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Naloxone is a medication used to quickly reverse the effects of an opioid overdose. It is available without a prescription for free at most pharmacies. Naloxone is administered by injection into large muscled areas such as the thigh or arm. It is safe to use on anyone that is unresponsive and you believe is overdosing on opioids.

This resource from the provincial government of British Columbia provides further information on the following:

- Where to find Naloxone and who is eligible for the government's "take home Naloxone" program.

-Links to resources such as recognizing the signs of an overdose and how to administer Naloxone.

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Research article: Implementing drug checking as an illicit drug market intervention within the supply chain in a Canadian setting

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Research article: Implementing drug checking as an illicit drug market intervention within the supply chain in a Canadian setting

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This research explores the link between stigma toward substance use and the benefits of drug testing services in relation to the opioid crisis.

"This crisis is being fuelled by drug prohibition and societal stigmatization, as well as structural violence experienced by people who use and sell substances"

Drug checking provides increased safety for those consuming them as well as information for the public about the supply circulating in the area. It is an immediate way to make the illegal drug market safer by offering people who use drugs a confidential place they can test their substance before taking it.

Providing peaceful interventions such as confidential drug checking that do not shame or criminalize the people using them is essential in decreasing the stigma around substance use and aiding in the opioid crisis.

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Substance is a drug-checking project by the University of Victoria in partnership with Health Canada and other organizations. They provide free confidential testing of illicit substances as a form of harm reduction to prevent overdoses amid the opioid crisis. The service also aims to combat substance use stigma by providing a safe space to test and learn about potential risks with different substances. They also provide free Naloxone kits and training on how to use them.

Substance

1802 Cook Street
Victoria, BC
V8T 3P6

Monday - Saturday
12PM - 7PM

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Through the evaluation and research of this pilot project, we seek to evaluate and compare the utility of several instruments and technologies in terms of cost, efficiency, and portability, as well as conduct surveys and interviews with service users to explore the utility of drug checking services and what works for whom, in what settings.

Service users will have the option to participate in surveys and interviews concerning their views on drug checking. Based on evidence from the pilot and evaluation we hope to develop a framework for further implementation, integration and scale-up of drug checking, linking harm reduction, health equity and social justice to the provision of drug checking.

Provide service users with further information about the composition of illicit substances than that currently available in the context of prohibition;

Determine the utility of a variety of drug checking instruments across different settings;

Offer drug checking reports via project website and other formats to inform service users and the general public of test results and aggregate data;

Effectively integrate drug checking services within harm reduction and health services, contributing to reduced illicit drug overdose events and fatalities;

Reduce stigma and criminalization for people who use drugs and improve health outcomes.

To meet our goals, we're offering a drug checking service at a few sites in Victoria while measuring its impacts through surveys and interviews with service users, while testing different drug checking instruments by effectiveness, acceptability, efficiency, accessibility, and appropriateness. We're also building an online database to link the chemical information each instrument detects with analytical and visualization tools to report on and project trends, reporting updates via our project website, while offering instrument data for analysis by citizen scientists.

Surveys and interviews aim to learn more about developing services across social location, with attention to processes and impacts of current drug policy and systemic oppression, asking questions about whether existing services meet user expectations, harm reduction practices in the overdose crisis, and how services should be offered.

Project staff work from diverse backgrounds including social work, chemistry and computer science, housed at the University of Victoria and hosted at services across Victoria. Together with project partners (including people who use drugs, local harm reduction services, the health authority, the provincial government, and instrument developers), over the next few years the project will develop services beyond Victoria, with suburban and rural communities throughout Vancouver Island; develop strategies to more permanently integrate drug checking into harm reduction services; and collaborate with drug checking projects across Canada to develop best practices.

Funded by grants from Health Canada and the Vancouver Foundation, project partners include the B.C. Ministry of Mental Health and Addictions, Island Health, harm reduction services (STS Pharmacy, AVI, SOLID Outreach Services), industry (Perkin Elmer, Cobalt, ProSpect Scientific, IBM). Ethical review for this project was provided by the Health Research Ethics Board at Island Health (HREB).

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Through the evaluation and research of this pilot project, we seek to evaluate and compare the utility of several instruments and technologies in terms of cost, efficiency, and portability, as well as conduct surveys and interviews with service users to explore the utility of drug checking services and what works for whom, in what settings.

