Harm reduction in recreational settings

When we hear the term “harm reduction,” we often think of supervised consumption services, needle exchanges or clean crack pipes. These are all important, life-saving measures, but is there a way harm-reduction can be applied to more casual substance users, such as the student who takes MDMA at a music festival, or the guy who likes to have a few beers after work or on the weekend?

About 15 years ago, I moved to Victoria from a small town in northern Canada to go to university. Almost immediately, I was introduced to the electronic music community. Soon, I was spending many a weekend dancing the night away at bush parties, sweaty halls or cramped basements. The scene was vibrant, welcoming and offered opportunities to experience all kinds of new things—including drugs I had never heard about before. Suddenly, I was seeing people ingest things with names I couldn’t spell or pronounce. I had a lot of questions: what did these drugs do? Where did they come from? Were they safe?

Luckily, there was an easy way to get some answers. At almost every one of these parties, there was a booth decked out in Christmas lights and beaded bracelets. A hand-painted banner was draped across the front that read “IslandKidz.” Modeled after the Dancesafe movement emerging around the same time in the U.S., the booth and its tireless volunteers were on hand to give out balanced information on various substances, hand out safe sex supplies, test pills or powders for adulterants, or just be a sober person to talk to if you were feeling overwhelmed or needed a safe space. They weren’t there to condone or condemn you for using drugs; it was your choice, and they believed you had the right to accurate information in order to make an informed decision.

An old photo of the IslandKidz booth in action.
An old photo of the IslandKidz booth in action.

I couldn’t believe that a service like this existed. (And, it turns out, we were lucky to have it; many other similar organizations weren’t able to operate with the relative ease that IslandKidz did at the time.) It made me feel empowered and respected, not vilified or dismissed—as many in that subculture often felt, whether they chose to use drugs or not. I didn’t know it then, but this would be my first encounter with harm reduction—and it would be far from my last. I would eventually end up volunteering for IslandKidz, driving down countless logging roads and spending many a late night chatting with partiers, handing out info flyers, and scraping mystery pills to see what they might contain.

Harm-reduction organizations like this appear to be making a comeback these days; look at groups like Karmik in Vancouver, ANKORS in the Kootenays, DanceSafe across the U.S., or Toronto’s TRIP Project. But they are far from the only harm-reduction measure trying to reach recreational substance users. In this series, we will hear about a website offering safer-use limits for illicit drugs developed by users themselves, a report that became a touchstone for almost every media article on festivals this summer, and some advice on ways to possibly avoid “bad” ecstasy. We hope these pieces help expand your idea of what harm reduction can be.

 

amanda photo

Author: Amanda Farrell-Low, Research Assistant, Centre for Addictions Research of BC

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

Harm Reduction in BC: We set the pace, but can we keep it up?

The harm reduction series on CARBC’s Matters of Substance blog has spent the past three months examining the scope of harm reduction as an approach to reducing harms of drug and alcohol use. These posts explore harm reduction as we know it today by going beyond evidence of injection drug users engaged in HIV prevention programs; rather, we establish that harm reduction now includes a wide range of user-informed, user-specific initiatives. For instance, some of the blog contributions include introductions to crack kit distribution, safe consumption services, syringe access for prisoners, opioid substitution treatment, managed alcohol programs, Housing First programs, and even e-cigarettes. Such initiatives have shaped a public health landscape in BC that focuses not on drug and alcohol use itself, but instead on the determinants of health which influence safer substance use environments.

This blog series has shown that harm reduction works – and as a pragmatic approach to public health, it is only appropriate that we highlight some more recent research taking place in the harm reduction field. The post by Ashraf Amlani and Dr. Jane Buxton reveals that B.C.’s Take Home Naloxone Program has saved an overwhelming 55 lives from 600 naloxone kits distributed since 2012. Among the over 30 research studies conducted at Insite, we learn that supervised consumption sites increase access to drug treatment, decrease drug use and disease transmission, and eliminate on-site overdose deaths – collectively, a social benefit worth approximately $6 million per year. We also learn that such approaches work across populations, with crack pipe distribution decreasing crack cocaine use and disease transmission in Vancouver.

These examples and other evidence have helped change both the political and public health climate in British Columbia. Harm reduction expert Dr. Carol Strike used such evidence to develop best practices, setting a higher precedence for public health practices across the country. Perhaps one of the main themes in these best practices, and our blog series overall, is user-informed, user-involved public health practice and policy. Actively engaging the people who are affected by drug and alcohol use not only makes sense and provides insight, but also creates a trusting environment, increases legitimacy and contributes to the self-worth of the community itself – a “win-win-win” situation.

An early post in the harm reduction blog series reveals that over three-quarters of British Columbians support harm reduction. Exciting, right? But even after 10 years of passionate debate, evidence building and community organizing, all of our guest bloggers acknowledge that there is still a lot of work to do.

Donald MacPherson, the Director of the Canadian Drug Policy Coalition, points out that one of the biggest hurdles we face is advancing public health policy in the face of criminalization of drug use. As such, MacPherson argues, we must continue to urge the government to eliminate criminalization of drug use in an effort to maximize a more comprehensive approach to drug problems. Without action, we risk perpetuating more harm being caused by these policies.

And although the public is becoming more comfortable with needle exchanges (over 72 percent of British Columbians are in support), they are still warming up to supervised injection sites across the country. One reason for this may be a more limited public perception and understanding of sometimes counterintuitive, non-traditional approaches to substance use, such as managed alcohol use programs and a Housing First model.

So what’s next? The fact remains that while we have gained momentum in public health, there is still a lot of work to do. Over the next couple years, we have the opportunity to translate evidence and public opinion into policy and connect it to a more comprehensive approach to public health. We’ll get there by raising our voices, continuing to present evidence and working to inform best practices. We certainly look forward to continuing the conversation.

AG

Author: Alissa Greer, Centre for Addictions Research of BC

*Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC