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.winnipeghealthregion.ca/careers/.
If you are interested in volunteering, contact WRHA Volunteer Services at 204−787−5078 or 204−787−7247 or email [email protected]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.
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 (204−981−0742) 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/covid19. 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 204−981−0742 and we can tell you where to get supplies close to where you are. Or check out our online map 24 hours a day.