Almost all harm reduction initiatives were created by people who use drugs (PWUD), out of necessity, in response to neglect and discrimination from existing health care and social services, or because no one else was responding to their needs. Needle and syringe programs, naloxone distribution programs, supervised injection and witnessed use, to name a few, all began because people who use drugs took things into their own hands.
The term “Satellite sites” is used to refer to informal harm reduction hubs operating out of the homes of people who use drugs. Informally operating in Toronto for over 20 years, these sites offer, at a minimum, access to sterile drug use supplies outside of more formal settings like health centres. Many Satellite sites offer much more than this – including naloxone and overdose response training, safe needle disposal, and referrals to health care services. In many cases these sites still operate informally, without added structure or external support. In some cases, they benefit from a connection with an external community health centre that can offer support, recognition, and remuneration for this important work.
This program guide was developed based on our experiences at two Toronto-based community health centres developing Satellite site programming out of the homes of people who use drugs: South Riverdale Community Health Centre and Parkdale Queen West Community Health Centre. We share our experiences in the hope that it will be helpful for community-based service providers who would like to develop similar programming, or explore other models of providing health and harm reduction services to people who use drugs, particularly in residential and other community settings.