Frequently Asked Questions
What is harm reduction?
What harm reduction services are available in Leslieville?
What are supervised consumption services (SCS)?
Does harm reduction encourage or enable substance use?
Why does a community like Leslieville need supervised consumption services?
Where can I find additional resource to learn more?
What is harm reduction?
Harm reduction is an approach that aims to minimize the harm or risk associated with various activities. We practice harm reduction in our daily lives in many ways. For example, we use seat belts and put children in car seats in vehicles. We wear protective equipment like earplugs, steel-toed boots, gloves, and hard hats when doing dangerous jobs. We take a friend for support when having a difficult conversation and we tell them where we are going on a first date. As the name suggests, harm reduction does not aim to completely eliminate all harm.
With respect to drug use, harm reduction approaches are commonly used across Canada — and in various parts of the world.
Harm Reduction International defines harm reduction as the following:
Harm reduction refers to policies, programmes and practices that aim to minimise the negative health, social and legal impacts associated with drug use, drug policies and drug laws.
Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.
The principles of harm reduction are:
- a commitment to evidence;
- respecting the rights of people who use drugs;
- a commitment to social justice and collaborating with people who use drugs; and
- the avoidance of stigma and discrimination.
The goals of harm reduction are:
- keep people alive and encourage positive change in their lives;
- reduce the harms of drug laws and policies; and
- offer alternatives to programs that exclusively seek to end drug use.
Harm reduction programs may provide:
- information on safer drug use;
- sterile drug use equipment (e.g., sterile needles, pipes, cookers, etc.);
- naloxone distribution (a medication that reverses opioid overdose);
- overdose prevention and reversal training;
- supervised consumption sites;
- drug checking (testing for fentanyl and other contaminants);
- substitution therapy / opioid agonist treatments (e.g., methadone and buprenorphine);
- safer supply programs;
- basic nursing care (e.g., wound care);
- legal/paralegal services; and
- referrals and access to other social services.
What harm reduction services are available in Leslieville?
South Riverdale Community Health Centre (SRCHC) provides a wide range of programs, which you can search here. The harm reduction program at SRCHC was launched 25 years ago. It has won several awards and its team has been invited to share learnings nationally and internationally.
SRCHC’s harm reduction services include drop-in sessions, safer drug use kits, supportive counselling, distribution of naloxone kits and overdose prevention and reversal training, drug checking, a supervised consumption site, safe disposal of supplies, education, and referrals to a wide range of healthcare and social services, including to withdrawal management and treatment programs.
Outside of Leslieville, The Works at Toronto Public Health supports over 60 agencies across Toronto to offer harm reduction supplies and services at over 100 locations and access points. A list and map of locations are available here.
What are supervised consumption services (SCS)?
According to the City of Toronto:
Supervised consumption services are health services that provide a hygienic environment for people to inject pre-obtained drugs under the supervision of trained staff. In addition to supervised injection, individuals are provided with sterile injection supplies, education on safer injection, overdose prevention and intervention, medical and counselling services, and referrals to drug treatment, housing, income support and other services.
Clients arrive at the program with pre-obtained drugs. Clients are given sterile injecting equipment and instruction on safer injecting practices. Staff supervise injections in a room dedicated to this purpose, and intervenes in the case of any medical emergencies.
Once the individual has injected their drugs they go to a waiting room where they continue to be observed for any negative drug reactions. They also receive information and referrals about other health and social supports and services at the agency or elsewhere in the community.
International research shows that supervised consumption services reduce drug overdoses, save lives, and limit the spread of HIV and hepatitis C related to unsafe injection practices.
The supervised consumption services available in Toronto are listed here.
Does harm reduction encourage or enable substance use?
No, there is no evidence that people start using drugs or increase their drug use because harm reduction services are available. See the Homeless Hub’s overview of this research.
Harm reduction is an approach that recognizes that people have always used substances (including more socially acceptable substances such as alcohol) and that a non-judgmental approach can help engage people in care.
Harm reduction is about meeting the person where they’re at and supporting their autonomy, including the positive changes they would like in their own lives, rather than demanding that they stop using drugs as a precondition for receiving services and support. Harm reduction programs act as points of connection for people regardless of where they are in their journey.
Why does a community like Leslieville need supervised consumption services?
The harm reduction program was initially launched at SRCHC in response to a Toronto Public Health study that identified the community as one with a high prevalence of drug use and HIV.
The SCS was added to the harm reduction services in 2017 after a process of community consultation and a feasibility study. (See City of Toronto staff reports of March 7, 2016 and June 16, 2016.) Evidence showed that, compared to the city overall, there were disproportionately high numbers of people who injected drugs within SRCHC’s catchment area, as well as higher rates of emergency department visits due to opioid or cocaine use. Some of the reasons cited at the time for wanting SCS in Leslieville included fewer overdoses, a reduction in public injection and discarded drug use equipment, lower burden on first responders and the healthcare system, and improved access to other health and social services for PWUD.
Substance use has been common throughout human history and occurs with people of all genders, ages, incomes, and ethnicities. Leslieville has changed considerably over the last decades, but the fact that people living and working in Leslieville use drugs has not changed.
Since 2016, more than 30,000 people have died from opioid-related overdoses in Canada. SCSs keep people alive by preventing accidental overdoses, reducing the spread of infectious diseases, and connecting clients to healthcare and social services. SCSs are a critical element in a comprehensive response to the overdose crisis. As a community, Leslieville needs evidence-based, accessible, responsive, and compassionate services to protect youth, adults, and seniors from the potential harms of substances and criminalization.
The COVID-19 pandemic has contributed to and exacerbated the overdose crisis. The national housing crisis is also putting an incredible burden on people. Across Toronto, there has been an increase in poverty, racism, hate crimes, intimate partner violence, homelessness, and mental ill-health. And at the same time, there have been significant cuts to social and health services. This is an emergency — and communities like Leslieville will benefit from working together to support the most marginalized and vulnerable through the compounding crises.
Where can I find additional resource to learn more?
You can check out our Resources page to go deeper.