Harm reduction is a strategy that is used in multiple areas of health care. For example, rather than advocating abstinence from sexual activity, we advocate the use of barriers to reduce the risk of passing sexually transmitted infections.
Harm reduction is also an approach that seeks to minimize the harms associated with drug use and drug policy, without requiring the individual to have a goal of abstinence. We know that people will always use drugs: to avoid psychological pain/trauma, to relieve physical pain, and to enhance creativity or pleasure. A number of Alliance members offer harm reduction programs for people who use drugs, including providing safer injection and smoking supplies and supervised injection sites.
The Case for Decriminalization
Canada is in the midst of a devastating crisis. More than 11,500 people died of opioid poisoning between 2016 and 2018. In 2018 alone, there were 4,460 deaths. The vast majority died from accidental poisoning linked to fentanyl or fentanyl analogues.
The crisis is exacerbated by current policies which criminalize drugs and people who use them. Canada’s drug laws have their roots in prohibition-era laws developed in the early 20th century. These policies were not based on evidence, but on racist, discriminatory and morally unjust assumptions about people who use drugs. In the 1970s, Canada emulated President Nixon’s ‘War on Drugs,’ which legitimized the disproportional targeting and incarnation of certain groups, including the poor and racialized. Current laws and policies are creating and perpetuating cycles of poverty, homelessness, incarceration, trauma, marginalization and too often death.
Advocates across the country are calling for a new way to address the ongoing and worsening opioid crisis. Decriminalization of drug use and possession removes criminal penalties linked to personal possession and use of drugs. Countries around the world are advocating for and successfully decriminalizing possession of illicit drugs for personal use. Others are legalizing, regulating and distributing safer drugs to people who use them.
There are various decriminalization models, including removing penalties on the use of some or all drugs, allowing possession within specified amounts and using penalties- such as fines or treatment requirements. Such policies have led to:
- Reduced health and non-health-related social costs related to drug use, especially among vulnerable populations
- Lower drug use among youth
- Increased access to treatment
- Increased drug substitution
- Decreased transmission of HIV and Hepatitis C
- Reduced drug-related deaths
- Reduced criminal justice overcrowding and costs
- Improved relations between the community and the police
Tainted drug supply is at the heart of the opioid crisis and safe Supply programs address drug poisoning at the root. Criminalization of drugs and drug use forces people to turn to underground markets, where the strength and toxicity of substances are unknown and the risk of experiencing harms is higher. Safe supply programs expand harm reduction beyond supervised consumption and treatment services. They include distributing substances to users as alternatives to street-level drugs that may be contaminated with other additives such as fentanyl. These programs already exist in some parts of the country, making it possible for providers to prescribe drugs such as hydromorphone and diacetylmorphine for people who use opioids. In 2019, the Federal government announced therapy involving hydromorphone and announced funding to explore safe supply options.
The need for change is urgent. There must be a shift in how officials approach drugs and usage. This issue must be approached through a public health lens, instead of a criminal justice one, and should focus on access to health, social services and harm reduction.
Join us in calling for Canada to adopt a human rights and public health focused response to the ongoing crisis. We’re calling for:
- The federal government to decriminalize activities linked to personal drug use
- Drug policy reform to advance a safe and regulated drug supply
- Support and funding for community-led organizations in the implementation of life-saving services and programs
- Comprehensive anti-stigma and anti-discrimination education
Harm reduction, decriminalization and safe supply keep people who use drugs alive, healthy and free from stigma, discrimination and incarceration. They give people the choice and autonomy to lead stable and meaningful lives. You can:
- Read and share the Alliance’s statement on decriminalization and safe supply
- Share these graphics on the case for decriminalization and safe supply
- Tweet using #safesupply #decriminalization #healthequity #onpoli
- Webinar: Harm Reduction Satellite Sites Program Guide Launch (October 26 2020)
- Research Article: "That's a double-edged sword": Exploring the integration of supervised consumption services within community health centres in Toronto, Canada (October 2019)
- Research Article: Implementation contexts and the impact of policing on access to supervised consumption services in Toronto, Canada: a qualitative comparative analysis (April 2019)
- Video: Why drug prohibition and criminalization has failed
- Information Sheet on Harm Reduction and the Overdose Crisis (2018) - (English/French)
- Open Letter to Minister of Health Regarding Decision on Consumption Treatment Services (April 2019)
- Health Canada: Opioid-Related Harms and Deaths in Canada (June 2019)
- Public Health Ontario: Interactive Opioid Tool
- CIHI: Opioids In Canada
- CATIE: Harm Reduction in Action: Supervised consumption services and overdose prevention sites (2018)
- National Safer Supply Community of Practice