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Harm Reduction Services and Numbers in Victoria

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Harm Reduction Services and Numbers in Victoria

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Mobile Van (deliveries & used syringe pick-up from Sidney to Sooke); Wed-Fri noon - 4pm

Case management support (713 Outreach Team partnership with Island Health)

Harm reduction supplies and support (peer support, counselling, referrals)

Overdose prevention and response training, including take-home naloxone

Education for safer drug use and safer sex

Street Nurse clinics

Referral and assistance navigating social and health care systems

Outreach education for youth and people who are incarcerated

Educational and leadership development programming (Street College)

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AVI's 'Victoria' office is located on the territories of the Lək̓ʷəŋən (Lekwungen) speaking peoples of the Songhees and Esquimalt nations.

PHONE 250-384-2366 FAX 250-380-9411
TOLL FREE / INFOLINE 1-800-665-2437
EMAIL info at avi dot org

OFFICE HOURS Mon-Fri 10am-3pm. The office is currently closed to the public due to Covid-19, but phones are answered and supplies are dispensed at the front door between 10:00am-3:00pm, Monday-Friday

MAILING ADDRESS 3rd Floor - Access Health Centre 713 Johnson St, Victoria BC V8W 1M8

HARM REDUCTION SUPPLIES Call 250-384-2366 for more info about supplies. Harm reduction supply distro from 10am-3pm, Monday-Friday at 713 Johnson St.

VICTORIA MOBILE HARM REDUCTION SERVICES (harm reduction supply delivery)
12-4pm Wed-Fri [250-896-AVIX (2849)].*Victoria area only

WESTSHORE/SOOKE MOBILE HARM REDUCTION SERVICES
Monday- Friday, 9:00am-5:00pm, 250-360-6315

HARM REDUCTION RESPONSE TEAM:
Low-barrier outreach services support people in the community to access harm reduction and psycho-social supports, including:

Access to hygiene, safer sex, drug use, pet food/products, and survival supplies

Van and foot outreach

Development of overdose prevention and response systems in housing, shelter and community settings

Community BBQs

Food distribution

Naloxone trainings

Educational seminars with relevant resources (drug checking, safer drug and sex advocates, etc.)

Harm Reduction Art Group

Grief and Loss Support/Groups

Referral and support to access healthcare, housing and community resources

Low-barrier support to maintain connection with health, housing and other community resources

hr.response@avi.org
Response Workers: 250-883-9022 or 250-883-9023
Systems Navigator: 250-889-5203

General services

INFOLINE 1-800-665-2437 Learn more about HIV & HCV safer sex, HIV testing or transmission, STDs and harm reduction. Find services for you or someone you know. All confidential calls taken by trained staff and volunteers.

Presentations for populations with greater exposure to HIV and HVC in prisons, social service organizations, and other community organizations are available by request.

Educational materials promoting improved health, safer drug use, safer sex and more are available to the public at all AVI offices and online.

Volunteer Services provides an opportunity to give back to your community while developing invaluable training and work experience

Services for people living with HIV and/or Hepatitis C

Short-term counseling focused on immediate needs and outcomes

Advocacy and support with income assistance, health care services, employment, housing, disability status applications and legal matters

Non-judgmental education and support for treatment, side effects, nutrition and symptoms

HIV+, member-only program and space for peers to interact while enjoying refreshments and a hot, nutritious lunch. Open to folks who are HepC+ on Tuesdays.

Weekly drop-in medical clinic

Public transportation ticket access

Referrals to other services

Prism Wellness

Prism Wellness' primary focus is to reduce HIV, Hepatitis C, STIs, and stigma in the Southern Vancouver Island communities of gender and sexual minorities. By promoting queer and trans health in these, our communities, we are accomplishing that goal. We encourage our community to make informed choices about their own sexual and substance use practices and wellness. Sex and harm reduction education to reduce HIV, hepatitis C and other sexually transmitted infections is part of our mission. It is paired with the cultivation of attitudes and behaviours that support safer, strong and stable foundations for overall community health and wellbeing.

