Moyo staff and Vitus Consulting Annual review meeting, August 2024. From Left to right: Rohan Mohindra Harm Reduction Satellite Program Coordinator; Ho Yan (Winson) Wong, 2SLGBTQ+ Training and Capacity Building Coordinator; Roxana Salehi, Founder & Senior Consultant (Vitus Consulting); Meyran Mohamed , Community Engagement Manager. Back row Left to Right: Adam Chalcraft, Harm Reduction Program Manager; Sharmin Sharif, Interim Executive Director; Sheila Khazamipour Health Promotion and Prevention Manager
The Alarming Rise of Opioid-Related Harms in Ontario
Harm reduction saves lives without increasing drug use. The Ontario government's recent decision to close multiple supervised drug consumption sites in Toronto has brought the debate surrounding this approach into sharp focus. In a province where opioid-related harms have been steadily rising for over a decade, with more than 2,800 Ontarians dying from opioid-related causes in 2021 alone, the urgency of this conversation is clear.
The situation in Peel is equally dire. Between 2018 and 2022, 682 opioid-related deaths were recorded in the region, underscoring the need for effective, evidence-based harm reduction strategies to save lives and mitigate the impact of the opioid crisis.
What Is Harm Reduction?
Harm reduction is a public health philosophy centered on reducing the negative consequences of drug use without necessarily requiring abstinence. Scientific studies consistently show that harm reduction strategies like needle exchange programs, supervised consumption sites, and naloxone distribution:
Significantly decrease rates of overdose,
Reduce the spread of infectious diseases like HIV and hepatitis C,
Improve overall engagement with health services.
These interventions do not lead to increased drug use but instead provide essential support to those who need it most.
A Community-Centred Evidence-Based Approach
Recently, Vitus Consulting met with Moyo Health & Community Services for our annual reflection and planning meeting. We reviewed the progress and evaluation data for their harm reduction project, funded by the Public Health Agency of Canada’s Harm Reduction Fund (HRF). Our discussions reinforced the critical importance of these strategies in Peel.
The project’s evaluation revealed some significant findings. For example, 40% of survey respondents (n=58) reported that they had not used other harm reduction services in Peel before coming to Moyo’s site. This underscores Moyo’s unique ability to reach individuals who might otherwise fall through the cracks. We will dig deeper to understand and explain this finding in the upcoming final evaluation of this project.
Moreover, 92% of respondents (n=64) stated that the services they received at Moyo had increased their ability to reduce drug-related harm, such as preventing overdoses, infections, and equipment sharing. This aligns with the broader literature, which consistently shows that harm reduction programs save lives.
An inclusive Approach at Moyo
Moyo stands out in this challenging work by approaching harm reduction through an inclusive lens. Not only are they implementing evidence-based strategies, but they are also incorporating Aboriginal harm reduction principles and actively working to fight stigma in communities often excluded from these conversations, such as South Asian communities. I am continually impressed by their dedication and every year get reminded of the importance of community-based public health interventions and advocacy.
The Road Ahead: Advocacy and Implementation
As we continue to face challenges—including securing funding and addressing community concerns—it's crucial to advocate for and implement these life-saving strategies in Peel and beyond. The evidence is clear, and the stakes are high.
References:
Platt, L., Minozzi, S., Reed, J., Vickerman, P., Hagan, H., French, C., ... & Hickman, M. (2017). Needle and syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs. Cochrane database of systematic reviews, (9). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012021.pub2/full Hawk, K.
F., Vaca, F. E., & D'Onofrio, G. (2015). Reducing fatal opioid overdose: prevention, treatment and harm reduction strategies. The Yale journal of biology and medicine, 88(3), 235.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553643/ Jarvis, B. P., Holtyn, A. F.,
Subramaniam, S., Tompkins, D. A., Oga, E. A., Bigelow, G. E., & Silverman, K. (2018). Extended-release injectable naltrexone for opioid use disorder: A systematic review. Addiction, 113(7), 1188-1209. https://pubmed.ncbi.nlm.nih.gov/29396985/
Irvine, M. A., Buxton, J. A., Otterstatter, M. C., Balshaw, R. F., Gustafson, R., Tyndall, M., & Coombs, D. (2020). Distribution of take-home opioid antagonist (naloxone) during the COVID-19 pandemic in British Columbia, Canada. CMAJ, 192(34), E985-E992. https://pubmed.ncbi.nlm.nih.gov/29678561/
Potier, C., Laprévote, V., Dubois-Arber, F., Cottencin, O., & Rolland, B. (2014). Supervised injection services: what has been demonstrated? A systematic review and meta-analysis. The International Journal on Drug Policy, 26(1), 7-15. https://pubmed.ncbi.nlm.nih.gov/25456324/
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