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Harm Reduction

Implementation supports and resources for authorized Harm Reduction Interventions.

Overview

There are 6 authorized Harm Reduction interventions for Nova Scotia Health. Each intervention is outlined below. Team Members with the appropriate competency who work in programs and services authorized to provide specific Harm Reduction interventions must implement these interventions or refer to, or seek support from, the relevant Nova Scotia Health program or service.

1. Education and Counselling

Education and counselling are interventions of their own and essential components of the other Harm Reduction Interventions detailed in the Nova Scotia Health Harm Reduction policy. These interventions include:

  • Educating people how to reduce risks and harms associated with substance use and sexual activities through sharing key messages and risk reduction techniques.
  • Implementing educational programs and outreach services with compassion and raising awareness about existing housing services (for example: 2-1-1), safer consumption, safer sex practices, and the availability of Harm Reduction services for individuals and for health care providers who work with them. 
  • Providing counselling, support, and referrals to health care and social services to individuals experiencing harm from homelessness, substance use or sexual behaviours.

Substance Use Medical Emergency (SUME) - Prevention Tips

The following resources provide information about responding to a SUME. Please note that they may use the term ‘overdose’ or ‘drug poisoning’ instead of SUME. This reflects changes over time in how we understand this type of critical incident.

  How to Spot Someone so They Never Use Alone

Canadian Association of People Who Use Drugs (CAPUD), 2021

 

SUME (formerly known as overdose) response

Safer drug use practices information

2. Access to Sterile Equipment

Providing access to sterile needles, syringes, sharps containers, safer smoking and other drug preparation and injecting equipment (for example, but not limited to, filters, cookers, sterile water, ascorbic acid, tourniquets) to reduce the risk of death and bloodborne infections, such as HIV and hepatitis, among people who use drugs. 

See additional supporting policy:

Recommended Resources

3. Naloxone Distribution and/or Administration

Nova Scotia Health Take Home Naloxone Program distributes and trains on the use of Naloxone, an opioid poisoning reversal medication, to Team Members working with people at risk of opioid poisoning, those at risk of opioid poisoning, and any member of the public interested in administering Naloxone.

  • Team Members are authorized by the province of Nova Scotia to administer Naloxone without an Authorized Prescriber order in the case of suspected opioid poisoning.
  • Team Members must have approval from their immediate supervisor/manager to receive Naloxone training and a kit.

To receive training and a kit, reach out to your manager to learn how the Take Home Naloxone program is implemented in your department, or reach out directly to the Take Home Naloxone Coordinator.

Recommended Resources

4. Condom and Other Safer Sex Supplies Distribution

  • Distributing internal and external condoms, oral dams, water-based lubricants, gloves, and other safer-sex supplies as well as promoting safer sex practices to reduce the spread of Sexually Transmitted Infections (STIs).
  • For Indigenous populations, Sexual Health Medicine Bundles may include traditional healing supplies. 
  • Assessing for and providing Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP).

Recommended Resources

5. Medications for Substance Use Disorder

Opioid agonist treatment (OAT) refers to methadone, buprenorphine, slow-release oral morphine (SROM), hydromorphone, and other pharmaceutical substitution or maintenance therapies for opioid use disorder. 

Offering medications such as methadone, buprenorphine, Sustained Release Oral Morphine (SROM), hydromorphone, and nicotine replacement therapies (NRT), varenicline and bupropion to reduce cravings and withdrawal symptoms, as well as the risk of a substance use medical emergency (i.e., drug toxicity) and substance use-related harm. Note: This would include a protocol to support use of injectable OAT and other short-acting opioid agonist medications, including hydromorphone, when required, and expanding access to OAT for opioid use disorder and other substance use disorders to include medications like naltrexone, acamprosate, etc.

Canadian Research Initiative in Substance Matters (CRISM)

Funded by the Canadian Institutes of Health Research (CIHR), CRISM is a national research consortium of over 1400 members focused on substance use disorders. It comprises five large interdisciplinary regional teams (nodes) representing British Columbia, the Prairie Provinces and Territories, Ontario, Québec, and the Atlantic Provinces.

CRISM guidance includes:

Additional Resources

6. Housing First and Homelessness Initiatives

Nova Scotia Health is integrating the principles of the Housing First Model, which prioritizes providing stable non-abstinence housing for people with substance use disorders and other complex needs, reducing the harm associated with homelessness. Team Members work with government and community partners for discharge planning and resources related to housing.

Housing First and Homelessness Initiatives in Nova Scotia

Additional Resources