V. Harm Reduction Implementation Guide

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The harm to Aboriginal individuals, families and communities resulting from substance use is immense – reaching across and through families, communities and generations.  There are many ways harm from drug use is experienced including the break-down of relationships and families, violence, loss of financial security, disease, and death; these harms are significant. Hepatitis C and HIV infection through injection drug use is happening very rapidly in Canadian Aboriginal communities – most call it a health crisis, some people even called it an epidemic. Our communities need to be able to respond to these issues in meaningful, culturally appropriate and community specific ways. Most Aboriginal people can agree that it is honourable and practical to work towards reducing the harms associated with substance use for both individuals and communities.

This Implementation Guide hopes to complement to enhance the Walk With Me – Pathways to Health Service Delivery Model (Canadian Aboriginal AIDS Network, 2007). It is not within the scope of this resource to discuss and describe everything there is to know about the vast landscape of Aboriginal harm reduction. There are many pathways to health and each person is free to choose the path for themselves.

As service providers and/or supporters of our relatives, it is our job to walk with our relatives; to actively listen in a non-threatening and non-judgmental way to get to know where they are at right now on their path. This is about ‘doing’ harm reduction and how to move your group or community towards the goal of harm reduction across all services. It’s a big job but the point of this implementation guide is to get ALL Aboriginal people thinking and talking about harm reduction and how they might be able to apply it in their setting (community, workplace, school, home, etc.). To do this, it is important to establish trust.

Trust is developed by spending time together and establishing a relationship. In order for people to reach out and ask for help, we have to instill trust. Creating safe spaces where relationships can be fostered between those who provide services and those who are seeking or requiring services is very important. In many cases for Aboriginal people most at risk, culturally safe services are often the only point of contact these individuals might have with the health care system and other support services.

There are many opinions about how Métis, Inuit and First Nations communities should move forward in responding to this issue. But it is important to remember that the patterns and modes – the drug(s) of choice and preferred manner of consumption – of substance use differ from region to region and from community to community.

Yet, some communities have celebrated successes in their interventions and responses – we can learn from their experience and help get communities ready to adapt it to fit their own realities. We must share our experiences and lessons with each other because there are still many communities struggling with how to meaningfully address substance use.

Each community requires it’s own culturally appropriate response to its home-grown issues. We hope that this guide will provide you with new tools to assist in normalizing harm reduction approaches in your community as one means of acknowledging and working to reduce the incidence of HIV/AIDS and Hepatitis C.

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