Healthy relationships through harm reduction

The importance of healthy, trusting relationships

I grew up in the North, and I feel blessed to be able to live and practice in my hometown of Quesnel. Guiding my work, I have two strong influences from my childhood: Medicine and ranching. On my mother’s side I come from several generations of nurses and doctors; my father’s family were pioneers and moved to this community 100 years ago.

Growing up as a ranch kid helped me to develop a strong belief that all living things have value and worth. This has helped me to recognize that our own advancement and success is based on how we honour relationships in our lives, and for me growing up, these were family and cattle.

When I was asked to write an article about my work in harm reduction and how it relates to healthy relationships, I had to sit with it for several days. Before my current role, I worked as a generalist public health nurse for 13 years, and part of my role was as the local street nurse, but for some reason, in my mind, I couldn’t get the two to connect. The more I thought about it though, the more I began to realize the reason for my difficulty was that these two concepts are inseparable. From my experience, it would be extremely difficult to apply the principles of harm reduction within health care without considering the importance of healthy, trusting relationships.

Harm reduction involving drugs and people who use drugs is a social justice movement that strives to uphold basic human rights. It means believing in, respecting, and supporting people who use drugs, whether abstinence is their goal or not. This kind of harm reduction is supported by evidence based research, and proven to be effective in reducing risks and ultimately reducing the burden on the health care system.

A good example of this method of harm reduction is the distribution of harm reduction supplies to people who use drugs. Providing clean, sterile equipment has also shown to reduce new infections of HIV and Hepatitis C within our communities.

Healthy relationships

Another benefit of distributing harm reduction supplies to clients, is the opportunity for service providers to develop meaningful relationships with the client; these relationships can ultimately lead to greater access to health care. We know that when people engage in services where they feel supported and accepted by staff, they are more likely to make positive changes and further access supports.

Relationship building is at the core of harm reduction work. When you show up for people and allow them to be seen and heard, they feel valued and worthy. This is so important within a demographic of individuals who often feel marginalized and ostracized in our communities.

This is a mutually beneficial relationship, as we, the service provider, can ask clients questions in order to gain a greater understanding of the barriers and challenges they face, and better understand the world they live in. This connection allows staff to hear real, lived experiences that can ultimately help them implement change.

The caring bonds and healthy connections created through harm reduction is lifesaving for clients. Over the past few years, the landscape of working with people who use drugs has changed drastically. In the past, we worried about keeping people safe, preventing HIV transmission, and other harms related to drug use; now, we’re worrying about keeping people alive.

In order for clients to engage in our services, receive education on how to safely use drugs, take harm reduction steps towards wellness, and to enter into treatment (if that is what they choose), they must be with us. It is well known that the number of people dying across the province due to unintentional illicit drug overdoses has continued to rise in 2017, despite exceptional work on the frontlines.

Reducing stigma and judgment

In today’s society, it’s important to use a thoughtful approach and be compassionate with our messaging. Stigma and judgment towards people who use drugs creates a climate where people do not feel safe to share experiences, and in turn, forces them to isolate themselves. Working closely with harm reduction has shown me how vast and diverse this population is in our communities.

Reducing stigma and judgment in our communities takes a collaborative approach. Northern Health has championed anti-stigma work in BC as a part of our overdose prevention strategy. You can make a difference by changing the conversation:

• Describe peers as individuals (i.e. “person with a substance use disorder” vs “drug user”).
• Decide not to share or engage in fear-based messaging about overdoses and drug use on social media.
• Be mindful of how you talk about people who use drugs; choose not to use discriminating language like “user,” “junkie,” or “addict.”

These small steps can work to help eliminate the feelings of isolation and judgment.

Harm reduction in the context of substance use is about advocacy and caring. It is understanding that people use drugs for a variety of reasons, and many will never become dependent or deal with an addiction. Above all, harm reduction services exist to support everyone in staying as safe and healthy as possible – and that’s what we’re all after: staying safe, healthy, and happy. Together.