I Dare You to Drink the Vinegar

 As the death toll in North America from the opiate overdose crisis continues to rise nurses must re-think the approaches that are being used in the healthcare services that are supposed to be designed to best help youth. There are now decades of evidence that support the ineffectiveness of the 1980s ‘Just Say No’ drug strategies targeted to prevent youth from using drugs. In reflection on my nursing career, mostly in programs and services designed to provide care for people who use substances, I feel heartbroken about the slowness of change in inpatient settings.  As I near the five-year anniversary of my joining what was heralded as an innovative mental health and substance use program for youth, I also critically question the erosion of that innovation to conform to a rigid system with rigid values about youth who use substances and how to best provide care for them. Three years ago, I walked into the care team station, early for my night shift. I began my night...

It is surprisingly difficult to find any information that does not support the efficacy and benefits of harm reduction. I am a supporter of harm reduction (in the sense that I tend to let scientific evidence inform my nursing practice). I am a Registered Nurse, meaning scientifically collected evidence guides my practice. My philosophical viewpoint is strong. And so, it seems odd that there is a reluctance to accept the evidence of harm reduction as something to guide policy change. Similarly, if harm reduction is not something to be embrace, it also seems odd that this is not so much based on research being conducted that shows that there may be problems with it and identifies better alternatives to current policy or how more of the same can somehow lead to improvement in the lives of people who use substances.  So here we go, letting something that those in positions of power and privilege feel in their hearts determine public policy. Not surprisingly, most of the information tha...

Harm reduction is not new to nursing. A harm reduction perspective is key in positioning nurses in a compassionate, relational space that breaks down stigma related to substance use.  Reducing Stigma of Drug Use  The central principle of harm reduction is the recognition that some substance use within any society is normal, meaning there will always be some people using some substances for various purposes.  This goal is relevant to individuals using drugs because currently many cultures and societies view substance use, especially use of illegal substances or misuse of prescription substances, as morally wrong and stigmatize those individuals who choose to engage in their use.  The goal of reducing stigma involves actively countering social exclusion and stigma of substance use and substance users.  Further, work towards this goal places an emphasis on promoting and supporting community mobilization, as seen in organizations like VANDU. The individual drug user...