​Prism Wellness services include group and solo support, Queer Eye for the Service Provider training, wellness groups, peer leadership programs, a biannual conference, outreach, drop-in testing and PrEP nights. To learn more visit their page at http://avi.org/prism-wellness

Harm reduction services for people who use drugs

Mobile Van (deliveries & used syringe pick-up from Sidney to Sooke); Wed-Fri noon - 4pm

Case management support (713 Outreach Team partnership with Island Health)

Harm reduction supplies and support (peer support, counselling, referrals)

Overdose prevention and response training, including take-home naloxone

Education for safer drug use and safer sex

Street Nurse clinics

Referral and assistance navigating social and health care systems

Outreach education for youth and people who are incarcerated

Educational and leadership development programming (Street College)

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AVI's 'Victoria' office is located on the territories of the Lək̓ʷəŋən (Lekwungen) speaking peoples of the Songhees and Esquimalt nations. PHONE 250-384-2366 FAX 250-380-9411 TOLL FREE / INFOLINE 1-800-665-2437 EMAIL info at avi dot org OFFICE HOURS Mon-Fri 10am-3pm.

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The Harm Reduction Therapy Center provides integrated mental health care and substance use treatment to people who, because their relationship with drugs is so intertwined with other emotional and social aspects of their lives, need more than simple “just say no” solutions and mainstream programs.

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Harm Reduction Teaching activities and resources

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Harm Reduction Teaching activities and resources

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Is an alternative to the disease causation model of substance use.

Accepts that at any given time some people are not ready to choose abstinence.

Accepts that substance use occurs in society and works to minimize its harmful effects

Accepts that people who are substance-dependent should have a voice in the creation of programs and policies designed to serve them

Values patient autonomy.

Does not exclude abstinence as an option

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Harm Reduction Teaching activities and resources

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Harm reduction is a pragmatic public health approach to practices, programs, and policies that aim to reduce the adverse health, social, and economic consequences of substance use without requiring individuals to abstain from substance use (CNA, 2011; Rassool, 2010).

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Decriminalization: Options & Evidence - Canadian Centre on Substance Use and Addiction (June 2018) 

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Decriminalization: Options & Evidence - Canadian Centre on Substance Use and Addiction (June 2018) 

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A growing body of evidence suggests that decriminalization is an effective approach to mitigating the harms of substance abuse; it is based on the notion that substance abuse is a complex health and social issue.

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Substance abuse is common in minority communities due to generational trauma and colonialism, that has led to them being genetically predisposed to addiction.

Stereotypes can often deter those from minority groups from seeking help for their substance abuse issues so it is important for professionals--and we as a community--to be aware of our subconscious biases.

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Al Anon family groups are meetings similar to AA but they are designed for the families of alcoholics. The purpose of these meetings is to help people who are concerned about a loved ones drinking problem. You are given the opportunity to learn from other peoples similar experiences and learn effective coping strategies. They offer a program specifically for teens as well.

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Who Are Al-Anon Members? Al-Anon members are people, just like you, who are worried about someone with a drinking problem. Family members have the opportunity to learn from the experiences of others who have faced similar problems. Read More Teens come together to

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One way that most people know of is AA or Alcoholics Anonymous. This is a free program that is available in almost every city in Canada and is confidential. This program however is not very diverse and may not be suitable for everyone.

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Getting sober young in A.A.: a member tells how Alcoholics Anonymous helped her to quit drinking at 17 and to find a community of sober friends at young people's meetings. If you think you're drinking too much, A.A. can help you, too. You're never too young to stop drinking.

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Getting sober young in A.A.: a member tells how Alcoholics Anonymous helped her to quit drinking at 17 and to find a community of sober friends at young people's meetings. If you think you're drinking too much, A.A. can help you, too. You're never too young to stop drinking.

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Understandings of relationship between humans and drugs:
- People use drugs for reasons.
- Self-determination is key to motivation.
- Change occurs in steps, or stages.
- Integrated treatment works best for people with multiple intersecting issues.

It works because it's:

Individualized: Each individual’s relationship with drugs and alcohol is different -substance misuse develops from a unique interaction of biological, psychological, and social factors.  We understand that people use drugs for a variety of reasons and we work hard to help each client understand their own motivations.

Client directed: We empower clients to prioritize which problems they want to address and to set goals.  We do not insist on particular outcomes.  Research tells us that when clients select their own goals, success is much more likely, and one success leads to another.

Respectful and compassionate: We are committed to developing a deep understanding of our clients, and helping create positive outcomes for them.

