MethodsMethods

National Advisory Committee

Harm Reduction Symposium

MethodsMethods

Site Visits andWalkabouts inSelected Cities

Whitehorse YT Victoria BC Edmonton AB Winnipeg MB Rouyn-Noranda

QC Ottawa ON Québec QC Halifax NS St. John’s NL

MethodsMethods

Site Visits andWalkabouts inSelected Cities

Whitehorse YT Victoria BC Edmonton AB Winnipeg MB Rouyn-Noranda

QC Ottawa ON Québec QC Halifax NS St. John’s NL

MethodsMethods

Focus Groups

List of Visited Sites and ProgramsList of Visited Sites and Programs

Whitehorse YT

No Fixed Address Outreach VanBlood Ties Four Directions Centre

Victoria BC Society Of Living Intravenous Drug Users (SOLID)Prostitutes Empowerment Education Resource Society (PEERS)Vancouver Island Compassion Society

Edmonton AB

Alberta’s Non-Prescription Needle Use InitiativeBoyle Street Community ServicesStreetworksAlberta Addicts Who Education and Advocate Responsibly (AAWEAR)

Winnipeg MB

Sage HouseSOS Solvent Users’ GroupBiidigen North End Schools Safer Corridors ProjectKali Shiva AIDS Services – Sunshine HouseNine Circles Community Health Centre

Rouyn-Noranda QC

Abitibi-Temiscamingue HIV/AIDS Regional ClinicArrimage Jeunesse

Ottawa ON OasisOttawa Public Health’s Safer Crack Use Initiative

Québec QC Point de repèresProstitute Intervention Project of Quebec (PIPQ)

Halifax NS Mainline Needle ExchangeDirection 180Phoenix Youth Centre

St. John’s NL Tommy Sexton CentreStreet Reach

List of Visited Sites and ProgramsList of Visited Sites and Programs

Focus Group Results

Focus Group Results

Whom we talked to:• n = 50 men; 30 women• ages 18 to 64:

•30% 18-34•35% 35-44•31% 45+

• 62.5% urban• diverse ethnocultural identities• 63.8% current users• 26.2% on methadone• 18.8% HIV; 53.5% HCV• 33.7% often or always worried about food• 23.8% homeless or hidden homeless

Treatment & CounsellingTreatment & Counselling

“I can get by just about everything… if I’m low on food, if I need a crack pipe, or condoms or anything, clean clothes… I can find it. The only thing is, is if you want to straighten out or something, there’s a problem there.”

The Canadian National Coalition Pilot Addictions Treatment Model Specifically for Sex Workers

The Canadian National Coalition Pilot Addictions Treatment Model Specifically for Sex Workers

“We wanted to be in a centre that used a harm reduction approach, that didn’t have the ‘You have to have 30 days clean before you can get in; if you’re caught using, you’re kicked out.’… They have the whole continuum on site, they have detox, they have 28 residential beds. They were very open and excited about piloting this model.” -- Lauren Casey, Executive Officer, CNCEW

“We wanted to be in a centre that used a harm reduction approach, that didn’t have the ‘You have to have 30 days clean before you can get in; if you’re caught using, you’re kicked out.’… They have the whole continuum on site, they have detox, they have 28 residential beds. They were very open and excited about piloting this model.” -- Lauren Casey, Executive Officer, CNCEW

Methadone MaintenanceMethadone

Maintenance“I find that with the methadone the only thing that helped me because it put that much time, like three years now between me and the drug. I’m not saying I've been clean the whole time, but 99% of the time I have been clean, and then I had counselling.”

“I wish we had something for crack addicts like they do for people that do the opium, the methadone. I really think there’s a need for that.”

