Nicola is the Substance Use & Harm Reduction Support Worker at Homes First. Harm reduction can be described as the strategies, ideas and approach to reduce the harm of substance use and unprotected sexual activity. Nicola manages the supply of harm reduction equipment to Homes First sites, which is provided by Toronto Public Health to allow people to use substances in a safer way or in a way that is more optimal for their health.
The other part of Nicola’s role involves direct programming with many residents at Homes First. She currently facilitates two harm reduction programs at two Homes First’s housing sites. One program provides addictions and life-skills counseling. With the program funded by Scarborough Addiction Services, Homes First can support residents with a life skills worker who provides one-on-one counselling. The program also helps facilitate a peer group, which supports self-care and building the capacity to respond to counselling treatment.
The second program focuses on building peer-to-peer support systems, made possible through funding from Toronto Urban Health Fund (TUHF). Homes First has been able to provide ongoing harm reduction training to 8 residents who act as the program’s peer supports. These peers run harm reduction workshops for other residents in the hotel, as well as providing one-on-one support for harm reduction and substance use for residents.
“Since joining the peer group, you know, you kinda have something to wake up to and it gives you a little bit of something to look forward to, and its really… its helped me a lot.” Said one of our residents.
Generally something seen in harm reduction initiatives across the world, peer-to-peer support puts emphasis on lived experience and working directly with others living that same experience. The intention behind peer programs is to allow people to connect with someone who they can relate to on a deeper level. This is particularly important, as people who use substances face stigma from society when seeking services for their substance use.
People who use substances struggle with the stigma around substance use in every possible way. It shapes the way that they understand themselves and what they have experienced. It often manifests as shame which is reflected in their relationships with family. Some people who use spend a lot of time feeling like they are failures, and that is a barrier to the person’s healing. It is difficult to persevere through healing when you don’t feel like it’s worth it because you’re not worth it.
Portugal is a great example of a country that has been proactive about harm reduction. In 1999 Portugal approved a national strategy that lead to decriminalization of all substances. “It made much more sense for us to treat drug addicts as patients who need help, not as criminals” said Goulao, an advisor for Portugal on the 1999 panel.
By eliminating the threat of criminalization, a great deal of stigma was also eliminated. The number of people seeking treatment increased by more than 60% in 10 years. The country has seen a decrease in the social cost of substance misuse, a dramatic decrease in the number of people in prison for drug law violations, and police have been able to focus on crime surrounding trafficking. All of this has freed up resources, allowing the government to invest in treatment and harm reduction practices.
According to Nicola, the most important thing to communicate is that people struggling with addictions are significant. We are still just scraping the surface of understanding these programs, what they do and how they work.