1. We are the people we've been waiting for Community Organizing around Harm Reduction in Rural Ontario Sean Lee Popham slp@tao.ca

2. Workshop Overview Introduce North Hastings and the Harm Reduction work that we have been involved with there Share lessons learned/challenges Benefits of Rural Harm Reduction Organizing Start conversation around Rural issues and Harm Reduction

3. Community organizing Power is often invisible. Create visible power. Make private conversations public.

4. Why HR/Substance Use Addiction have been used to control populations for a long time. – Alcohol and Colonialism – CIA and crack cocaine into black communities in the 70's Substance use as a way to alter one's consciousness We live in a culture of addiction

5. Harm Reduction work in North Hastings Starting in 2009 we built from a meeting of 3 nurses to an organization of 13 different stakeholder organizations Town was “dry” until the 1970's Religious social environment and frontier town Visible drug culture

6. North Hastings Harm Reduction Network Established in January 2009 First project surveys of people using drugs in the area Developed questionnaire and process in spring 2009 June-December 2009 conducted 10 surveys

7. NHHRN Presence created work Drug stores changed hand, risk of losing NE site (Aug/2009) Establishing new NE site when new mental health drop-in opened (Feb/2010)

8. Attempts to create user-led groups April to November 2010 Identified in research as an interest Drug use groups, help us with research, Hep C Learned alot about barriers and issues

12. Lessons from attempts at engaging drug users Lack of space for low-income people to gather Barriers to confidentiality Our own fear about publicly discussing issue

13. Increasing Support Fall 2010- cluster of 5 suicides of men 18-55 with some connection to drug use Sense of possibility of “backlash” against people using drugs in community December 2010 meeting with wider stakeholders

14. Substance Use Strategy Network Winter 2011 -Created mission statement and statement of beliefs -Organizations endorsed statement of beliefs -Internal education

15. Principles Substance use, including caffeine, nicotine, alcohol and other substances, is part of the range of human experience and has been since the beginning of human existence Problematic substance use, which interferes with the ability to enjoy life or function to one’s full potential, or which creates significant health problems, must be addressed comprehensively and with compassion, using evidence based public health interventions and services that are client-led Problematic substance use can arise from unacknowledged or un-addressed physical and mental health issues or other life stressors; substance use may be a means of coping with those issues Moralizing and punitive responses to substance use are unhelpful and tend to further stigmatize and demoralize individuals who use substances Harm reduction approaches provide the opportunity to respond in a way that reduces some of the risks of substance use while engaging with substance using individuals with dignity and respect Effective approaches to problematic substance use encompass a full spectrum of strategies from prevention to harm reduction to abstinence No one should be denied services merely because they are using substances

16. Objectives To reduce individual and community harms related to substance use through education and advocacy To work to reduce the stigmatization of people who use substances To actively engage people who use substances in our work and in creating peer driven services To particularly address the needs of people less well-served by traditional services, including women and youth To develop and advocate for the implementation of needed services, including a range of flexible addictions, health, mental health, crisis, prevention and harm reduction services in North Hastings To work together with other individuals and organizations who share similar objectives and approaches

17. Substance Use Strategy Network Celebrate Youth Movement The Switchyard Bancroft Medical Clinic Hastings Prince Edward County Health Unit North Hastings-Quinte Healthcare Corporation Mental Health Services North Hastings Family Health Team Maggie’s Resource Centre for Women North Hastings High School Parent Council Ontario Works, Hastings County Bancroft Family Health Team Assertive Community Treatment Team Bancroft Family Health Team Community Advisory Committee Member Organizations

18. Below the Radar Conference June 2011 70 plus participants Half day of education on issues in the community, Methadone maintenance and stigma around drug use Half day of discussion's around what was needed in the community

19. Needs Identified at conference A locally based methadone clinic Increasing the support and engagement of young people Challenging institutional stigma within agencies Supporting families living with substance use

20. Further education Letters to the editor April 2012 “everyone a first responder” -1/2 day education event aimed at making everyone in town able to respond to substance use crisis

21. Methadone Clinic Spring 2012 OATC clinic opens in town Concerned letters to editor By-Law banning new clinics SUSN hosts education forum Letters to both OATC and Town Council

22. Lessons learned Start a group We repeatedly prepared ourselves for backlashes that never materialized Harm Reduction makes sense – “if my son was using needles I'd want someone to give him a clean one” Pharmacy Tech at NEP The length of time it takes to create connections with people who are using substances

23. Challenges Distance and travel Lack of anonymity/knowledge of personal history Lack of space for low income people

24. Benefits of Rural Harm Reduction Organizing Much less red tape bureaucracy People have decreased reliance on the state A pragmatic view of life Ability to work with different agencies

25. Below the radar……. Questions?