Nothing for us, without us!


Despite the fact that harm reduction services and ideas are always started by people who use drugs, they are not always included in the design and delivery of these programs as they become more formalized, especially in healthcare settings and for medical issues related to drug use.

The Toronto Community Hep C Program has been trying to change this since we started more than 10 years ago. Our program strives to include people who use drugs in all aspects of program delivery. We actively solicit the input of people who use drugs on a monthly basis through a patient advisory board. We offer training for current and former clients to become community support workers. Since 2011, we’ve trained 33 clients, 11 of whom have gone on to work in our program and another 10 have found gainful employment elsewhere.

We also engage current and former clients in our knowledge exchange and research activities. Two of our community support workers recently represented the program at the 7th International Symposium on Hepatitis Care in Substance Users in Portugal. And just this past November, we hired 12 current and former clients as outreach worker research assistants to evaluate if point-of-care hepatitis C antibody testing improves program engagement.

We believe this is something every agency can do. We have produced several resources to hopefully encourage other groups to ‘give peers a chance’. We encourage other service providers working in harm reduction to check out the following materials:

  • Toronto Community Hep C Program – Beyond Treatment; Involvement of People with Lived ExperienceWatch this video on South Riverdale Community Health Centre’s YouTube channel.
  • “From client to co-worker: a case study of the transition to peer work within a multi-disciplinary hepatitis C treatment team in Toronto, Canada”.  This article, published in the Harm Reduction Journal, tells the story of two of our community support workers and talks about what helped and what didn’t as they became peer workers.
  • Toronto Community Hep C Program Peer Manual. This training manual and resource guide provides agencies with tips on how to meaningfully engage with clients beyond service provision. You can download the online version or order a free print copy from CATIE.

The Toronto Community Hep C Program will continue to involve people who use drugs in its programming and services because we firmly believe in “nothing for us, without us”. Our next scheduled event will celebrate the potential and the achievements of workers with lived experience of homelessness and substance use.


Kate Mason is a researcher with the Toronto Community Hep C Program. For more information about the Toronto Community Hep C Program, contact Paula Tookey.


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