Content warning: This story mentions overdose, substance use, the toxic drug crisis and death. Please read with care. To connect with your local mental health or substance use centre, call 310-MHSU (6478).
“I disagree with safe injection sites, which enable addicts to continue their addiction rather than solving the root problem.”
This anonymous comment from a business owner in Kamloops (Tk’emlúps) voiced frustration and misinformation about harm reduction in the 2024 Impacts to Business Report, a collaboration between the Kamloops North Shore Business Improvement Area Association, Downtown Kamloops and the Kamloops and District Chamber of Commerce.
The Wren listened to people with lived experience with addiction recovery, health care professionals and people working in recovery to better understand the roots and function of harm reduction. Broadly, the goal is to provide life-saving healthcare to people who may not yet be interested or responsive to addictions treatment or who cannot access services.
While members of the public may carry personal opinions about these policies, experts remind The Wren that harm reduction comes from a longstanding body of evidence and research.
Harm reduction, explained
Harm reduction was introduced as one of four pillars in Canadian drug policy as far back as 1987. Today, harm reduction informs the delivery of overdose prevention services, such as supervised consumption sites and drug checking, according to the B.C. health authority.
If harm reduction isn’t available, “substances will still be used in unsafe ways,” the B.C. youth-led Naloxone Society explains on social media. Harm reduction aims to save lives.
In the most basic sense, we all engage in harm reduction when we know we are at risk.
Tanya Tolman, coordinator for Interior Community Services’ Acadia Program and Youth Street Outreach, explains how harm reduction extends beyond drug use. The Youth Street Outreach team gives out free water bottles, Gatorades, fans, frozen towels, freezies, hats and sunscreen to youth on the streets during seasonal Kamloops (Tk’emlúps) heatwaves. These supplies are considered harm reduction, but for extreme heat.
Darlene Webb, director of health and recovery services of ASK Wellness, explains further.
“Harm reduction crosses over into many aspects of our life. We wear a seatbelt for harm reduction, we brush our teeth with toothpaste that has fluoride in it for harm reduction, [it is] in every aspect of our life,” she says. “But somehow it’s a different spin on it when it has to deal with the substance-using population of the world.”
These practical strategies make an act that may be risky safer. For example, providing new, sterile needles limits blood borne infections like hepatitis B, hepatitis C and HIV-AIDS. In the 1990s, Vancouver was facing one of the fastest spreading HIV epidemics documented in the developed world. By 2005, studies about the safe consumption service Insite showed users were 70 per cent less likely to report needle-sharing than those who did not use the safe consumption facility. Research also showed an increase in the use of detoxification services and addiction treatment.
Similarly, the medication naloxone works to temporarily kick opioids off the brain’s receptors, buying enough time for medical help to arrive.
Free drug testing is available to Kamloopsians at drugchecking.ca or via 250 299 7219. Testing the illicit drug supply helps ensure that people who use drugs, including young people experimenting with party drugs, lower their risk of overdose from unknown and unregulated amounts of chemical compounds like the veterinary sedative xylazine.
“Harm reduction means we acknowledge that this might not be the safest thing to be doing. But how can we make it safer, right?” says Jessica Measseney, acting program coordinator at ASK Wellness.
“It’s one of those things, it’s going to keep someone alive until they make it onto the next bed available at detox.”
Supervised consumption sites
A supervised consumption site is a private health care space for individuals to consume drugs while supervised by trained staff. Consumption sites do not provide drugs for people to use. Staff — such as a nurse or harm reduction worker — provide recovery resources and after-care, ensuring the person is safe and connected to support services. Supervised consumption sites help prevent public drug use and overdose by ensuring someone is there to help in the event of drug toxicity.
To learn more about harm reduction in practice, The Wren toured Interior Health’s Kamloops Mental Health & Substance Use clinic on Lansdowne Street with Jessica Mensinger, clinical operations manager of the substance use team.
The Lansdowne location is known for offering a full range of treatment and support services, including same-day appointments to see a medical doctor.
Other free services offered include one-on-one and group counselling, early psychosis intervention, seniors and youth services, eating disorder treatment and withdrawal management. It serves as a one-stop shop for wrap-around medical and mental health care.
The safe consumption site isn’t as popular as many might think, Mesinger explains. In fact, it’s actually the least used service at their location.
A barrier to supervised consumption sites is the lack of supervised inhalation sites for people who use drugs by smoking. A recent BC Coroners Report on unregulated drug deaths indicates that smoking is the most common way people use drugs, responsible for 71 percent of deaths. But in Kamloops, there are no sanctioned spaces for smoking drugs.
