The Harm Reduction Manual is intended to be a learning tool and reference guide for service providers and policymakers to deliver high quality harm reduction services across health and social service settings.
The BCCDC and FNHA recently developed the Harm Reduction Manual to bring together best practice guidance for anyone who provides services to people who use substances across BC.
This manual is intended to be a learning tool and reference guide for policymakers and service providers - including nurses, social workers, peer workers, mental health staff, housing workers, and more. It aims to support the delivery of high-quality harm reduction services across a range of health and social service settings and across the comprehensive system of substance use care.
The manual is organized in 12 sections to help readers find the information that’s most relevant to them, including: Truth & Reconciliation, People with Lived and Living Experience of Substance Use, Harm Reduction, Harm Reduction Supplies & Distribution Guidance, Naloxone, Substance in the Unregulated Drug Supply, Safer Substance Use Practice, Overdose Prevention Services, Opioid Poisoning Response, Stimulant Toxicity, and Additional Resources.
The manual will be available online and updated regularly to ensure it stays current and useful for everyday practice.
Section 1 - Introduction
Section 1 introduces the Harm Reduction Manual by providing a land acknowledgement, an overview of the sections in the manual, information about its collaborative development, and its scope, purpose, and guiding principles.
Section 2 - Truth and reconciliation
This section discusses our shared obligations to uphold the inherent rights and title of BC First Nations and the inherent rights of all First Nations, Métis, and Inuit Peoples living in BC. This section uses Puglaas Jody Wilson-Raybould’s (Kwakwaka’wakw from We Wai Kai Nation) three practices—learn, understand, and act—as a roadmap to work towards truth and reconciliation in harm reduction.
Section 3 - People with lived and living experience of substance use
People with lived and living experience (PWLLE) of substance use are people who have used substances in the past (lived experience) or currently use substances (living experience). PWLLE are central to harm reduction, bringing knowledge and expertise that improves services, shapes healthier drug policies, and builds stronger community networks. This section highlights key principles and resources for service providers and policymakers to meaningfully collaborate and work alongside people with lived and living experience of substance use.
Section 4 - Harm reduction
Section 4 provides an overview of the concept of harm reduction and how to use this approach to deliver services. This section identifies groups of people who face barriers to harm reduction services in BC—young people, people who are pregnant or parenting, 2SLGBTQIA+ community, newcomers, and people who work in trades—and ways to promote service delivery and accessibility for these specific groups. This section identifies considerations and ways to improve access to harm reduction across unique service settings including acute care facilities, community-based health and social services, community care facilities, correctional centres, and rural and remote areas.
- Section 4: Harm Reduction
Section 5 - Harm reduction supplies and distribution guidance
This section provides information about harm reduction supplies for safer substance use and safer sex. It also provides information on the BC Centre for Disease Control (BCCDC) harm reduction supply program, including what supplies are available for harm reduction sites to order, how to use the supplies, and how to distribute the supplies.
Section 6 - Naloxone
This section provides a summary of naloxone, the medication used to reverse opioid poisoning (overdose). Information is provided on how naloxone works, provincial naloxone programs, where to find naloxone training, and how to distribute naloxone as a registered Take Home Naloxone site.
Section 7 - Substances in the unregulated drug supply
Section 7 provides information on common substances in the unregulated (currently illegal) drug supply, including opioids, stimulants, hallucinogens and combined substances, and novel substances. It also explains how these substances work in the body, and how they can affect health, including poisoning, withdrawal, and substance use disorder. This section also includes links to infographics that explain new, or novel, substances in the unregulated drug supply.
Section 8 - Safer substance use practices
Safer substance use involves taking steps to lower the risk of harms. Section 8 includes information and links to resources about how to use substances in safer ways using harm reduction practices for safer inhalation, safer injection, and safer rectal use.
Section 9 - Overdose prevention services
Section 9 is still in development. This section will provide guidance to deliver overdose prevention services (OPS).
Section 10 - Opioid poisoning response
Section 10 outlines best practices for anyone trained and able to respond to a person who may be experiencing an opioid poisoning outside a hospital setting. It explains what happens in the body during opioid poisoning, and how to recognize the signs of an opioid poisoning. It explains how responders should use the SAVE ME steps to respond to a suspected opioid poisoning. It also discusses what types of supports can be shared after a drug poisoning, including aftercare for the person who experienced a poisoning, support for the responder, and culturally informed support for loved ones and family.
Section 11 - Stimulant toxicity
This section provides information on stimulant toxicity (also called overamping) that occurs when a toxic amount of a substance overwhelms a person’s body. It outlines how to recognize signs and symptoms, differentiate stimulant toxicity from mental health crises, how to respond, and how to provide stimulant toxicity aftercare. This section also includes considerations for stimulant use, extreme heat, and chronic disease.
Section 12 - Additional resources
This section includes links to additional resources to support the health of people who use substances, including: Indigenous health resources, needle disposal and injuries, extreme weather, toxic drug alerts, patient transport fees, wound care, and skin infections.
Key BCCDC resources found within this section:
