Harm reduction interventions are health services designed to decrease the harm associated with drug use, without necessarily requiring abstinence, and to give people experiencing problematic substance use the option to access treatment and other health and social services. Over the past decade, harm reduction services have expanded beyond interventions like safer injection education and syringe distribution programs to include supervised consumption services, safer inhalation kits, take-home Naloxone, drug checking kits, and low-threshold opioid substitution.
A large amount of scientific evidence shows that harm reduction services targeting illicit drug use prevent HIV, overdose, and injection-related risk behaviours. This large evidence base supporting the cost-effectiveness and benefits of harm reduction interventions should translate into straightforward policy support for integrating harm reduction into standard health services. However, Canadian provinces and territories show wide variations in how these services are implemented, and the approach remains very controversial. Health policy makers must consider public support for these services when creating policy frameworks to guide priorities, decisions, and resource allocation.
Expanding harm reduction services and better integrating them into healthcare systems requires a clear understanding of many factors that influence policymaking, such as the opinions of key decision makers.
This research project examines these factors through a provincial and territorial study of harm reduction policy. By examining provincial and territorial policy documents, analyzing media articles, interviewing key policy stakeholders, and surveying the public, this project examines how harm reduction is understood and implemented in each province and territory and what opportunities and challenges exist for expanding services and better integrating them into healthcare systems.
The overall aim of this research is to help governments and other stakeholders expand access to valuable health services for people who use drugs. This research will help organizations who support people who use drugs to advance the development of fair and evidence-based policy to support harm reduction services across Canada.
We collected all publicly available provincial/territorial and health authority-level policy documents relevant to harm reduction, published between 2000 and 2015. We analyzed these 102 documents, resulting in a series of 13 case reports – one for each province and territory. Case-level findings were further analysed, both within and across cases, resulting in a national-level summary of results presenting key findings and lessons learned about the state of harm reduction policy across Canada.
View key findings of our national level summary here.
We analyzed the harm reduction policy sets of each province and territory, resulting in a series of 13 case reports. These reports include background information on the state of harm reduction services and policy in each jurisdiction, based on policy documents published between 2000 and 2015. We also provide an in-depth discussion of each policy framework, and present individual results of a standardized framework of indicators, called the CHARPP Framework.
We sought feedback on these case reports from individuals within each jurisdiction, but were not able to find reviewers from every province and territory. If you have questions, comments, or feedback on the findings of these case reports, we would be happy to hear. Please get in touch with our research coordinator at email@example.com.
- Newfoundland and Labrador
- New Brunswick
- Nova Scotia
The CHARPP Framework is a set of indicators designed to measure the quality of formal harm reduction policies in Canada. Learn more and view all the indicators here.
See how the provinces and territories stack up according to the CHARPP Framework here.
Other published work
- Hyshka E, Anderson-Baron J, Karekezi K, Belle-Isle L, Elliott R, Pauly B, Strike C, Asbridge M, Dell C, McBride K, Hathaway A & Wild TC. Harm reduction in name, but not substance: a comparative analysis of current Canadian provincial and territorial policy frameworks. Harm Reduction Journal. 2017 Jul 26;14(1):50.
- Wild TC, Pauly B, Belle-Isle L, Cavalieri W, Elliott R, Strike C, Tupper K, Hathaway A, Dell C, MacPherson D, Sinclair C, Karekezi K, Tan B & Hyshka E. Canadian harm reduction policies: A comparative content analysis of provincial and territorial documents, 2000-2015. Int J Drug Policy. 2017 Jul;45:9–17.
Key Informant Interviews
Between November 2016 and December 2017, we conducted in-depth interviews with 75 key policy stakeholders from each province and territory across Canada. This included staff, managers, advocates, leaders, and people with lived experience in the sectors of harm reduction, HIV/AIDS, addiction, law enforcement and mental health. We aimed to gain their perspectives on provincial/territorial harm reduction policy making and factors that influence the provision of harm reduction services in their respective jurisdictions.
Analysis of this large data set is still underway, and findings will be made available as they are published.
We identified and collected a collection of 5,681 news articles, published between 2000 and 2016, that covered harm reduction. We analyzed these texts to describe the volume and content of print media coverage of harm reduction. Findings of this research will be made available as they are published.
The collection of news articles will be available as a standalone library of harm reduction media texts for future research and analysis purposes.
For more information on accessing the media library, please contact our research coordinator at firstname.lastname@example.org.
Public Opinion Survey
We are in the process of finalizing a large scale public opinion survey, designed to provide nationally and provincially representative data on the public acceptability of harm reduction services, as well as perceptions of illicit drug use. An online survey of nearly 5000 randomly-sampled Canadian adults will be undertaken.
We are working with a third-party survey firm to complete this research, with an expected completion date of summer 2018.
Funded by the Canadian Institutes of Health Research