Transcript Toronto Harm Reduction Task Force

Toronto Harm Reduction
Task Force
Holly Kramer, Project Coordinator
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.
“The wisdom of the
community will always exceed
the knowledge of the expert.”
-John McKnight
Harm Reduction =
“…decreasing the adverse health,
social and economic consequences
of drug use without requiring
abstinence from drug use.”
[Riley et al]
In other words….
…a
harm reduction approach
does not view or promote
abstinence as a goal, either
in the short or the long term.
The only goal of harm reduction is
to reduce or mitigate harms to:
• Individuals (users)
• Families
• Communities
• Society
Harm Reduction offers…
A social justice
response,
rather than a
criminal
“justice”
response, to
drug use.
Harm Reduction…
a philosophy,
a way of thinking,
a premise,
an approach,
a perspective…
NOT a sticker, a buzzword, or a conundrum
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
Harm Reduction is…a way of thinking…
a way of “doing business”
meets people “where
they’re 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.
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
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!
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 they’re at” by:
• Encouraging safer use
• Offering alternatives
A harm reduction approach provides
for people’s needs regardless of use
Harm Reduction distinguishes
between use and behaviour…
EG: Designated drivers are harm reduction
in action…
We don’t say, “don’t drink”; we say “don’t
drink and drive.”
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.
Drug use:
SIGN
SYMPTOM
MANIFESTATION
COPING MECHANISM
BALM
UNMET NEEDS
DESPAIR
PAIN
ILL HEALTH
TRAUMA
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
Providing service from a harm
reduction philosophy:
Recognize the value and
necessity of self
determination and of
individual support plans.
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
Some websites of interest:
www.canadianharmreduction.com
www.drugpolicy.org
www.harmreductionjournal.com
www.ihra.net
www.habitsmart.com
www.atkinson.yorku.ca/dce
www.toronto.ca/health/drugstrategy
[email protected] 647.222.4420