Non-dogmatic: We do not ask clients to adopt labels such as “alcoholic or addict”, or to believe that they have a disease, in order to change or quit substance use.

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Harm Reduction Therapy (HRT) integrates mental health and substance use treatment and offers it to people who actively use drugs and whose lives are so traumatized and chaotic that they cannot meet the conditions of most programs and clinics. Either they avoid those programs for being too demanding or they are excluded from those programs for "behaviors" that are considered disruptive.

HRT is part of the harm reduction movement, a grassroots social justice and public health movement to end the racist War on Drugs that overwhelmingly targets black and brown people and that has contributed to the United States incarcerating more of its people than any other nation on earth.

HRT is based on the reality that behavior change is usually slow, and a leap from active substance use to complete abstinence is almost always unrealistic and often unnecessary to reduce or eliminate harm. Coercion and punishment are not helpful and, in fact, impede the process of true change. Harms from drinking and drug use can, , be reduced as quickly as possible without hanging onto the hope that a person will quit all their drugs. Harm reduction offers many strategies to reduce harm and save lives, and harm reduction therapy helps people reflect and consider other changes to their relationship with drugs.
Introduction to Harm Reduction: This short video highlights the radical notions of harm reduction and the basic principles of harm reduction therapy.
What is unique about HRT?
Relationship with drugs
HRT is founded on well-established understandings of humans' relationship with intoxicating drugs and on what motivates us to change.

People use drugs for reasons. There is no time in human history when we have not sought and used intoxicating substances- for pleasure, religious and cultural ritual, enlightenment, or for relief of pain and suffering. We say that people have a "relationship with drugs" and, like all relationships, some are healthy, others unhealthy, and people experience ups and downs with their substance use throughout their lifespans.

Self-determination is key to motivation. When people are offered a relationship that respects their autonomy and acknowledges their competence, they are much more highly motivated. Research also shows that when we are offered choices instead of mandates, we tend to make healthier ones. Why? Because our resistance is not aroused and we feel empowered when we have freedom of choice. Those are the conditions for motivation!

Change occurs in steps, or stages - most of us are not ready for change at the moment we realize something is wrong. We need to embrace and explore our ambivalence. Others are ready for action and need help to plan and execute change. At HRTC, we are adept at helping people to identify their stage of change and to successfully move from one stage to another.

Integrated treatment works best for people with multiple intersecting issues. Harm reduction therapists are skilled and able to respond to mental health, substance-related, and other life issues. What comes first is determined by the client, sometimes in consultation with the therapist, sometimes not.

What It Takes to Practice Harm Reduction Therapy: In this short video, Jeannie and Patt talk about their unique perspective on drug use, including the importance of recognizing the benefits that people get from drugs, not only the harms. They also challenge therapists to learn to be comfortable talking about drugs with their clients. Harm Reduction Therapy works because it is:

Individualized: Each individual's relationship with drugs and alcohol is different -substance misuse develops from a unique interaction of biological, psychological, and social factors. We understand that people use drugs for a variety of reasons and we work hard to help each client understand their own motivations.

Client directed: We empower clients to prioritize which problems they want to address and to set goals. We do not insist on particular outcomes. Research tells us that when clients select their own goals, success is much more likely, and one success leads to another.

Respectful and compassionate: We are committed to developing a deep understanding of our clients, and helping create positive outcomes for them.

Non-dogmatic: We do not ask clients to adopt labels such as "alcoholic or addict", or to believe that they have a disease, in order to change or quit substance use.

Guiding Principles of Harm Reduction Therapy
HRTC's guiding ethos is "Come as you are, take what you need, leave when you're ready." The structure and the process of our work are organized around this principle of client-centered care.
Come As You Are
HRTC welcomes everyone, especially the people other mental health and drug treatment agencies turn away or alienate. There are no criteria for coming to HRTC, and we work with what people want, not what we think they need. We work at their pace, not ours.

We believe in hospitality first. We treat people as we would if they came into our own home. We want to make sure people are comfortable so that they can attend to the very hard work ahead of them should they choose to change their relationship with drugs or other aspects of their lives. We offer cold and hot drinks, hot cooked food, and lots of great snacks so that people are nourished and cared for.

