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Harm Reduction

Registered nurses (RN), regardless of where they work, frequently care for people experiencing the impacts of substance use, including illegal substance use. Nursing care in this context can raise questions and issues for RNs and can have an impact on the care itself. Harm reduction is a public health response that seeks to diminish the harms of illegal drugs — but it is only a partial approach to addressing the health inequities associated with illegal drug use.

How CNA supports a harm reduction approach

Harm reduction and currently illegal drugs: Implications for nursing policy, practice, education and research, a discussion paper prepared by the Canadian Nurses Association (CNA), presents evidence on harm reduction strategies and benefits to public health and safety. The paper reviews policy at all levels that highlight tensions between public health and prohibitionist approaches to illegal drug use — tensions in which RNs may be caught between evidence, ethics and policy. It also covers legal and ethical perspectives on the distribution of harm reduction supplies, supervised injection and nursing care to people who use illegal drugs. The evidence in this paper is meant to inform discussions about policies, practices and standards to improve the delivery of health care, particularly to those involved with substance use.

The CNA-Canadian Association of Nurses in AIDS Care (CANAC) joint position statement on harm reduction highlights safety promotion, the prevention of death and disability, and the importance of treating all individuals with respect, with dignity and in a non-judgmental manner, regardless of drug use or engagement in other at-risk practices.

As intervenors in the 2011 Insite Supreme Court of Canada case, CNA joined the Registered Nurses’ Association of Ontario and the Association of Registered Nurses of B.C. to support nurses working with persons who have drug addictions in Vancouver’s downtown east side. The unanimous ruling in favour of Insite acknowledged the supervised injection site’s positive impact, both on the population it serves and on the surrounding community, as numerous studies have shown.

CNA has taken a strong stance in opposing the federal government’s proposed amendment to the Controlled Drugs and Substances Act, known as the respect for communities act (Bill C-65). The bill sets out revised application criteria for opening and maintaining supervised injection sites. Following the Supreme Court of Canada ruling, requiring the federal government to grant an exemption for Vancouver’s Insite, this new legislation may create unnecessary obstacles for supervised injection sites. CNA believes in an evidence-based, harm reduction approach to illicit drug use, which promotes safety and prevents death and disability. To add your voice to CNA’s opposition [PDF, 97.7 KB], sign our petition asking the federal health minister to improve access to prevention and treatment services for persons with drug addictions.

Among others, two national nursing specialty groups are also lining up against Bill C-65:

Related resources

Nurses and harm reduction


Harm reduction in Canada

Insite supervised injection site

Harm reduction internationally