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What is harm reduction?

Drug addiction is a major social issue that can sometimes have dramatic health consequences for users of psychoactive substances (PAS). A variety of tactics can be used in tackling addiction. Between punishment and treatment, the justice system and the health system: what is harm reduction and what are its goals?

Drugs: a criminal matter?

Many drugs are illegal in Canada. This means that it is prohibited to produce, import or export, traffic or even possess them. These drugs include:

A person found in possession of illegal drugs (note: some of them can be legally produced and marketed in certain forms like opioids, amphetamines or ketamine) can be charged with a criminal offence and convicted, regardless of whether the drugs are for trafficking or personal use. However, criminalizing drug possession does not prevent addicts from obtaining and using illicit drugs, often with disastrous health consequences.

Using in spite of prohibition

Because drugs are criminalized, addicts have no choice but to use them in secret, with all the risks that this entails for the health of users and the general public:

  • The use of uncontrolled substances, often mixed with other highly toxic substances
  • The use and sharing of unsterilized equipment (syringes, pipes, etc.), which leads to the transmission of infectious diseases
  • A lack of preventive and educational measures to raise public awareness of the dangers associated with drug use
  • Poor medical care for people with addictions
  • Associated criminal behaviour (e.g., stealing property and money to buy drugs)

In light of these issues, alternatives to punishment have been slowly developed around the world. Harm reduction was first attempted in Europe, in the 1980s.

Harm reduction in Canada

What is a harm?

A harm is “a negative, hurtful activity.” It is also “the harmful result of something.” The harms associated with drug use refer to the harmful consequences of this use for individuals who use drugs, for their loved ones and for society as a whole.

Harm reduction is a pragmatic and compassionate approach based on a simple reality: drug addiction persists in society despite the criminalization of drug use and possession. Society can choose to regulate consumption with health measures, or try to control it through legislation, leading to imprisonment.

Criminalization and punishment alone do not address the public health issue of drug use: since drug possession is a crime, users are treated as criminals. They are forced to either hide or face legal consequences.

As the name implies, harm reduction is about reducing the harmful effects of drug use. It is different from the exclusively punitive approach of trying to eliminate consumption by banning substances.

This approach is used throughout Canada, including in Quebec. In concrete terms, it consists of:

  • Helping people with addictions to manage their drug use
  • Providing sterilized and single-use equipment
  • Providing psychosocial support to help people who want to overcome addiction and reintegrate into society
  • Informing, educating and communicating effectively about safe drug use
  • Providing substitution treatment, particularly for opioid addiction
  • Referring people to other medical or social resources

Supervised Injection Services (SIS)

Supervised injection services are places where people with addictions can inject their own drugs using safe equipment under the supervision of qualified professionals, such as nurses.

In addition to supervised injection, SISs can provide access to other care such as screenings for sexually transmitted infections, immunization, contraception, and information and education.

To find an SIS, go to

Harm reduction helps reduce the mortality risks associated with overdoses. It also provides effective support to people living with addictions to help them maintain their health and control their use.

Note: harm reduction cannot prevent all risks associated with substance use, including health issues and potential legal consequences, since possession of these substances remains illegal in Canada.

Sources : Institut national de la santé publique du Québec (INSPQ) / Government of Canada / Association des intervenants en dépendance du Québec (AIDQ) / Association québécoise des centres d’intervention en dépendance (AQCID) / CIUSSS Centre-Sud / Cliquez Justice

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