1. Harm Reduction Jessica Ashton Legislation and Professionalism Jenifer Dykeman April,17,2015

2. What is it? Harm Reduction is an approach that has many different programs and services. The purpose of harm reductions is to reduce the risks of harm and disease associated with the use of drugs. Many people who use the Harm reduction approach are either unable to stop due to the type of drug addiction or they simply not ready to stop.

3. What are the different types of Harm Reduction? - Needle exchange programs which is where people go to exchange their dirty needles for clean and new needles this reduces the risk of having diseases such as HIV and AIDS. -There are also prescriptions that you can take to help get through the withdrawal and overall addiction but more specifically opioid addictions and theses prescriptions are called Methadone and naltrexone. These medications are taken at a clinic under supervision and there is a process in which one must go through in order to be allowed to have this form of treatment. - There are places called Harm reduction sites these sites provide a safe place for users to take their substance of choice and reduce the chance of over dose and disease these places are supervised by medical personal such as Nurses. These harm reduction sites include safe injection sites. There is currently only one in Canada which is called Insite. -Outreach programs The government also put commmericals and ads to raise awareness about impaired drinking.(N.A,2013)

4. How does Harm reduction fit within the field Of Child and Youth Work? Clients may ask about where they can go if : They need birth control or condoms The client may disclose that they themselves are struggling with an Addiction and they are not ready or unable to quit so they may ask what are their options? Our jobs as CYWS it to be able to gage how ready they are to make the change. It is also our job to be networkers and point them into the right direction. So that they can get the resources that they need to get back on the right path. It may be also our job to give presentions on the need to knows when it comes to Harm reduction. Another important thing to understand about Harm Reduction is that many people choose these services or programs because they are in either precontemplation or contemplation stage within their drug Addiction. These stages that I referred to come from what is called the stages of change.The stages of change come from professionals within the Addictions field but more specifically this model helps Drug and Alcohol but can also help us as CYWs figure out the level of readiness to change within our clients. It can help us gage their readiness in many situations such as addictions or mental health related of any major life changes or choice they the clients have to make. One important thing to understand is that it is not a linear pattern you may have clients who say they are ready to receive help the one day and then the next day say they don’t think they want to do this. This would be an example of how a client can go from the contemplative stage to precontemplative stage. Here is a chart that shows all of the stages with descriptions of each one.

5. Stages of change with brief explanations Precontemplation is when the client is in denial, not ready to change refuses to change and/ or does not fully understand the consequences of their actions. Contemplation is when you realize and understand that there is a problem and you typically weigh out the pros and cons to changing their behavior by the end of this they decide they want to change. Planning or preparation is the stage where you and the client explore different options and create a plan they want to change in this stage. Action stage is when you put the plan into action and make positive changes to their current lifestyle whether it is treatment continuing counselling, groups moving out of the home they are living in. Maintenance stay is maintaining or sticking to the plan for more than six months with little or no extra support or assistance. Termination is the final stage where your client is not tempted or triggered anymore and they no longer need assistance from you as a professional within the helping profession.

6. Safe injection kits What is provided? And What is their Purpose? Filters helps prevent little solid pieces form going through Insulin needle 1cc 29 gauge, Swabs to clean the injection site Sterile water which helps prevent infections, Cookers or steri-cup are used to heat up their substance of choice Dry swabs to clean blood Turnikes are used to help find the injection site Vitamin C or ascorbic acid is an acidifier that breaks down the drug so that you can safely inject.

7. Video Clip Safe injection https://www.youtube.com/watch?v=Miv8i-slK2whttps://www.youtube.com/watch?v=Miv8i-slK2w

8. Safe inhalation kits Whats provided? Whats its Purpose? Glass stems is the base of the pipe and where you put your substance of choice in. Screens purpose of this is to help from little pieces coming through so that there is only smoke. Plastic mouthpieces the main purpose is that you have a mouth on your own but you can also put it on other peoples pipes so that you can share. Push-sticks are to help you put the screen into the pipe Lip balm​ is to help prevent the chapped lips associated with smoking through a pipe.

9. What resources are available in Peterborough PARN This agency provides services needle exchange programs, safe injection and inhalation kits this is part of what they offer within their harm reduction program they also refer clients to other services such as food banks as needed. Peterborough Public Health Unit Sexual Health Clinic the sexual Health Clinic provides provides low cost birth control, condoms, STI testing and treatment.

10. Programs and Services Offered in toronto Methadone Works is an clinic that does not just offer Methadone and Naltroxone substitutions programs they also offer on-site one on one counselling that can make referrals to other agencies that Assist clients with finding housing other community resources. The thing I found interesting is that with this clinic they are not allowed to have take at home doses of these prescriptions while other programs have a point system where you can earn to take some doses at home. Over dose prevention program that provides users,their friends and their families with information on how to recognize and understand the warning signs of overdose this program also offers take home doses of the naloxone with instructions on how to use it properly. This program is called Preventing Overdose In Toronto or the POINT Program. The last program I found was called The Works this facility provides testing for STI and other diseases such as : HIV, Hepatitis C, Hepatitis B and Syphilis. They also offer free vaccines for Hepatitis A and B, Tetanus, Pneumococcal and Influenza to help combat the risks of attracting these disease due to drug use.(2015)

11. What are some forms Of Harm reduction that we do not usually think about? Condoms Birth Control Plan B Bong or Pipe Covers Tobacco free policy

12. What is the Legislation associated with Harm Reduction? Drug exemption policy the purpose of this Policy was so that Insite which is a safe Injection site could be piloted under the government. But Harper has proposed a new law which is called the Respect in Communities Act which makes it almost impossible to continue to stay open but also extremely difficult to establish one in other parts in Canada. Some of the criteria associated with this Act includes “providing information outlining the views of police, municipal leaders, public health officials and provincial health ministers.The applicant is also required to provide documentation that shows the site’s expected impact on crime rates, treatment options for drug users, the public health reasons for needing such a site and evidence there are resources to sustain the site's operations”( 2015).

13. What are the problems with Harm reduction Facilities? Stigma around safe injection sites and needle exchange programs Property Values Decrease in the neighbourhoods where the facilities are established Government Feels that drug use and crime will increase

14. What is your opinion on…? Safe Injection sites? Safe injection and safe inhalation Kits? Yah or Nah? I want to hear your opinions on this

15. QUESTIONS

16. References Understanding Harm Reduction Substance Use. Health Link (2013, April ). Retrieved March 25, 2015, from http://www.healthlinkbc.ca/healthfiles/hfile102a.stmhttp://www.healthlinkbc.ca/healthfiles/hfile102a.stm What is harm reduction? (2015, January 1). Harm Reduction International Retrieved March 25, 2015, from http://www.ihra.net/what-is-harm-reduction Harm Reduction - Alcohol and Other Drugs - Healthy Lifestyle | City of Toronto. (n.d.). Retrieved March 28, 2015, from http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=cf9b62ca69902410VgnVCM 10000071d60f89RCRD http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=cf9b62ca69902410VgnVCM 10000071d60f89RCRD Updated: Health Canada grants exemption to Insite drug injection centre. (n.d.). Retrieved March 28, 2015, from http://www.vancourier.com/news/updated-health- canada-grants-exemption-to-insite-drug-injection-centre-1.1803957http://www.vancourier.com/news/updated-health- canada-grants-exemption-to-insite-drug-injection-centre-1.1803957 Stages Of change. (n.d.). Retrieved March 31, 2015, from http://youcan.ca/edmonton/images/YOUCAN-Stages-of-change-med.jpg (Photo) http://youcan.ca/edmonton/images/YOUCAN-Stages-of-change-med.jpg