Direction 180 Low Threshold Methadone Maintenance Program

Direction 180 Low Threshold Methadone Maintenance Program

“We’ve got people since day one that will use drugs ‘til the day they die and they don’t want to stop, so by keeping them engaged in the process, we’re keeping them alive,” -- Cindy MacIsaac, Executive Director, Direction 180

“We’ve got people since day one that will use drugs ‘til the day they die and they don’t want to stop, so by keeping them engaged in the process, we’re keeping them alive,” -- Cindy MacIsaac, Executive Director, Direction 180

Peer InvolvementPeer Involvement“And it’s been really beneficial. I’ve done a lot of public speaking in the last year since I really got involved with the user groups and started them off and… it’s really been good for the self-esteem and it’s given me a goal to shoot for. It was the main thing that got me straight, and I think that’s great, and it was that people listen to me now. Yeah, if I can prevent even one kid [from going] through what I did for 30 years, then I am a success, right?”

Needle Distribution

Needle Distribution

“If I had prompt access to free needle exchanges when I was actively using just prior to catching HIV… if I was given the knowledge early on and access to harm reduction strategies, there is a good chance that I would not be HIV positive.”

Point de repères – Community-Based Needle Distribution – “Street Guides”

Point de repères – Community-Based Needle Distribution – “Street Guides”

Mario Gagnon, Executive Director at Point de repères, won the 2008 Kaiser Foundation’s National Award for Excellence in Reducing the Harm Associated with Addiction and Substance Abuse for his work in community programming.

Mario Gagnon, Executive Director at Point de repères, won the 2008 Kaiser Foundation’s National Award for Excellence in Reducing the Harm Associated with Addiction and Substance Abuse for his work in community programming.

Drop-In Centres and Shelters

Drop-In Centres and Shelters

“Socially, for me, having [a place] to hang out with every day… makes me feel part of a family. I don’t have any direct family here… and having the drop-in centres… is really helpful for me. Every day I enjoy waking and look forward to go getting a coffee and talking with my friends at … drop-in centres around town.”

Tommy Sexton CentreTommy Sexton Centre

“We seem to be getting more and more people who inject drugs and… wanting harm reduction because a lot of the other shelters are not able to handle that and support the residents as much when it comes to the harm reduction model. We are fine with it. As you can see, we have our needles, everything is laid out... We just want to make sure that they are safe and that they are doing it safely.” -- Richard Baker, Housing Coordinator, Short Term Shelter

“We seem to be getting more and more people who inject drugs and… wanting harm reduction because a lot of the other shelters are not able to handle that and support the residents as much when it comes to the harm reduction model. We are fine with it. As you can see, we have our needles, everything is laid out... We just want to make sure that they are safe and that they are doing it safely.” -- Richard Baker, Housing Coordinator, Short Term Shelter

Health Professionals & Service Providers

Health Professionals & Service Providers

“And I got a really big sore on my leg. The last time I used, that’s where I used. And like he’s been saying to me, ‘Go to the hospital, go to the hospital.’ But I’d rather take a month for it to heal on its own, or let my leg fall off, than go to a doctor… because they, you know, you go in, they treat you like shit.”

Award Winning Health Professionals in Abitibi-Temiscamingue

Award Winning Health Professionals in Abitibi-Temiscamingue

Danielle Gélinas, Coordinating Nurse - Jill Sullivan Award for Excellence in Clinical Practice by the Canadian Association of Nurses in AIDS Care in 2007 

Danielle Gélinas, Coordinating Nurse - Jill Sullivan Award for Excellence in Clinical Practice by the Canadian Association of Nurses in AIDS Care in 2007 

Clinical Innovation Award - Quebec Order of Nurses:• Danielle Gélinas, Suzanne Fiset and Pauline Clermont in 2006 for the Clinic project and its multidisciplinary approach • Pauline Clermont, Suzanne Boucher-Veilleux and Isabelle Cornet in 2007 for the Pikatemps Program

Clinical Innovation Award - Quebec Order of Nurses:• Danielle Gélinas, Suzanne Fiset and Pauline Clermont in 2006 for the Clinic project and its multidisciplinary approach • Pauline Clermont, Suzanne Boucher-Veilleux and Isabelle Cornet in 2007 for the Pikatemps Program

Information DisseminationInformation

Dissemination“More knowledge of consequences… If I knew back then what I know now, I wouldn’t have suffered like I did half as much, about hep C, about AIDS, about sticking needles in my arm, about leaving scars in my arm.”

