NOMA Presentation Harm Reduction Pillar April 26, 2012 Gillian Lunny

Harm Reduction Evidence-based public health policies designed to reduce the harmful consequences associated with drug use and other high risk activities

Northwest Points 8 communities 17 locations Clean and sterile equipment Free condoms Safe disposal for clients and community Information, support & referrals 2008- 158 countries with evidence of IDUs, 11.6 million IDUs worldwide, estimates suggest 3.3 million or more than ¼ of this pop has HIV. At least 77 countries provide NEPs NEP effectiveness - are associated with reductions in the incidence of BBIs in the drug-using population, and, by extension, their families and communities. - reduce the circulation of contaminated injection equipment in the community - do not increase rates of drug use among existing users or encourage initiation of drug use - do not increase crime rates 81 cities across Europe, Asia, and North America with and without NEPs found that, on average, HIV seroprevalence increased by 5.9 percent per year in the 52 cities without NEPs and decreased by 5.8 percent per year in the 29 cities with NEPs.

Principles of Harm Reduction Pragmatic Realistic, obtainable goals Non judgmental Focus on harms Meeting people where they are at Do no harm Pragmatism- HR accepts that drug use is a common feature of human experience. It acknowledges that, while carrying risks, drug use also provides the user with benefits that must be taken into account if drug using behaviour is to be understood. From a community perspective, containment and amelioration of drug-related harms is an effective option. Acknowledges that while eliminating drug use and addiction entirely is ideal, something has to be done until this happens. 2. Goals- It’s focus is on immediate, achievable goals. Most harm-reduction programs have a hierarchy of goals, with the immediate focus on proactively engaging individuals, target groups, and communities to address their most pressing needs. 3. Nonjudgmental: No moralistic judgment is made either to condemn or to support use of drugs, regardless of level of use or mode of intake. 4. Focus on Harms: See drug use through a Public Health Lens What are the harms? To the user BBIs to communities discarded needles. The fact or extent of a person’s drug use per se is of secondary importance to the risk of harms consequent to use. 5. Meeting people - Not where we think they should be. This means that I do not put my values or ethics on someone else and I am not the decider of what they do; they are. We are all the experts in our own lives. 6. Do no harm – HR programs have never shown to cause harm – increased drug use, increased initiation of drug use or increased infections. Using this view, if all I tell someone is to abstain and they do anything different than what I just told them to do, they have no tools or education to help to keep them safe.

Northern Ontario Braces for HIV Outbreak The Harms Northern Ontario Braces for HIV Outbreak “Health officials in Saskatchewan are cautioning their counterparts in northern Ontario that swift action is needed if the region hopes to avoid an HIV outbreak similar to the one the prairie province has been struggling with for years.”

The Harms

The Harms

Harm Reduction

Resources

Equipment

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