At the opening of the 25th Harm Reduction International Conference in Montreal held in Montreal in May of this year, the Federal Minister of Health Jane Philpott announced that more people have died in the overdose epidemic in the past few years than during the height of the AIDS crisis in the late 80s and early 90s. This fact is made even more tragic considering that it need not happen.
This grim reality was on the minds of many and was the catalyst for a workshop hosted by Direction 180 and Mainline Needle Exchange, two community agencies that are at the forefront of harm reduction efforts in Halifax and in other areas of Nova Scotia.
Held on June 8th at the Mi’kmaw Native Friendship Centre, representatives from community agencies, government, health professionals, police, and community stakeholders including people with lived experience, gathered to learn and talk about opportunities to work together in the face of a crisis of opioid-related deaths.
Similar to the AIDS crisis of thirty years ago, people are sick of watching people die while governments and agencies are slow or offer ineffective responses. Much like how people living with and affected by HIV galvanized and pushed for action, people who use drugs and their allies are using the mantra of “nothing about us without us” to organize and demand action.
Four guest speakers from British Columbia were invited to speak along with local researchers, Nova Scotia’s Chief Medical Examiner, and members of the newly formed Halifax Area Network of Drug Using People (HANDUP).
The strong take home message was that the voices of those with lived experience need to be heard. Meaningful involvement and inclusion, not tokenism, of those who use drugs is critical in moving forward to find and implement practical solutions to prevent further deaths and to create better health outcomes. This is not easy as the global prohibition and criminalization of drugs and drug use not only prevents any quality control and uniformity in the products, but marginalizes and stigmatizes users. Evidence was presented that multiple harm reduction services and supports are needed.
One example of a necessary harm reduction approach is the establishment of safe consumption sites which allows users a safe environment while building trust with outreach workers allowing them hook up with community services and treatment options and improve their quality of life. Another program with positive results has been the Take Home Naloxone projects rolled out in Halifax and Sydney.
Members of the Atlantic Interdisciplinary Research Network on Social and Behavioural Issues in Hepatitis C and HIV (AIRN) were present for this workshop and also the Canadian Public Health Association’s annual conference, held in Halifax the same week. AIRN has a history and a strong reputation for supporting community-based research in order to improving the lives of people affected by HIV and HCV in Atlantic Canada, and has been working to advance evidence-based approaches.
AIRN recently conducted an evaluation of Mainline Needle Exchange, a program which has been at the forefront of Atlantic Canada’s harm reduction efforts for the past twenty-five years. AIRN looked at the impact it has had in the community and the challenges it faces.
It found that the response to the overdose crisis differs significantly across the four provinces of Atlantic Canada, with varying levels of government commitment and action. Availability of select harm reduction and testing services for HIV and other STBBIs – community-based methadone, anonymous HIV testing, and free naloxone, for example – is relatively limited, and creates grave barriers to needed services. Other harm reduction and testing initiatives, such as safe consumption sites, community-based detox, and point-of-care testing, available elsewhere in Canada are not available at all.
About the author: Michael Liddell serves in a leadership role as a community member of the Blended Leadership Committee of the Atlantic Interdisciplinary Research Network for Social and Behavioural Issues in Hepatitis C and HIV/AIDS (AIRN).