By: Melanie Davis

             Safe Injection Sites face a lot of uncertainty as power changes hands, and public perception on the opioid crisis changes. One factor that remains is that these sites save lives. There is a substantial body of literature that focuses on the successes of these services: their cost-effectiveness, overdose prevention, and declining crime rates are a few measures that have been frequently recognized in studies.  The research has clearly reinforced that this method of harm reduction has significant benefits for people who use drugs and the community’s they reside in – but where can we seek out room for improvement?

            Through providing harm reduction services, individuals show a commitment to folks’ safety and security, regardless of any habits or life choices they exercise. This is a powerful method to empower folks, but revisiting the structure of services can be helpful to ensure they are connecting to their community to the best of their ability. Upon opening its doors in 2003, Insite was the first Safe Injection Site in Canada, located in the Downtown East Side of Vancouver (DTES). The experimental approach, with data collection and research focused on testing the outcomes of the service, was needed to justify the success of these harm reduction measures. As the opioid crisis continues to take the lives of our community members, it is imperative that we revisit the structure of harm reduction services to ensure they are inclusive, accessible, and empowering.

            To ensure these values are reflected in harm reduction services across the nation, it must be recognized that engaging people who use drugs in the policymaking process ought to be at the core of decisions moving forward. Harm reduction services are in place to protect, and those with lived experience are the most qualified to present any dangers or disadvantages they have faced while accessing harm reduction services. One example could be the limitations that rules on folks injecting themselves with drugs, can limit who can access these services. People who experience different physical abilities may be restricted if they rely on others to assist them when using drugs. This is one of many instances where fostering meaningful dialogue between policymakers and people who use drugs can result in harm reduction services that are accessible for all.

            One example to look to when developing peer engagement strategies is the British Columbia Harm Reduction Services & Strategies; peer engagement has led to the development of specialized training sessions, the BC Take Home Naloxone program, and an annual harm reduction client survey. Not only has peer engagement led to the development of life-saving harm reduction strategies, but they have created a set of best practices to promote and encourage peer involvement in harm reduction policy. This demonstrates meaningful effort to give folks who use drugs a seat at the table, while ensuring they feel safe, recognized, and valued through the process. Best practices may look different based on the needs of people in varying communities, but it is imperative that policymakers and front-line workers alike are working towards the same goal – providing services to save lives.

            Safe Injection Sites receive most of the attention when discussing harm reduction initiatives, but there are many alternative options worth considering or implementing. Mobile needle exchange services, wound care clinics, and outreach services all have unique benefits and constraints. How these services impact their community all depends on the needs of folks within in it, their success is hinged on the incorporation of peer engagement through their development. Engaging with peers will ensure all facets of the target group are considered, and services are tailored to the unique needs of each community. Each person experiences drug use differently, resulting in communities having unique needs when accessing harm reduction services. Engaging with people who have lived experience can increase rates of access and empowerment within the community, as people who use drugs will feel that their experiences are being heard.

Melanie Davis.
BA(H) Political Science & Labour Studies

MA Candidate, Political Science

University of Guelph