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Toronto Harm Reduction Task Force Holly Kramer, Project Coordinator.

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1 Toronto Harm Reduction Task Force Holly Kramer, Project Coordinator

2 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.

3 The wisdom of the community will always exceed the knowledge of the expert. -John McKnight

4 Harm Reduction = …decreasing the adverse health, social and economic consequences of drug use without requiring abstinence from drug use. [Riley et al]

5 In other words…. … a harm reduction approach does not view or promote abstinence as a goal, either in the short or the long term.

6 The only goal of harm reduction is to reduce or mitigate harms to: Individuals (users) Families Communities Society

7 Harm Reduction offers… A social justice response, rather than a criminal justice response, to drug use.

8 Harm Reduction… a philosophy, a way of thinking, a premise, an approach, a perspective… NOT a sticker, a buzzword, or a conundrum

9 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

10 Harm Reduction is…a way of thinking… a 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.

11 CRACK PIPE KITS example of h.r. tool Glass stem Non-toxic (as opposed to pop tins); smooth rim (as opposed to broken bottles) Screens Non-toxic (as opposed to brillo) Gum, lip balm To produce saliva/treat cuts/burns: reduces risk of disease transmission TOOL FOR OUTREACH WORKERS To engage/build trust with hard to reach users

12 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!

13 Harm Reduction is a continuum… all 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

14 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.

15 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.


17 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

18 Providing service from a harm reduction philosophy: Recognize the value and necessity of self determination and of individual support plans.

19 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

20 Some websites of interest:

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