Harm Reduction - Presentation

[Audio] 1. 7. 2013 Welcome to Healthy Sexuality and Harm Reduction! This presentation covers Need-to-Know information to prepare you for your visit to HSHR. You can expect to spend ( 45 min to an hour) on this presentation..

[Audio] 1. 7. 2013 No voice over. The healthy sexuality and harm reduction building is located on the original lands of the Anishinabe, Oji-Cree, Dakota and Denes people, and on the homeland of the metis people. We respect the treaties that were made on this territories, we acknowledge the harms and mistake of the past, we dedicate ourselves to move forward in partnership with Indigenous communities in a spirit of reconciliation and collaboration..

[Audio] 1. 7. 2013 Topics covered in this presentation are; - Introduction to HSHR - Harm Reduction Philosophy - Background Info - Providing care to the Community members There are links through out the presentation that can be used to access further resources. Please pause the presentation and visit these resources as needed..

[Audio] 1. 7. 2013 This section will introduce you to HSHR, providing information on what is the program mission, what services are provided and who the services are for..

[Audio] 1. 7. 2013 Script: the HSHR program aspires to promote the health of people in Winnipeg by promoting healthy sexuality and harm reduction. This is done on multiple levels by reducing the burden of STBBI's, diminishing harms associated with sexuality, drug use and society's response to these practices and working to redress the social and health inequities that exist. https://wrha.mb.ca/public-health/service/healthy-sexuality-harm-reduction/.

[Audio] 1. 7. 2013 Script: HSHR collaborates with community members to identify what issues are most important to them. They organize outreach clinics for key populations. On the right-hand side, there is a picture of what the street connection van looks like. Click on the link to visit the WRHA website. https://professionals.wrha.mb.ca/old/extranet/publichealth/services-healthy-sexuality.php.

[Audio] 1. 7. 2013 https://streetconnections.ca/ Script: Services provided by HSHR include testing and treatment for STBBI's and confidential contacting for exposure to STBBI's. HSHR services are mobilized through the street connections van to increase accessibility. Staff at HSHR also provide counselling related to STBBI's and connect clients to health and social services. HSHR provides harm reduction supplies to the community and delivers education to both community members and health care providers..

[Audio] 1. 7. 2013 https://nccdh.ca/resources/entry/public-health-speaks-intersectionality-and-health-equity Script The services provided by HSHR are available to all residents of Winnipeg. It aims to meet the needs of people most at risk of harm from STBBI and criminalized activities including sex work and illicit substances use..

[Audio] 1. 7. 2013 No script also should we just delete this slide?.

[Audio] 1. 7. 2013 https://serc.mb.ca/wp-content/uploads/ 2018/06/HarmReduction-wrha.pdf Script: Harm reduction is a philosophy that is supported by evidence, it aims to reduce the harms associated with drug use and sex without trying to reduce the behaviour itself. Some principles to keep in mind are that harm reduction is client-centred, non-judgemental and facilitative rather than coercive. It promotes autonomy and dignity. It targets the causes of risks and harms..

[Audio] 1. 7. 2013 For the next few slides, we will be looking at what substance use is, criminalization, prohibition of drugs and indigenous harm reduction..

[Audio] 1. 7. 2013 Substance and drug use are terms often used interchangeably. People use drugs for different reasons. Some reasons include relaxing, fitting in, coping, as an experiment and to enhance performance. There are different types of substances that people use, the most common substances consumed are caffeine and nicotine. Substances may be legal (such as caffeine, nicotine and cannabis)or illegal such as methamphetamine or cocaine..

[Audio] 1. 7. 2013 Statics reveal that between 70- 90% of people who use illicit substances do not experience problematic use or substance dependence. This is different from the common belief that all drug use is problematic. drug use occurs on a spectrum, it can range from beneficial to casual or not problematic to problematic to dependence. Moving on this spectrum is dependent based on individual factors. Progression is not linear, one can remain beneficial or problematic throughout the period that they are using the substances..

