frequently asked questions

What do you mean by harm reduction?

The Inter­na­tion­al Harm Reduc­tion Asso­ci­a­tion defines harm reduc­tion as poli­cies, pro­grammes and prac­tices that aim to reduce the adverse health, social and eco­nom­ic con­se­quences of the use of legal and ille­gal psy­choac­tive drugs with­out nec­es­sar­i­ly reduc­ing drug con­sump­tion.” This means that we help peo­ple who use drugs to become as safe and healthy as pos­si­ble, with­out insist­ing that they quit in order to access impor­tant services.

Harm reduc­tion is neu­tral and does not judge whether behav­iour is right’ or wrong.’ We know that peo­ple who use drugs can devel­op abscess­es or catch an infec­tion by shar­ing used nee­dles and syringes. Harm reduc­tion dis­tri­b­u­tion pro­grams are a cen­tral form of harm reduc­tion. We try to pro­vide the tools peo­ple need to help keep them­selves safer. This helps keep us all safer too.

This approach is endorsed by major med­ical and legal organizations:

  • World Health Orga­ni­za­tion (WHO)
  • Unit­ed States Insti­tute of Medicine
  • Glob­al Fund World Bank
  • Inter­na­tion­al Fed­er­a­tion of Red Cross and Red Cres­cent Societies
  • UN Spe­cial Rap­por­teur on the Right to Health

In addi­tion, 84 coun­tries sup­port harm reduc­tion in pol­i­cy or prac­tice. 77 coun­tries have nee­dle dis­tri­b­u­tion programs.

How does this kind of work make pub­lic health sense?

Here in Win­nipeg, researchers found that peo­ple who use drugs were almost 4 times more like­ly to share their nee­dles if they didn’t have a source of sterile/​unused ones. This trans­lates not only to more used nee­dles on the street, but also to increas­ing rates of HIV and hepati­tis in the community.

We rec­og­nize that it is a lot eas­i­er to take a lot of tiny steps rather than one or two huge steps (like quit­ting drugs on the spot). We talk with our clients about unsafe prac­tices and ways of stay­ing safe, and we can col­lect used nee­dles, so they do not end up on the street. Then, when and if a per­son needs sup­port (like addic­tions treat­ment, etc.), they have some­one they can talk to. In this way, harm reduc­tion ser­vices make it eas­i­er for peo­ple who use drugs to re-engage in soci­ety instead of catch­ing an infec­tion or suc­cumb­ing to a drug overdose.

An inter­na­tion­al study showed that 29 cities around the world with harm reduc­tion pro­grams showed a decrease in HIV rates by 5.8% per year. At the same time, rates increased on aver­age by 5.9% per year in 51 cities with­out a harm reduc­tion pro­gram. As recent­ly as April 2015, bans on nee­dle-dis­tri­b­u­tion in the Unit­ed States have been linked to an out­break of HIV. Harm reduc­tion pro­grams are high impact and ben­e­fit the entire com­mu­ni­ty for lit­tle investment.

Does this encour­age or enable more drug use?

No, it doesn’t. The goal of harm reduc­tion pro­grams is to help peo­ple who use drugs stay health­i­er (and alive) and reduce their expo­sure to harms. Sci­en­tif­ic stud­ies have shown that harm reduc­tion pro­grams do not increase or even main­tain drug use. Instead, the pro­grams ben­e­fit those peo­ple who don’t want to quit, are not ready to quit, or have relapsed. For instance, a 2018 mod­el­ling study sug­gests that an ear­li­er pub­lic health response includ­ing time­ly imple­men­ta­tion of a nee­dle dis­tri­b­u­tion pro­gram might have pre­vent­ed the 2014 – 2015 HIV out­break in Scott Coun­ty, Indi­ana. As this blog post points out, harm reduc­tion does enable’ peo­ple to pro­tect them­selves and their com­mu­ni­ties from HIV, hepati­tis, and overdose.

How does this approach affect crime?

In places where harm reduc­tion pro­grams exist, cer­tain crimes, such as break-ins, bur­glar­ies, and vio­lent crimes, actu­al­ly saw a slight decrease. This is because we focus only on keep­ing users safe, while exist­ing drug traf­fick­ing and deal­ing laws con­tin­ue to be enforced. Oth­er stud­ies found no con­sis­tent asso­ci­a­tion between liv­ing close to harm reduc­tion sup­ply dis­tri­b­u­tion pro­grams and vio­lence. A study sug­gest­ed that these pro­grams do not adverse­ly affect rates of vio­lence around them. 