Harm reduction can also look like sharps disposal bins, which help improve safety for the wider public. Sharps disposal in public washrooms, parks and busy streets prevents someone from hurting themselves on a used needle or broken glass. The City of Kamloops’ Overdose Prevention Team provides sharps disposal services and residents can request a sharps bin.
Sean Marshall, executive director of Blue House Recovery, offers his perspective on harm reduction from the vantage point of an abstinence-based program.
“I think it’s often thought that harm reduction agencies and treatment and recovery agencies butt heads because one place is trying to get people off of drugs and one place is helping people use more safely. I just think that couldn’t be more untrue,” he says.
“If somebody uses a drug to the point they’re completely on the streets and they’re spending all of their time, say, using fentanyl in the hundreds of dollars a day, and they have to steal to support their habit — if they can reduce the amount that they use to more reasonable amount, where they can start thinking more clearly and start getting their health back and start making better decisions, that’s valuable.”
Marshall also points out harm reduction supplies may be more easily accessible compared to the months-long waitlists for treatment.
Safer supply and Opioid Agonist Therapy
Safer supply is another harm reduction practice that involves providing non-lethal, regulated, controlled dosages of medications to people at high risk of overdose. In recovery, safer supply is a doctor-prescribed, safe dose of an opioid, stimulant or benzodiazepine medication.
The aim of safer supply is to prevent overdose from uncontrolled substances, stop people from buying street-level, illicit and unregulated toxic drugs and connect people to health and social services.
Opioid agonist therapy is a form of treatment that provides a daily prescription medicine for people addicted to opioids including fentanyl, heroin, morphine, oxycodone, hydrocodone and codeine. Examples of these therapies include Suboxone, Sublocade, methadone and Kadian.
All opioid agonist therapies are used to reduce withdrawal symptoms and cravings. Research shows people who use these stabilising therapies are more likely to follow through with live-saving medical treatment, including recovery.
Barriers like not having a family physician and stigma associated with drug use can prevent the estimated 24,000 people using opioids from accessing these life-saving treatments, according to the Centre for Addiction and Mental Health and other health researchers. To make it easier, the province launched a telephone-based health service called the Opioid Treatment Access Line earlier this year.
Jessica Measseney, acting program coordinator at ASK Wellness, disagrees with the claim that harm reduction is giving people free drugs.
“I would say that’s a huge myth. I’ve seen a lot of people be able to get onto a safe supply program. And that’s something that’s going to keep them alive.”
Webb agrees. “When people say we’re providing them a safe supply — it’s not like we’re giving them illegal street drugs. We’re talking about a doctor prescribing methadone or Kadian, or Suboxone or Sublocade. That’s the safe supply. So I think there’s a little bit of a blur about what safe supply really is.”
The limitations of harm reduction
“I think my struggle with harm reduction, I think one of the reasons people can pull it apart like, ‘see, it didn’t work,’ [is because] it can’t be applied in a silo, or as the only intervention,” a Kamloops therapist and community-outreach worker, who requested confidentiality to protect their employment, tells The Wren.
“There’s so many more things that need to go into what’s going on…[harm reduction] works best in tandem with other interventions and supports.”
Marshall agrees there needs to be “a plethora of resources and a plethora of options” in order to see meaningful change or improvement, including low-barrier, 12-Step, holistic and culturally appropriate programs.
“I think that’s super important and a key that’s missing: What works for somebody might not work for another person,” he says.
Addictions recovery researcher Trevor Starchuk agrees that people working toward different systems of recovery care need to work together.
“There’s so much fighting over harm reduction versus recovery,” he says. “The thing is, brilliant minds came up with all these systems of care…. They all have their place. We need to weave them together in a way that works.”
Harm reduction and crime
Some Kamloopsians have suggested that safe consumption sites and social agencies are contributing to local crime.
Kamloops RCMP does not track neighbourhood-specific crime data, which makes it difficult to observe crime trends next to health services like safe consumption sites. The Wren looked at the Kamloops RCMP’s 2023 summary report to better understand general crime trends in Kamloops.
Certain types of crime did increase over the previous year, such as shoplifting and business break-ins. However the number of crimes against people, property and other criminal code violations in Kamloops slightly decreased between 2022 and 2023.
“Everybody likes to talk about the visible poverty and the crime that they see downtown,” explains Kamloops Farmers’ Market manager Greg Unger who works on the front-lines of local food security programs. “But, across North America, crime is on the decrease. And yeah, homelessness is on the uptick, but that’s not related to crime.”
The Kamloops therapist encourages folks to be curious about the stigma, biases and beliefs they hold.
“I think giving people access to what they need to be as safe and healthy as possible is the bottom line. We all utilize harm reduction strategies in our daily life.”
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