Outreach ServicesOutreach Services

“Bring the services to them because a lot of people won't come.”

Female Respondent: “I remember … I was scared to just to walk up to the needle van.”Male Respondent: “There’s a lot of shame.”

No Fixed Address Outreach Van and Safer Crack Use Kit ProgramNo Fixed Address Outreach Van and Safer Crack Use Kit Program

“The safer crack use kit program has overtaken the needle exchange program with 62% of clients accessing the fixed site program at Blood Ties solely for safer crack use kits.” -- Patricia Bacon, Executive Director, Blood Ties Four Directions Centre

“The safer crack use kit program has overtaken the needle exchange program with 62% of clients accessing the fixed site program at Blood Ties solely for safer crack use kits.” -- Patricia Bacon, Executive Director, Blood Ties Four Directions Centre

Challenges and Lessons LearnedChallenges and Lessons Learned

Contact Us:Contact Us:

Walter CavalieriThe Canadian Harm Reduction NetworkEmail: Telephone: +1.416.928.0279Toll Free: +1.800.728.1293www.canadianharmreduction.com/project

Walter CavalieriThe Canadian Harm Reduction NetworkEmail: Telephone: +1.416.928.0279Toll Free: +1.800.728.1293www.canadianharmreduction.com/project

Lynne Belle-IsleCanadian AIDS SocietyEmail: lynneb@cdnaids.ca Telephone: +1.613.230.3580 ext 126Toll Free: +1.800.499.1986www.cdnaids.ca/learning_from_each_other

Lynne Belle-IsleCanadian AIDS SocietyEmail: lynneb@cdnaids.ca Telephone: +1.613.230.3580 ext 126Toll Free: +1.800.499.1986www.cdnaids.ca/learning_from_each_other

AcknowledgementsAcknowledgements

• Members of the National Advisory Committee Patricia Bacon, Blood Ties Four Directions Centre, Whitehorse, YT Mario Gagnon, Point de repères, Québec, QC Cindy MacIsaac, Direction 180, Halifax, NS Gillian Maxwell, Keeping the Door Open: Dialogues on Drug Use,

Vancouver, BC Marjorie McNeill, Play It Safer Network, Flin Flon, MB Chantale Perron, Liaison Officer, Méta d’Ame, Montréal, QC Ryta Peschka, Oasis, Ottawa, ON Carol Romanow, Society Of Living Intravenous Drug Users (SOLID),

Victoria, BC Christopher Smith, Toronto, ON Marliss Taylor, Streetworks, Edmonton, AB

• Focus Group participants, everyone who helped with the site visits, walkabouts and written material, and the contractors.

• Members of the National Advisory Committee Patricia Bacon, Blood Ties Four Directions Centre, Whitehorse, YT Mario Gagnon, Point de repères, Québec, QC Cindy MacIsaac, Direction 180, Halifax, NS Gillian Maxwell, Keeping the Door Open: Dialogues on Drug Use,

Vancouver, BC Marjorie McNeill, Play It Safer Network, Flin Flon, MB Chantale Perron, Liaison Officer, Méta d’Ame, Montréal, QC Ryta Peschka, Oasis, Ottawa, ON Carol Romanow, Society Of Living Intravenous Drug Users (SOLID),

Victoria, BC Christopher Smith, Toronto, ON Marliss Taylor, Streetworks, Edmonton, AB

• Focus Group participants, everyone who helped with the site visits, walkabouts and written material, and the contractors.

Thanks to our FundersThanks to our Funders

This project has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

Support for the work of a photojournalist in association with this project was provided by the Ontario HIV Treatment Network and an anonymous donor.

This project has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

Support for the work of a photojournalist in association with this project was provided by the Ontario HIV Treatment Network and an anonymous donor.