How­ev­er, stud­ies have found that enforce­ment cam­paigns in the prox­im­i­ty of harm reduc­tion sup­ply dis­tri­b­u­tion pro­grams result­ed in few­er nee­dles reach­ing peo­ple who use drugs, dis­cour­age­ment of safer inject­ing prac­tice, and increased inci­dence of vio­lence.

How much does this pro­gram cost?

A harm reduc­tion pro­gram costs lit­tle com­pared to its sav­ings. A 2015 review found that harm reduc­tion ser­vices can be cost-effec­tive by most thresh­olds in the short-term and cost-sav­ing in the long-term.” A sin­gle nee­dle costs about 10 cents, much less than treat­ing the infec­tions it can pre­vent. Con­ser­v­a­tive esti­mates place the ratio of sav­ings-to-costs at about 4:1. Australia’s gov­ern­ment esti­mat­ed that their harm reduc­tion pro­grams had pre­vent­ed approx­i­mate­ly 21,000 hepati­tis C infec­tions and 25,000 HIV infec­tions after about a decade of oper­a­tion, sav­ing about $7.8 bil­lion. That’s a sig­nif­i­cant sav­ings to tax­pay­ers due to pre­ventable health care expenses.

Who runs Street Connections?

We are part of Healthy Sex­u­al­i­ty and Harm Reduc­tion, in the Win­nipeg Region­al Health Authority’s (WRHA) Pop­u­la­tion and Pub­lic Health Pro­gram. Street Con­nec­tions has been part of the WRHA since 2001. Before that, it was affil­i­at­ed with oth­er Win­nipeg agencies.

How can I start work­ing or vol­un­teer­ing with Street Connections?

All hired posi­tions are post­ed on the WRHA careers web­site: http://​www​.win​nipeghealthre​gion​.ca/​c​a​r​eers/.

If you are inter­est­ed in vol­un­teer­ing, con­tact WRHA Vol­un­teer Ser­vices at 2047875078 or 2047877247 or email volunteer@​wrha.​mb.​ca.

Does this kind of pro­gram increase dirty” nee­dles in our community?

No. Harm reduc­tion pro­grams often recov­er as many nee­dles as they dis­trib­ute, which means few­er used nee­dles dis­card­ed in the com­mu­ni­ty.

Clos­ing down nee­dle dis­tri­b­u­tion pro­grams has been asso­ci­at­ed with out­breaks of HIV, yet no effect on drug use rates of dis­card­ed needles .

If you do find a used nee­dle, we can help. For more infor­ma­tion, check out [What to do when you find a nee­dle?]

I’m try­ing to locate some­one. Can you tell me if you’ve seen them?

No. We do not share infor­ma­tion about who we pro­vide ser­vices to. All ser­vices are con­fi­den­tial. We can get a mes­sage from you and put their name in the mes­sage sec­tion of our newslet­ter for up to three weeks. If they come to us, we can give them the mes­sage from you.

When I called Street Con­nec­tions, there was no answer.

The sched­ule is a guide to tell you where you can find us.

You can find the sched­ule here.

Some­times we are not able to fol­low the sched­ule exact­ly. For a num­ber of rea­sons, we may be late, miss a stop, or have to shut down early.

If you need to see us dur­ing the evening, make sure to call before 9:00 pm.

Can you bring me a crack or bub­ble kit to my home?

We do not do home vis­its for safer crack use or bub­ble kits. You can pick one up from the Street Con­nec­tions office, by flag­ging down our van, or by meet­ing us at one of our van stops. You can also vis­it one of our part­ner agen­cies. If you’re not sure where to go, you can call us dur­ing the day (2049810742) or check out our map any­time.

Do you give out food or bus tickets?

We do not give out bus tick­ets. Click on the Ser­vices’ link at the top of the page to see what we provide.

Do I have to give my name when I get sup­plies or a Sex­u­al­ly Trans­mit­ted Infec­tion test?

Sup­plies are giv­en out anony­mous­ly. You do not need to give your name. If you want test­ing, we need your name to put on the sheet that goes to the lab. Your health infor­ma­tion is con­fi­den­tial and pro­tect­ed by the Per­son­al Health Infor­ma­tion Act.

Where can you find infor­ma­tion on COVID and Harm Reduction?

You can find infor­ma­tion by vis­it­ing https://​mhrn​.ca/​c​o​vid19. This page of includes Man­i­to­ba-spe­cif­ic and oth­er rel­e­vant resources regard­ing COVID-19.

I need sup­plies dur­ing the day. Where Can I get them?

Dur­ing the day, call Street Con­nec­tions at 2049810742 and we can tell you where to get sup­plies close to where you are. Or check out our online map 24 hours a day.