1. November 2011 Presenters:Lori Kerr and Patti Bell

2. Harm Reduction Coalition in York Region Terms of ReferenceDefinition of Harm ReductionBasic principles of Harm ReductionMandateMembershipGoals/Objectives Harm Reduction in York Region- November 2011

3. Why Harm Reduction? If you say that I cant come to your program because I am using, then youre telling me that I dont deserve to heal. Until Im clean, I am not good enough. Harm Reduction in York Region- November 2011

4. MembershipHarm Reduction in York Region- November 2011

5. Examples of Harm Reduction Activities in York Region Harm Reduction in York Region- November 2011

6. Harm Reduction InitiativesStreet OutreachEducation, achievable optionsSupplying condomsModerate/Controlled using strategiesNeedle Exchange & Safe Disposal (Sharps)Safer Inhalation ProgramsTolerance zones (e.g., Supervised InjectionSites)Methadone Maintenance ProgramsPrescription of heroin and other drugsWet shelters, Dry shelters, managedAlcohol Programs (MAP)User groups, peer supportCounselling & Referral Harm Reduction in York Region- November 2011

7. Why Here? Canadian Human Rights Act (June18, 2008)For all purposes of this Act, the prohibited grounds of discrimination are race, national or ethnic origin,colour, religion, age, sex, sexual orientation, marital status, family status, any previous or existing mental or physical disability and includesdisfigurement and previous orexisting dependence on alcohol or a drug, and conviction for which a pardon has been granted. Harm Reduction in York Region- November 2011

8. Street Outreach In 2010 the van was approached on 916 occasions by persons withpotential addiction or usage issues. Some of the more common substances used include oxycontin,marijuana, alcohol, crack cocaine, etc. Of the 916 contacts, 390 accessed the needle exchange program. Almost 24,000 clean needles were given out and 192 bio bins. Just over 8,000 needles were turned in for safe disposal. Harm Reduction in York Region- November 2011

9. Street Outreach Safer sex Food and Shelter and Referralsinformation Health care Counselling clothing sleeping and (condoms information & support distribution bags linkages available) Harm Reduction in York Region- November 2011

10. York Region Alliance to End HomelessnessHealth Care Supports not Currently Available to Homeless and At-Risk People in York RegionGaps in Existing Health Care Support Specific Needs IdentifiedShelter Needs Wet Shelter Year-round Inn from the Cold (emergency shelter) Supportive housingHealth Centres Community Health Centres beyond VaughanSafe Spaces or Supplies More unscheduled drop-in centres (like Krasman Centre) Safer use crack kitsTreatment Needs Residential withdrawal management/ detox Street health care services Mobile foot care Pediatric care Dental care Specialists- reduced waitlists More nurse practitionersQuality of Care Assurance of confidential care and consultations Ethno-cultural support (especially in the north) Harm Reduction in York Region- November 2011

11. Needle Exchange ProgramWhat is a Needle Exchange Program (NEP)?All Health units in Ontario have needle exchange programsProject YES York Exchange ServicesServices: Needle distribution/safe disposal of used needles Injection supplies Information on safer injection Referrals Condoms & lubeAll Services are Free and Confidential Harm Reduction in York Region- November 2011

12. Needle Exchange Program Locations Mobile site in partnership with Loft/Crosslinks StreetOutreach van Fixed sites: Rutherford Guardian pharmacy Newmarket Sexual Health Clinic Richmond Hill Sexual Health Clinic Markham Sexual Health Clinic Vaughan Sexual Health Clinic 1-905-955-2471 1-866-553-4053 Harm Reduction in York Region- November 2011

13. Current Needle Exchange Program York Region Locations Harm Reduction in York Region- November 2011

14. Future Needle Exchange Program York Region Locations ?? Harm Reduction in York Region- November 2011

15. Blue Door Shelters Board training on Harm Reduction Board supported and approved formal policy Management completed York University Harm Reduction Certificate Staff received mandatory trainingInternal Harm Reduction Committee to assist with policy implementation and continuing education Acknowledgement and education in Blue Door Shelters intake process Estimate over 50% of residents use substances to cope On-site sharps disposal containers Developed and distribute Harm Reduction pamphlet for all clients Harm Reduction in York Region- November 2011