[Audio] 1. 7. 2013 - These are a list of common drugs in Canada, the list contains both licit and illicit substances. - The most popular drug used in Winnipeg is Methamphetamines also known as Crystal meth. - Down or purple down contains crack cocaine, fentanyl, and benzo. Benzodipine has a high potency and cannot be reversed by naloxone/ Narcan in a case of an overdose. - MDMA ( Ecstasy)is often swallowed in tablets or capsules form - Some club drugs include GHB, LSD and Rohypnol. - MDMA (Ecstasy)is often swallowed in tablets or capsules form - Solvents/ Inhalants are products with poisonous fumes that people inhale to get high example includes gasoline. (according to this article: https://winnipeg.ctvnews.ca/new-drug-of-choice-on-winnipeg-streets-naloxone-use-skyrockets- 1.5035232:.

[Audio] 1. 7. 2013 Canada prohibits the production, sale, transportation, and possession of certain substances. This allows people found to be participating in any of these activities to be punished. Prohibition is meant to eliminate the supply of prohibited substances, however, as we have seen, the market for prohibited drugs still exists and is unregulated and unpredictable..

[Audio] 1. 7. 2013 Criminalization of a substance affects people who are found to be participating in prohibited activities. They can be punished by law and often face many social and physical harms caused by being labeled as " criminals". Some of these harms include stigma, discrimination, refusal of service and barriers to services. It is important to understand that criminalization and prohibition of substances creates many more harms on both the societal and individual level than the use of the illicit substances themselves..

[Audio] 1. 7. 2013 The concept of indigenous harm reduction acknowledges the affect of colonization on Indigenous communities and the over-representation of the Indigenous peoples in the category of people who use drugs. Harm Reduction in the Indigenous context must include the de-colonization of policies and program environments..

[Audio] 1. 7. 2013 Indigenous harm reduction is about reducing the harms of colonization.

[Audio] 1. 7. 2013 No voice over. Indigenous people including first nations, Metis and Inuit have all experienced hundreds of years of colonization, persecution and ongoing structural violence..

[Audio] 1. 7. 2013 No voice over. First Nations people are five times more likely to experience an overdose and three times more likely to die from an overdose than non-First Nations people..

[Audio] 1. 7. 2013 Script: The recommedation for harm reduction and policy Indigenous community-based leadership: Policies and programs must be conceptualized, led and implemented by indigenous people and communities. Indigenous people are the experts on what they need Peer-leadership, engagement and support: This is core principles of indigenous harm reduction Multi-level and multi-sectoral approach: Recognition that harmful substance use is embedded in a larger network of health and social inequities. Diverse and Inclusive: understanding that this is not one size fits all approach. All must be welcomed into spaces that might have left some out. Evidence and Evaluation: Government to direct funds to community-driven and community-led initiatives Adequate and sustained funding with long term vision: The federal and provincial government need to provide adequate funding for indigenous harm reduction as programs are being left seriously underfunded in all jurisdictions..

If the larger issues are not addressed, all the needles exchange services are not going to change anything..

[Audio] 1. 7. 2013 https://caan.ca/wp-content/uploads/ 2021/05/Indigenous-Harm-Reduction-Policy-Brief.pdf http://www.hivlegalnetwork.ca/site/wp-content/uploads/ 2013/04/Greater+Involvement+-+Bklt+-+Drug+Policy+-+ENG.pdf.

[Audio] 1. 7. 2013 The next section of the presentation will cover stigma and misconceptions surrounding harm reduction and people who use drugs, the importance of language use and exemplify types of harm reduction supplies distributed, finally, you will be directed on how to prepare for your visit..

[Audio] 1. 7. 2013 Stigma and misconceptions surrounding Harm reduction and people who use drugs affects people in negative ways. This.

[Audio] 1. 7. 2013 According to CATIE resources " stigma is a process of exclusion; it involves seeing a person or group of people as tainted or disgraced. Stigma often emerges in the form of derogatory language that shames and belittles people ( Canadian Centre on Substance use and Addiction). Stigma manifests in negative attitudes, judgement, stereotypes and problematic language that can dehumanize people who use drugs.

