Harm Reduction and Substance Use in Healthcare

Harm Reduction & Substance Use

• Harm reduction is a public health approach focused on preventing the harms of substance use, not reducing substance use itself.
• It's a philosophy and a set of programs and services.
• Substance use is viewed as a health issue.
• The approach is evidence-based.

Class Objectives

• Discuss the application of harm reduction principles in nursing practice.
• Explore how personal attitudes and beliefs influence nursing practice when caring for people who use substances or have addiction.
• Understand the legal, social, and ethical issues surrounding substance use and their impact on nursing practice.

Equity-Oriented Health Care

• Key dimensions of equity-oriented healthcare: trauma and violence-informed care, harm reduction, and cultural safety/anti-racism.
• Tailoring care and programs to local contexts, actively countering racism and discrimination, actively seeking input from community partners, tailoring care for inter-related violence forms, enhancing social determinants of health, optimizing use of place and space are part of 10 strategies to enhance ability for equity-oriented services.

Story Time

• No specific content.

Stigma and Substance Use

• Stigma and substance use can negatively affect healthcare outcomes.

Stigma Pathways to Health Outcomes Model

• Drivers of stigma include stereotypes, fear of contagion, historical norms, unequal power dynamics, and lack of awareness.
• Types of stigma exist for racialized identities, sexual orientations, gender identities, and age.
• Stigma practices include discriminatory policies, harmful stereotypes and behaviours, and social exclusion.
• Stigma experiences include enacted stigma, internalization of negative stereotypes, and anticipated stigma.
• Outcomes for affected populations include reduced access to care, reliance on coping strategies that can be harmful, risk of violence and injury, and poorer mental and physical health.
• Addressing stigma at the individual, interpersonal, systemic, and institutional levels impacts outcomes.

Continuum of Cultural Safety

• Stages of cultural safety include trauma-informed care, anti-racism, cultural sensitivity, cultural competence, and cultural humility.
• Recognizing historical traumas, avoiding perpetuation of historical power imbalances, reducing power differences, respecting diverse needs, and considering social, political, and historical contexts are part of it.

Opioid Crisis (2023 Jan-Mar)

• 1,904 total apparent opioid toxicity deaths in Canada Jan-Mar 2023.
• Rates vary significantly by province and territory in 2023.
• Data indicates an average rate of 21 deaths per day.

Characteristics of Fentanyl-Related Deaths

• Deaths involving fentanyl doubled between the start of 2016 and 2017.
• Men account for a higher percentage of apparent opioid-related deaths.
• Deaths among individuals aged 30-39 show variations across Canadian provinces and territories.

Harm Reduction - Defined

• Harm reduction aims to minimize negative health, social, and legal impacts of drug use.
• It's grounded in justice and human rights.
• It does not require people to stop using substances as a condition of receiving services.

Principles of Harm Reduction

• Harm reduction is a set of practical strategies that aim to reduce negative consequences of drug use.
• It's a social justice movement rooted in respect for the rights of people who use drugs.
• Harm reduction can include safer use, managed use, abstinence, and addressing conditions of use.
• Harm reduction does not have a one-size-fits-all formula.
• Principles include immediacy of needs, focus on health and rights of substance users, challenging discriminatory policies, promoting human rights, public health approach, and adaptive strategies.

Advocacy

• Advocacy is supporting or recommending a cause or course of action to improve systems and societal structures for greater equity and health.
• Nurses can advocate for eliminating social inequities, individually and collectively.

Decriminalization of Personal Use of Psychoactive Substances

• Decriminalization of personal use of psychoactive substances can reduce barriers to healthcare.

Changing the Script - Young Nurses Voices

• A discussion on the changing landscape of harm reduction policies.
• Provides links to news and YouTube videos for further context.

Workshop Content

• Bevel Up is a movement or organization.

Additional Harm Reduction Resources

• List provides links to various organizations and resources related to harm reduction.
• The links offer further information on principles, details, and resources.

Research with Communities - DTES

• Research that includes communities, addressing issues involving substance use, and providing ethical considerations.

Building on Indigenous Advocacy

• Emphasizing crucial role of Indigenous communities in driving change in harm reduction.

Pitfalls and Potentials of Research in DTES

• Risks in research include perpetuating stigma, undermining community initiatives, triggering traumas, misrepresenting individuals and communities, and creating unnecessary barriers.
• Potential positive outcomes can include initiating positive change, educating and empowering communities, highlighting complex issues, advocating for community resources, and creating new sources of income and skills for individuals.

What We Expect From Researchers

• Researchers are expected to clearly communicate, practice ethical review with community members and institutions, involve community members.
• Conduct research and provide reciprocity through shared knowledge, and collaborate for a positive impact.

Taking Care of Each Other: Indigenizing Harm Reduction

• Discussion focused on support and partnership, especially related to indigenous approaches to harm reduction and research.

Additional Resources

• A collection of links to various websites about harm reduction, including training, resources, and organizations.

Explore the critical concepts of harm reduction and its relevance in public health, particularly regarding substance use and the opioid crisis. This quiz discusses the impact of stigma on healthcare access and ethical concerns in nursing practice related to substance abuse. Test your knowledge about current statistics, principles, and equity-oriented healthcare strategies.