16. Data from Ontario Harm Reduction Distribution Program First wave data is from 2007 Surveyed approximately 70 injection drug users Compared York Region to Ontario Final report: Ontario Harm Reduction Distribution Program Final Outcome Evaluation April 2009 http://www.ohrdp.ca/wp- content/uploads/pdf/OHRDP.Prov.Rpt_LLeonard.pdf Note: statistics from the final study are not included in this presentation since the data is not isolated to York Region. Harm Reduction in York Region- November 2011

17. Injection Drug Use In the 6 months before the survey... 40 36 35 30 25 19Percentage 20 17 13 Ontario 15 York Region 10 5 0 Injected daily Injected with a shared needle Harm Reduction in York Region- November 2011

18. Some first wave results: Ontario/York Region Commonly used injected drugs... 44 Crack 43 23 Morphine 53 York Region 41 OntarioOxycodone 53 77 Cocaine 71 Percentage Harm Reduction in York Region- November 2011

19. Some first wave results: Ontario/York Region Disposal of used equipment... 80 80 70 60 50 37 40 OntarioPercentage 30 26 York Region 20 13 10 6 5 0 Needle Exchange bottle/can Loose Plastic Harm Reduction in York Region- November 2011

20. Some first wave results: Ontario/York Region 100 80 78 90 80 70 60 50Percentage Ontario 40 30 York Region 20 10 0 Shared drug smoking equipment Harm Reduction in York Region- November 2011

21. Some first wave results: Ontario/York Region Commonly used non-injected drugs... Crystal 9 Meth 15 Cocaine 75 58 78 York Crack Region 66 Alcohol 78 70Marijuana 82 74 Percentage Harm Reduction in York Region- November 2011

22. Data from the Shout Clinic Harm Reduction Report, Toronto, 2010 Conducted by: Funded by:Shout Clinic delivers The Wellesley Institute advances urbanprimary, interdisciplinary care to youth health through rigorousages 16 to 24 years through a trauma research, pragmatic policyinformed and harm reduction solutions, social innovation, andphilosophy. community action. Harm Reduction in York Region- November 2011

23. Dependency and Addiction Issues 47% of respondents were (in the past 6 months) unsuccessfulin trying to cut down or quit their drug of choice; 37% werenot interested50% of respondents used drugs to avoid withdrawal symptomLow use of drug treatment services Harm Reduction in York Region- November 2011

24. Barriers Youth experienced a wide range of barriers to accessingservices and supports and practicing harm reduction, such as: Policy Structural Attitudinal Knowledge Complex & Multi-dimensional Harm Reduction in York Region- November 2011

25. Recommendations - Harm Reduction, Public Health ProfessionalsYouth emphasized the importance of 90% of survey respondents think thatprotecting youth with accessible, and harm reduction is an appropriate andappropriate harm reduction services useful approach to substance use and approaches, rather than issues. punishing them for their drug use. Harm Reduction in York Region- November 2011

26. Recommendations - HarmReduction, Public Health Professionals1. Deliver services where and when youth need them2. Spread the word better advertisement of services3. Provide supplies that youth need and will use4. Relevant program options that are appealing to youth5. Provide greater access to educational materials and resources6. A safe place to use safe injection and consumption sites Harm Reduction in York Region- November 2011

27. Recommendations for Addiction and Harm Reduction Professionals Increase options(for treatment and youth specific programs)Easier accessPeer-workers and people with lived experience Harm Reduction in York Region- November 2011

28. Recommendations for Police Bring police on board Training for police Policy reform Develop a harm reduction unit as part of TPS Effective complaint process and greater policeaccountability Harm Reduction in York Region- November 2011

29. Recommendations for Mental Health Professionals Tackle social stigma and promote mental health services More responsive services Program options Positive relationships Harm Reduction in York Region- November 2011

30. Harm Reduction in York Region- November 2011

31. Why Harm Reduction? By promoting Harm Reduction we will have safer and healthier communities as a result of our combined effortsHarm Reduction Coalition of York Region Website: http://hrcyr.posterous.com Harm Reduction in York Region- November 2011

32. The Future for York Region Expansion of needle Safer disposal of used Education! Education! exchange sites in York equipment/sharps Education! Region containers Harm Reduction Making our dreams a Policy and procedure Coalition of York reality, having development for Region expanding everybody meeting organizations membership and people where theyre activities at Harm Reduction in York Region- November 2011

33. Harm Reduction in York Region- November 2011