public
health response to drug use. It is what it is
and we cannot force our will on another, we
can only guide.
I call it “illuminating the path”

24. Any final thoughts or…

25. We’re done!