Scaling back harm reduction will scale up blood-borne infections
Following nearly a decade of leadership in responding to the toxic drug crisis, harm reduction programs in some parts of Canada are now being scaled back. In some communities, programs like supervised consumption services and safer drug use equipment distribution are being defunded, restricted or forced to close. This is despite strong evidence that supervised consumption services prevent overdose deaths, increase safer substance use practices, increase access to healthcare including treatment and mental health services and reduce public drug use. Safer drug use distribution programs, often referred to as needle and syringe programs, prevent viral infections like hepatitis C and HIV, serious bacterial infections and tissue damage. Taken together, there is another likely outcome of this policy shift hiding behind the headlines of the toxic drug crisis: more blood-borne infections.
By limiting access to these programs, we risk going back to transmission levels not seen since before these programs were rolled out in the 1980s and 90s.
In February, CATIE attended the 15th Canadian Symposium on Hepatitis C, which was hosted by the Canadian Network for Hepatitis C (CanHepC) as part of the Canadian Liver Meeting. The symposium brought experts from across the country to Toronto where they shared the latest in hepatitis C research.
The theme this year was hepatitis C prevention. During the event, CATIE asked presenters and attendees to share their insights on the role of harm reduction in preventing hepatitis C and what can be done to make it more accessible across Canada. We asked: how can harm reduction prevent hepatitis C and other blood-borne infections and support the broader health of people who use drugs? And how can we practically make harm reduction more accessible to communities who need these services?
What is the role of harm reduction services in preventing hepatitis C?
Making harm reduction more accessible
What can be done to make harm reduction services more accessible to prevent new hepatitis C infections and other preventable harms?
Harm reduction prevents hepatitis C, HIV and other blood-borne infections
Harm reduction services are one of the most important and effective ways to prevent new hepatitis C and HIV infections in Canada. They do this primarily through safer substance use education and distribution of sterile drug use equipment. And for clients who might not be engaged in traditional healthcare, they can be important access points for hepatitis C and HIV testing, linkage to care and treatment.
Harm reduction services do a lot more than prevent hepatitis C, HIV and other blood-borne infections – they are essential community services. They are spaces where people can come as they are, be met with kindness and compassion, and receive life-affirming and lifesaving care. These services can link clients to other supports for their health and wellbeing, such as social supports, medical care, mental health services and treatment programs.
However, harm reduction services are under threat in many parts of Canada. Scaling back these programs will result in more harms for people who use drugs, including hepatitis C, HIV and other blood-borne infections, overdoses and deaths, not to mention fewer opportunities to connect with other health and social services.
Rivka Kushner is CATIE’s manager, hepatitis knowledge mobilization. She has a master of public health degree in health promotion and previously worked in knowledge exchange related to substance use, workplace health and environmental sustainability.