JHS of Alberta The Reporter Harm Reduction

While harm reduction focuses its attention on the reduction of drug related harms, it also recognizes that abstinence is an option for some. Treating every user on an individual basis means that there is no room for moralistic judgements in harm reduction programming. The drug use is neither condemned or supported. The extent of an individual’s use is secondary to focusing on the harms related to his or her use. The harms can be related to the individual (such as their mental and physical health), family or community. Harm reduction policies also work using a hierarchy of goals. Hierarchy of goals is the series of goals set out to deal with drug misuse, starting with the most pressing and immediate needs of the user. While the final goal is abstinence or safer use of drugs, it is the user who sets the goals in his or her hierarchy. All of these harm reduction features attempt to balance the costs and benefits of drug use, ensuring that the immediate needs of the user are addressed but that the risks of use are also identified and monitored. These features contribute to the popularity of harm reduction policies because they offer more options for attending to drug abuse. Harm reduction also diverts unnecessary cases away from an over-burdened criminal justice system.

Canada and Harm Reduction
The growth of harm reduction programs in Canada represents society’s willingness to see drug misuse as a health and social issue rather than one solely to be dealt with by the criminal justice system. As harm reduction programs gain momentum in Canada, we begin to see creative contributions being made by the police, corrections, courts and other social service agencies. Several organizations, such as the Correctional Service of Canada, Canadian Centre on Substance Abuse, Health Canada, and the Canadian HIV/AIDS Legal Network, have all contributed to research and program development oriented toward the reduction of harm as it relates to drug use.

“...the number of
options available for
drug related problems
are greater using
harm reduction
policies. ”

The Correctional Service of Canada (CSC) has committed to doing all that it can to reduce the negative consequences of drug use in its prisons. In 1997, 158 cases of HIV were known to the CSC. There were twenty additional AIDS cases known to the Service and there is an increasing possibility that offenders are acquiring these diseases through intravenous drug use while incarcerated. In response to the increasing numbers of infectious diseases within federal corrections, CSC has brought into its institutions bleach kits, condoms and the methadone program.

The Ottawa-Carleton Health Department, along with the Youth Services Bureau, developed the SITE needle exchange program. The program is designed to reduce the risk of contracting HIV or Hepatitis by providing needle exchanges, condoms, bleach kits, health education, anonymous HIV testing, counselling and referrals. In Toronto, a drug court has been set up to assist the underlying medical and social needs of the accused. The court’s staff, including the judge, prosecutor and defence counsel, all have a working knowledge of the issues surrounding drug use. Montreal police in the Parc Extension district get tough on those selling drugs but offer treatment to those in simple possession of a narcotic. These approaches provide other options besides criminalization.

International Perspectives on Harm Reduction
Although harm reduction is new in North America, it is not new to other parts of the world. Amsterdam has had needle exchanges in operation since the early 1980s and methadone programs have been available since the 1970s. Mobile methadone clinics offering liquid methadone to drug dependent persons have been related to more people entering into drug treatment programs in Amsterdam. The police in both Germany and the Netherlands focus enforcement efforts toward harm reduction. Officers work with health officials and drug user groups to ensure that there is adequate access to social programs, while targeting large-scale drug trafficking.

Many cities in Australia, United Kingdom, Switzerland, Germany and the Netherlands have facilities known as injection rooms. Switzerland opened its first injection room in the late 1980s. These centres offer drug users the opportunity to “obtain clean equipment, condoms, advice and medical attention” in a safe, contained environment. Research on the rooms regards them as a safer option to open injection and as an effective means to reduce the transmission of infectious diseases. Such programs have been cost-effective in dealing with drug use.

The John Howard Society and Harm Reduction
The John Howard Society recognizes that Canadians are somewhat reluctant to accept harm reduction policies because they are seen as condoning drug use. However, the Society sees that the number of options available for addressing drug related problems are greater using harm reduction policies. There is no room for options using the zero-tolerance policy. The John Howard Society views treating drug dependent persons in the community, where he or she can receive support and where more programs are available, as a more suitable option to incarceration.


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