Our caring hospitality builds trust that people can rely on us. As one participant advertised as he rode his bike down the alley waving one of our grilled cheese sandwiches, "You gotta get up here! You can talk to these people. THEY LOVE US!"
Take What You Need
We offer people a menu of options . We ask them what they need and we work very hard to give them what they ask for. We believe that whatever we have - whether information or resources - belongs to our clients. We act as generous hosts, not as gatekeepers who determine what people get to have or not have.
Leave When You Are Ready
We meet people "where they are at", emotionally, motivationally, and literally. We go where people live and hang out, and we adapt to their needs. Clients at HRTC direct their care, identifying the areas that they need help with. This autonomy and self-determination keep them invested in their treatment. All of our services are offered on a drop-in basis. People come and go as they see fit. We believe that people know when they are ready to pause or when they have arrived at a satisfaction point. They get to take breaks, they get to leave, and they get to come back whenever they want. We believe in people's wisdom to know what they need and when they need it.

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What is Harm Reduction Therapy? - HRTC - Harm Reduction Therapy Center

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Harm Reduction Therapy (HRT) integrates mental health and substance use treatment and offers it to people who actively use drugs and whose lives are so traumatized and chaotic that they cannot meet the conditions of most programs and clinics. Either they avoid those programs for being too demanding or they are excluded from those programs for "behaviors" that are considered disruptive.

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Take these important steps to help reduce stigma:

do not define any person by their drug use

be respectful, compassionate and caring to those who use drugs

educate your friends and family - pass on facts and challenge stereotypes

remember that addiction is a treatable medical condition, not a choice, and is deserving of care just like any other medical condition

be aware of your attitudes and behaviours because they may be influenced by stereotypes, negative stories and images about people who use drugs

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On this page

About stigma

Overdose-related deaths and other harms are affecting our friends, families and communities. Addiction is not a choice. It is a treatable medical condition yet many people affected by addiction face stigma.

Stigma is negative attitudes, beliefs or behaviours about or towards a group of people because of their situation in life. It includes discrimination, prejudice, judgment and stereotypes, which can isolate people who use drugs.

Stigma makes it harder to reach out for help

We can make it easier for people to get support by letting them know they are not alone, and that substance use does not define who they are. Addiction is a treatable medical condition, not a choice.
Help end the stigma
Stigma matters

People who use drugs, especially those struggling with addiction face discrimination and barriers to getting help.

Stigma can:

lead a person to avoid getting help because they are afraid of judgement or getting in trouble with work, their loved ones or even the law

cause a person to hide their drug use or use drugs alone

affect a person's ability to find housing and jobs, which affects their health and quality of life

contribute to people who use drugs receiving a lower quality of care from the healthcare system when they access services

Addiction is not a choice

There is a common misconception that addiction is a choice and that people can stop using drugs when they want to. Addiction is complex. People develop addictions because of many reasons, including:

events in life, especially trauma and chronic stress

environmental factors

mental well-being (emotions, thoughts, feelings, and mental illness)

genetics and biology

Some people try drugs once or use them occasionally. Others use drugs more often, sometimes to try to cope with trauma or pain. No matter the reason, no one chooses to become addicted. Addiction and physical dependence make it hard to stop using drugs even when it's hurting you or people in your life. Recovery is possible but it looks different for everyone.

The three types of stigma

Changing how you talk about drug use

The language you use has a direct and deep impact on people around you. You can reduce stigma by changing the words you use to talk about drug use. Using kind words can make it easier for someone to speak up, to feel understood or to receive help.

You can:

use person-first language, for example say 'person who uses drugs' instead of 'drug user'

use neutral, medically accurate words when describing drug use

avoid slang such as "addict" and "junkie"

use language that shows care and concern, rather than judgement

speak up when you hear someone being treated or talked to in a disrespectful way

use language that acknowledges and promotes the fact that recovery from addiction is possible, and looks different for everyone

Help end stigma

Take these important steps to help reduce stigma:

do not define any person by their drug use

be respectful, compassionate and caring to those who use drugs

educate your friends and family - pass on facts and challenge stereotypes

remember that addiction is a treatable medical condition, not a choice, and is deserving of care just like any other medical condition

be aware of your attitudes and behaviours because they may be influenced by stereotypes, negative stories and images about people who use drugs

Learn how to talk to a friend or family member about drugs.

