What is harm reduction? What is safer supply?
Safer supply is an example of a harm reduction approach to substance use. Harm reduction approaches acknowledge, without judgement, the risks that come with various human activities, including substance use, and aim to address and manage those risks without requiring people to stop the activity.
For example, using unregulated (or street-based) fentanyl comes with risks because of the contamination of the supply, the possibility of fatal overdose, and the criminalization of drug use. Safer supply aims to reduce potential harms of opioid use and its criminalization by providing people with an alternative opioid of a known dose and strength. This is a pragmatic response because people who use opioids may not want to stop or be able to stop, but they still deserve to stay alive and as healthy and safe as possible.
There is more information about harm reduction and safer supply at the links below.
What supports are available to family and friends of people accessing harm reduction programs?
Traditional approaches to substance use, such as treatment with methadone, often assume that all people with problematic substance use must stop using to be healthy. However, there can also be a strong moral component to these approaches that reflects attitudes about what people should do, rather than asking what they want for themselves. This means that many programs for people who use drugs and their loved ones also reflect these attitudes, which can be confusing if treatment or other approaches are not desired or not working.
There are some supports emerging for loved ones of people who use substances that prioritize the values of harm reduction and personal autonomy. A few are listed below.
Harm Reduction Programs at Parkdale Queen West Community Health Centre
Families, friends, and supporters may wish to become involved in knowledge sharing about harm reduction and safer supply or may require immediate crisis support. See the resources below, and please use the contact form at the bottom of the page to suggest additional resources.
Frequently Asked Questions
Parkdale Queen West Community Health Centre (Parkdale Queen West CHC) is a community-based health service organization located in south-west Toronto. We offer a broad range of services, including primary health care, dental care, harm reduction, health promotion, counselling, and community development programming. We offer services at three main clinic locations, as well as within the community.
We work to improve the health and wellbeing of individuals and communities who are at risk and/or face barriers to accessing high quality health care services and supports. Priority is given to individuals and groups who encounter barriers to high quality health care services, including marginalized or vulnerable populations such as newcomers, Indigenous and racialized communities, people who are homeless or street-involved, people living with mental health issues, people who use drugs, people with disabilities, isolated seniors, LGBTQ communities and people living in poverty.
Harm reduction is a principle and set of practices that acknowledges and seeks to manage the risks that come with many regular human activities, including sex and substance use. Harm reduction takes a non-judgmental and non-punitive approach and does not aim to stop people from engaging in these activities, but instead promotes health and safety and accepts the person as they are.
Harm reduction approaches are important because they honour the choices that people make for themselves rather than imposing a behaviour change that people may not want to or be able to make (for example, stopping their substance use). Instead, tools and strategies are offered to promote people’s safety and autonomy (for example, injection kits to help people avoid infection and naloxone for when people are using outside of supervised spaces).
A supervised consumption service (SCS), sometimes also known in Ontario as a Consumption and Treatment Service (CTS), is a place where people can use their drugs legally and with support. Staff at the SCS are highly trained in overdose response and offer education on injection technique, safer use practices, and other community resources for people who use drugs. Clients at the PQWCHC SCS can receive nursing care and be referred to an array of health services offered at the centre, including primary care, anonymous hep C and HIV testing and hep C care, the Four Winds Indigenous Health and Wellness program, and dental care.
Sometimes, harm reduction approaches to substance use and treatment are seen as in opposition to one another, when in fact they exist in a spectrum of services for people who use drugs.
For some people, treatment, and abstinence, are the paths that best support their wellbeing and goals. But harm reduction does not assume that substance use must stop for people to live full, healthy lives, or that substance use ought to be avoided and has no benefits. Harm reduction approaches make it possible for people to manage the risks that may come with their substance use so that they are alive and as healthy as possible, and can decide for themselves if they wish to change their substance use or not.
Safer supply is a substance that people can use that has a known dose and purity. Alcohol purchased at the liquor store is one version of a safer supply – it is a regulated supply of a controlled substance (versus moonshine of unknown or unpredictable potency). Safer supply can also be pharmaceuticals with known dosing and content that can be used for similar effects instead of street-obtained substances, such as the opiate hydromorphone instead of fentanyl.
People using a street-level supply of substances are at risk of harm from both the unpredictability of the unregulated supply and from criminalization. A safer supply can therefore support people to avoid some harms because they can manage their dose and reduce illegal activities associated with obtaining an unregulated supply.
The Safer Opioid Supply Program offers prescriptions for hydromorphone as an alternative to people using unregulated fentanyl. The primary goal of the program is to support people to decrease their risk of overdose and death from using the contaminated street-level supply. However, the program also integrates primary care, counselling, mental health support, and individual case management (e.g., housing support, accompaniment, financial support) to support clients in many aspects of their health and lives. To learn more about the outcomes of the Safer Opioid Supply Program, you can read the 2023 Evaluation Report here, or see the highlights of the evaluation on this infographic.
The Safer Opioid Supply Program does not have an open intake model, and there is no way to join the program when it is closed for intakes. Instead, intake periods are announced on the SOS webpage and via the SOS mailing list. All the information needed to apply is given when intakes open. Visit the SOS webpage to learn more.
There are resources available to help you learn about harm reduction services and access support as a family member or friend of someone who uses drugs.
You can learn more about harm reduction to be able to talk with your loved one about these approaches and services at the National Harm Reduction Coalition (US) website.
You can learn more about organizing and advocacy by and for people who use drugs (often abbreviated PWUD) by visiting the Canadian Association of People Who Use Drugs (CAPUD) website or the Ontario Network of People Who Use Drugs (ONPUD) website.
You can reach out for support or to join Moms Stop the Harm, a nationwide network of families advocating to change failed drug policy, providing peer support to grieving families, and assisting those with loved ones who use or have used substances.
You can contact us using the Contact Form to suggest additional resources needed or other ideas to support loved ones of people accessing harm reduction services at PQWCHC.
Please note: Do not request to join the SOS Program via this Contact Form – instead, add your email address to this mailing list. Requests to join the SOS Program received via this form will not be acknowledged or accepted.
To stay in touch and receive periodic email updates about resources and opportunities for family, friends, and supporters of people accessing harm reduction programs, please add your email address to our resources mailing list. (Note that this list is separate from the SOS Mailing List – if you wish to receive SOS program updates as well, add your email to both lists.)