[Audio] 1. 7. 2013 In the population we are working with people who use drug are either considered bad or dangerous for using substances. The stigmatization does not just start in one day, it is gradual and becomes solidified in place after repeated scenarios are said or shown.

Misconception About Harm Reduction. Harm reduction encourages or enable people to use more drugs.

Language Use.

(Canadian Public Health Association - Language Matters (CPHA), 2019).

Words matter Word choices can exclude or include groups of people, can convey stereotypes, expectations or limitations of ones identity..

Be inclusive U se langue that reflects the unknown or known diversity of your audience. We cannot assume based on beliefs or appearance.

Examples of Inclusive and More Accurate Word Use.

Terms That Focus on Weakness or Place Plame on the Person.

Person-First Language. “[STBBI]-infected” “Abuser/junkie” “Ex-user/former addict” “Alcoholic/Drug User/ drug addict”.

Person-First Language. “Person living with [STBBI]/person diagnosed with [STBBI]” “Person who has been incarcerated/person with a felony conviction/person convicted of [] offense, person on parole/person on probation” ”Person involved in the sale or trade of sex/ sex worker” (using the term sex worker acknowledges that sex work is work.).

[Audio] 1. 7. 2013 This section of the presentation will provide information about Harm reduction supplies provided to clients..

[Audio] 1. 7. 2013 Sterile syringes are a common harm reduction tool distributed. Distributing this item helps people who use IV drugs reduce their chance of acquiring blood born infections such as HIV and ( Hep C?). There is no limit on the amount of Sterile syringes a client can receive. Small portable Sharps containers an tourniquets can be provided as well..

TOURNIQUETS. SHARPS CONTAINER. SYRINGE.

[Audio] 1. 7. 2013 These supplies help a person using drugs to do so in a safer manner. Small sterile water ampules used for dissolving drugs, vitamin c as a safer source of acid and a sterile cooking tool used to heat the drug. Heating the drug helps to dissolve a drug to liquid state and reduces the bacterial and viral load..

COOKER. STERILE WATER. VITAMIN-C.

[Audio] 1. 7. 2013 Alcohol swabs are distributed to assist people injecting drugs venously to clean the site before-hand. It is discouraged to use the swab post-injection as this may increase the likely hood of cross-contamination. Small cotton filters - pictured in the centre here - can be provided to help filter drugs as they are draw into the syringe. On the right is pictured a " 20 kit" which is a common way to distribute safer use items, the kit contains 20 syringes, alcohol swabs and sterile water ampules..

[Audio] 1. 7. 2013 Supplies distributed to decrease some harms associated with smoking drugs include a safer crack use kit - Pictured on the left - which includes a glass tube, two plastic tubes for mouth pieces and a pushing stick. Additional items available to clients are bubble pipes and brass screens..

[Audio] 1. 7. 2013 HSHR also provides a variety of free condoms, flavoured, latex, non-latex, and internal. Lubricant is available as well. Pictured on the right is a naloxone kit, naloxone is a opioid antagonist that can reverse the effects of opioids and is used in the case of a suspected opioid poisoning. Clients can receive up to 2 naloxone kits and must be trained on administration prior to distribution..

For Your Visit to HSHR How to Prepare.

Plan Ahead. 1. Your Visit May Include. 2. Keep Yourself Mobile.

Plan Ahead. Plan your transportation, look up bus routes and parking. There is all-day paid parking across from 496 Hargrave, the angle parking in front of the building is only suitable for short visits (2hrs). If you are unfamiliar with driving downtown look up your route and note which streets are one-way. Leave yourself extra time, traffic can increase travel time especially during rush hours. There are multiple construction sites on the way to the office, use routes you are familiar with to avoid unforeseen circumstances..

Home Visit. 1. Outreach Clinics. 2. Street Connections Experience.

[Audio] 1. 7. 2013 https://professionals.wrha.mb.ca/caring-for-people-who-use-drugs/#:~:text=Providing% 20safe%20and%20inclusive%20care,family%2C%20and% 2For%20society..

Don't bring expensive items. 1. Use a backpack or bag that leaves your hand free.