Related Links

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Overdose-related deaths and other harms are affecting our friends, families and communities. Addiction is not a choice. It is a treatable medical condition yet many people affected by addiction face stigma. Stigma is negative attitudes, beliefs or behaviours about or towards a group of people because of their situation in life.

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Harm Reduction: Canadian Drugs and Substances Strategy

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Harm Reduction: Canadian Drugs and Substances Strategy

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Evidence shows that harm reduction is a vital part of a comprehensive, compassionate and collaborative public health approach to substance use disorder.

On this page

Harm reduction

The Canadian drugs and substances strategy supports measures that reduce the harmful health, social and economic effects of substance use on:

Not everyone is willing or able to enter treatment at all times. Until people are ready and able to seek treatment, harm reduction programs work to:

reduce risks

improve health

connect people with other key health and social services

Harm reduction activities under the Pillars of the Canadian drugs and substances strategy

We are reducing the harms associated with problematic substance use by:

working with provinces and territories on new legislation to regulate and restrict access to cannabis

conducting public education awareness and monitoring programs before and after legalizing and regulating cannabis

making it easier to access naloxone, a drug used to help temporarily reverse opioid overdoses by:

making it available without a prescription

supporting provincial and territorial response efforts by obtaining nasal spray and injectable naloxone

supporting new front-line harm reduction interventions to reduce the risk of sexually transmitted and blood-borne infections that result from:

sharing drug use equipment

other related behaviours

streamlining the application process for communities that wish to open supervised consumption sites

researching harm reduction through the Canadian Research Initiative in Substance Misuse (CRISM)

including harm reduction measures to federally funded health services for First Nations and Inuit communities

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Harm Reduction: Canadian Drugs and Substances Strategy

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Evidence shows that harm reduction is a vital part of a comprehensive, compassionate and collaborative public health approach to substance use disorder. The Canadian drugs and substances strategy supports measures that reduce the harmful health, social and economic effects of substance use on: Not everyone is willing or able to enter treatment at all times.

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Substance abuse and trauma are strongly linked, as well as linked to mental health, stigma, health care barriers, etc.
Trauma informed practice means recognizing these links and not re-traumatizing people.

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We recognize the strong link between trauma and mental health and substance use challenges in patients and clients across BC Mental Health and Substance Use Services. Most of our patients and clients have experienced traumatic events - often more than one.

We also recognize the effects of trauma in the circumstances and challenges that bring people to us. Besides affecting mental wellness and substance use, trauma can also trigger reactions such as self-harm or aggression that may make someone's health challenges worse, deepen stigma, create barriers to health care and employment, and even contribute a conflict with the law.

In light of this, we have implemented trauma-informed practice principles across the organization. This means that our leaders, physicians, and clinical and support staff are all sensitive to the effects of trauma, and work to avoid re-traumatization and make sure that all of our clients and patients feel safe and supported. We also advocate for using trauma-informed practice principles in mental health and substance use treatment programs across British Columbia.

We follow trauma-informed practice principles as defined by the Substance Use and Mental Health Services Administration (SAMHSA), known as the Four R's:

1. An organization-wide realization, or understanding, of how trauma affects people.

2. The ability to recognize the signs of trauma.

3. A system-wide response to trauma that informs all behaviours, language, programs, and policies.

4. Resisting re-traumatization of patients, clients and staff. Organizations can unintentionally create conditions that will re-traumatize people.

More information and guidance about the Four R's and trauma-informed practice is available in the Substance Use and Mental Health Services Administration's trauma-informed practice manual, called SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach (PDF).

We also use and recommend these two resources:

While some of our clients' and patients' care plans include trauma-specific therapy, BC Mental Health and Substance Use Services' approach to trauma-informed care is much broader than individual treatment options. In all interactions with our clients and patients, our administrators and health care workers work to provide a strengths-based safe place for growth and healing that focuses on recovery and resiliency, regardless of the type of trauma a person has experienced.

This trauma-informed approach extends to all of our programs, including the Forensic Psychiatric Hospital, the Burnaby Centre for Mental Health and Addiction, the Heartwood Centre for Women, Correctional Health Services and others. It also informs the care model and many of the design choices for the province's new Red Fish Healing Centre for Mental Health and Addiction, scheduled to open in fall 2021.

