A comparative analysis of provincial/territorial harm reduction policy: Implications for expanding access to health services for people who use illicit drugs

Harm reduction is an approach to illicit substance use that focuses on providing health services to people who use drugs without necessarily requiring abstinence. Harm reduction services developed during the 1980s in the form of syringe exchange programs but since then, a number of other services such as supervised injection facilities and overdose prevention programs have been developed and evaluated. Scientific evidence indicates that harm reduction services prevent the spread of HIV/AIDS and other diseases, reduce the risk of overdose death, and connect people who use illicit drugs to addiction treatment and other health and social services. In light of these benefits, countries worldwide have been expanding harm reduction services from small-scale community-based programs into routine components of their healthcare systems. In Canada, most provinces and territories have at least some harm reduction interventions, but many large service gaps still exist. Expanding harm reduction services and better integrating them into healthcare systems requires a clear understanding of a number of different factors, e.g. decision maker's views and knowledge about harm reduction, that influence policymaking in this area. The proposed research project examines these factors through a cross-provincial and territorial study of harm reduction policy. By examining provincial and territorial policy documents, analyzing media articles, interviewing key policy stakeholders, and surveying the public, it examines how harm reduction is interpreted and implemented in each province and territory and what opportunities and challenges exist for expanding these services and better integrating them into healthcare systems. The overall aim of the research is to help governments and other stakeholders expand access to valuable health services for people who use illicit drugs.