Blog: Harm Reduction, People Who Use Drugs, and Their Communities

Introduction

In early May, ESPC volunteer Jayme Wong published a blog post on supervised consumption sites in Alberta, detailing the debate surrounding their closures. Since then, the Alberta government has decided to close yet another service site in Calgary. While it has promised to move these services to another location, there is no indication as to when or where this will happen. People who advocate for keeping supervised consumption sites open stress the importance of harm reduction offered by these services. This blog post will dive deeper into what harm reduction means and the positive impact it has on people who use drugs.

What is Harm Reduction?

Harm reduction is a public health approach that aims to decrease the negative consequences of drug use to users and their communities. Harm reduction is based in humanism and argues that people who use drugs have the right and the ability to make their own choices. As such, harm reduction-based services are accessible, flexible, and non-judgmental. People who use drugs are encouraged to start where they are at, that is, they do not need to make changes to their current lifestyle in order to receive support. Some features of harm reduction include providing people who use drugs access to safe supply, supervised drug use, and naloxone in order to reduce drug poisoning deaths. Harm reduction also involves challenging policies that misrepresent and stigmatize people who use drugs, and advocating for better health policy.

An essential tenet of harm reduction is recognizing that people who use drugs are the best source of knowledge about drug use and must be included in decision-making. Therefore, most information in this blog post comes from Alberta Addicts Who Educate and Advocate Responsibly (AAWEAR), a group of people with histories of hard drug use who strive to improve the quality of life of people who use drugs. AAWEAR is an Alberta-wide organization with chapters in Calgary, Lethbridge, and Edmonton. AAWEAR’s 2019/20 Annual Evaluation contains a survey conducted with people who use drugs in various communities. This evaluation includes essential information about harm reduction and the positive impact it has on people who use drugs.

AAWEAR members engage in on-the-ground outreach using harm reduction principles to meet the immediate needs of drug users. Activities include: distributing harm reduction supplies like clean needles and condoms, safely disposing used needles, offering first aid (including naloxone), and distributing wellness supplies such as hygiene kits, water, snacks, socks, and underwear. Alongside these activities they share knowledge about safer drug use practices, listen to people’s concerns, offer mental health support, and connect them to other community supports. Members also educate the non-drug using community to bring awareness to health issues, and advocate to decision-makers for the creation of better policy around drug use and its impacts on people who use drugs.

All members of AAWEAR have histories of hard drug use. Getting involved with this organization can provide social connection and a sense of belonging, allow people to gain new skills—both to help others and develop their personal wellness—and build confidence.

Who Benefits From Harm Reduction?

The individuals that AAWEAR supports in Edmonton are primarily in their 30s (31%), male (55%), and Indigenous (58%). According to Alberta Health Services (AHS), males aged 30–39 also have the highest rate of opioid poisoning deaths—in 2020 there were 259 drug poisoning deaths amonth this particular demographic. This indicates that AAWEAR is giving harm reduction supplies to the people who need them most.

Many of the peers that AAWEAR members reach use harm reduction practices. In Edmonton, 95% of the AAWEAR’s Annual Evaluation survey participants had accessed clean drug use supplies, and 65% had injected at a supervised consumption site. In 2019, the same reference period as this report, AHS reported that Edmonton supervised consumption services were visited 63,504 times. Thus, one can see that these sites are a widely used and valuable resource for people who use drugs in Edmonton.

There is a prevalent misconception that harm reduction practices result in simply providing people with drugs and enabling negative behaviours. However, as shown by AAWEAR’s work, harm reduction is an approach that aims to improve the overall well-being of people who use drugs. These individuals are given access to clean drug use supplies, but they are also provided with immediate subsistence needs, education, and support. These practices allow people who use drugs to make informed decisions, stay safe when they choose to use drugs, and improve their well-being.

Too often, discussions about drug use, harm reduction, and supervised consumption sites focus on the impact drug use has on the mainstream community—often depicting people who use drugs as dangerous and disruptive. This rhetoric describes people who use drugs as a threat to communities, when in reality they are part of our communities; helping them helps us all. There is a perception that supervised consumption services bring more drug use into a community, which causes harm to businesses and residents. But this perception is inaccurate. People who use drugs have been there the whole time; offering targeted services allows people to use drugs in a safe space rather than on the street, and it reduces the number of needles discarded in public spaces. As such, it increases safety not only for people who use drugs, but for other community members as well.

When we look at harm reduction through the lens of people who use drugs, we can understand how vital these services are. Harm reduction literally saves lives and does so in a way that upholds the dignity and inherent worth of people who use drugs. These individuals are not dangerous outsiders; they are our neighbours. Harm reduction-based services are essential to creating safe and thriving communities for all.