Linda Mantel with Glide Harm Reduction shows a strip that determines whether fentanyl is in a user’s heroin at a safe injection site simulation at Glide Memorial Church’s Freedom Hall on Wednesday, Aug. 29, 2018. (Kevin N. Hume/S.F. Examiner)

Column: harm reduction – meeting people where they’re at

“When people living with addiction receive judgement and rejection, it drives them away from safety”

Drug addiction is, most often, a response to pain and suffering; a coping strategy, when nothing else seems to work. Healing does not happen overnight, and it requires, among other things, patience, respect, inclusion, support, and a sense of safety.

Some try to quit. They need our support to do so. Greater access to replacement therapy, detox and rehabilitation services are certainly needed. But these approaches only work for some, and relapse is frequent.

Others are not ready or able to quit. They also need our support: to find housing, work, connection and safety. They don’t want to die of an overdose or acquire a lifelong infection such as HIV, nor do they want to expose anyone else to these risks. They need sterile syringes, a convenient way to dispose of them safely and a trusted friend at their side who can rescue them if they overdose. They also need an open door to other health and social services, where they will be welcomed regardless of their current health needs and goals.

When people living with addiction receive only judgment and rejection, it isolates them, compounds suffering and shame, and drives them further away from safety. What people need most is empathy.

When we talk about harm reduction, it means meeting people where they’re at, not where we would like them be. Decades of experience and research have consistently found this approach to be very effective. It saves lives and provides a gateway to healing.

The need for comprehensive safety and support has become especially urgent as the unregulated illegal drug supply that people continue to depend upon has become increasingly, and unpredictably, lethal. Friends, family, and front line service providers have been working hard to keep people safe during this crisis; they require more support as well.

Northern Health, like all health authorities in B.C., is committed to harm reduction, both as a philosophy of care and as part of the range of services we offer people with addictions.. In partnership with a variety of community agencies, Northern Health already offers needle distribution and recovery, overdose response training, naloxone distribution, and opioid substitution therapy (Suboxone and methadone). These are actions that reside within the scope of health providers across the north.

We are also committed to working with local governments, Indigenous nations, law enforcement, housing agencies, community organizations, and our clients, to develop effective and coordinated approaches to substance use that work for everyone. In communities like Quesnel and Prince George, we are meeting regularly with these partners to foster mutual understanding and plan services together.

Addiction has deep social roots and is present in every community in B.C. It will take all of us working together to fully tackle this issue. We are grateful to all of those who have invested time and energy in learning more about the realities of addiction, developing practical and coordinated responses, and delivering dignified and compassionate care, in communities throughout the north.

Dr. Sandra Allison is chief medical health officer and Dr. Andrew Gray is medical health officer for Northern Health.

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