The Truth Behind Harm Reduction

CAMH Connexions

Winter 2005-06

Lately there has been some discussion in the media around what is the most effective response to alcohol and other drug issues in the City of Toronto. The media's interest has come as a result of the recent passage of the Toronto Drug Strategy by the City of Toronto, with input from a number of organizations, one of which was CAMH.

The framework for the strategy has been based upon a comprehensive and integrated approach to tackling alcohol and other drug issues in the city, with a focus on the areas of prevention, harm reduction, treatment and enforcement. This approach was taken because according to research — here and in other countries — bringing together the energies of the health, social services, housing, education, employment and criminal justice systems has the greatest impact on complex drug problems and their effects on a community.

Although the Toronto Drug Strategy includes 66 recommendations, there are three that generated the most interest:

• the decriminalization of small amounts of cannabis
• a study of whether supervised consumption sites are needed and/or feasible
• the distribution of safe crack kits and cookers.

All are based on a harm reduction approach to treatment that essentially focuses on trying to reduce the harm for people who use substances, their families and the communities who may be affected by that use. Harm reduction outreach strategies — like the very successful needle exchange programs — are also about connecting people with supports and services that can improve and sometimes save their lives.

Dr. Peter Selby

"We have to meet people where they are at, rather than where they should be," says Dr. Peter Selby, Clinical Director, Addictions Program, CAMH.

"Addiction, by definition, is the continued use of a drug despite the harm it causes the individual medically, psychologically, socially, financially, or in other ways. Providing safe crack kits is a very useful first step in encouraging crack cocaine users to seek treatment. People who use services such as needle exchange programs or safe consumption sites often go on to use addiction treatment programs like the ones CAMH provides."

At CAMH we take a harm reduction approach that employs recognized strategies used throughout the world to reduce negative health and social consequences of drug use. Harm reduction accepts that total abstinence from all drug use is not a realistic goal for some people, particularly in the short term. Rather than requiring people to commit to complete withdrawal from all drugs as a precondition to treatment, CAMH works with clients to establish personal goals that can range from total abstinence to a "moderate" use of the drug.

"People do not set out to become addicted," emphasizes Dr. Selby. "One of our biggest challenges in treating those who have alcohol or substance use issues is the stigma they face from people in our community."

As Paulette Walker, a graduate of the Drug Treatment Court Program at CAMH says, "My goal or ambition for my life was not to become a crack addict. The circumstances of my life and the power of the drug eventually made my addiction to crack beyond my control. Through hard work and determination, I have now stayed clean for three years. I am one of the lucky ones."

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