Our approach to trauma-informed practice is guided by six principles:

Safety

Trust and transparency

Peer support

Collaboration and mutuality

Empowerment, voice and choice

The importance of cultural, historical and gender issues

This approach, in which clinicians acknowledge what has happened, allows clients and patients to be more engaged in their care.

To increase awareness among staff, physicians, clients and mental health practitioners across the province of the prevalence of trauma and the impact it has on mental and physical health and substance use.

To increase knowledge of trauma-informed principles and practice among all mental health professionals within our programs, PHSA and other health authorities.

To increase capacity among our mental health practitioners to better serve people affected by violence and trauma and improve outcomes for patients, clients and families.

To create safer environments for our patients, clients, staff and physicians by enhancing physical safety in care settings and interpersonal safety through all interactions.

To provide patients and clients opportunities to engage by giving them choices, chances to collaborate, and make safe connections with other patients and clients staff, physicians, loved ones and community members.

To empower patients and clients by recognizing their strengths, fostering resilience and believing in their recovery.

Current trauma-informed practices at BC Mental Health and Substance Use Services include the following:

We have rolled out therapeutic and relational security at the Forensic Psychiatric Hospital, which is increasing awareness and understanding of patient triggers and how clinicians may respond, reducing patient reactivity and aggression. To learn more, visit our therapeutic and relational security page or download the See Think Act workbook, produced by the U.K.'s Royal College of Physicians. You can also watch this video:

All PHSA staff participate in San'yas Indigenous Cultural Safety Training to help them provide culturally safe care to Indigenous patients and clients, many of whom are struggling with historical and intergenerational trauma.

We use a number of trauma-informed policies and procedures to make sure our clients and patients feel safe and to avoid re-traumatization. For example, we use the least restraint necessary at the Forensic Psychiatric Hospital. Also, when clients at the Burnaby Centre for Mental Health and Addiction or the Heartwood Centre for Women return from a day pass, while we do search their belongings, we do not subject them to a full-body search.

When patients and clients arrive at the Burnaby Centre for Mental Health and Addiction or the Heartwood Centre for Women, we help them identify triggers and situations that may cause them to react. A resource called the Calm, Cool, Collected Tool identifies positive coping strategies for them to use during their treatment.

Following this, we help many of our patients and clients create comfort plans, which help them recognize and respond to distressing situations. We're also creating comfort kits, which are made up of personal items that help a client feel grounded, such as essential oils, toys or a blanket.

A comfort room at the Forensic Psychiatric Hospital is a place patients may visit when they are feeling triggered or upset. A calming sensory environment helps clients feel more relaxed, safe and secure.

As we build the Red Fish Healing Centre for Mental Health and Addiction, we're considering trauma-informed practice in every aspect of the building design. Examples include the following:

All client bedrooms in the purpose-built, 105-bed residential treatment facility will be private single rooms with ensuite bathrooms.

Each client will be able to control the natural light and temperature in their own room.

Furniture, fixtures, textures and colours will maximize client comfort and safety by providing a calm, healing environment.

Exam rooms, counselling rooms, admission areas and other spaces will have two ways of entering and leaving.

We share regular trauma-informed practice tips in staff and physician newsletters, recognizing those who have implemented trauma-informed care well.

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We recognize the strong link between trauma and mental health and substance use challenges in patients and clients across BC Mental Health and Substance Use Services. Most of our patients and clients have experienced traumatic events - often more than one. We also recognize the effects of trauma in the circumstances and challenges that bring people to us.

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Substance abuse refers to harmful or hazardous use of psychoactive substances, including illegal drugs, use of alcohol and pain meds.

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Stigma is a negative attitudes, beliefs or behaviours about or towards a group of people because of their situation in life. Stigma is one of the biggest barrier for people people seeking and receiving treatment for substance abuse. (Stigma and Discrimination | CMHA Victoria Office (BC Division))(Health Canada, “Stigma around Drug Use”)

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Stigma can lead a person to avoid getting help because they are afraid of judgement or getting in trouble with work, their loved ones or even the law. Many people don’t ask for help because they feel ashamed or scared. (Stigma and Discrimination | CMHA Victoria Office (BC Division))(Health Canada, “Stigma around Drug Use”)

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A Trauma-Informed Practice Guide for Working with Children, Youth, and Families (January 2017)

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A Trauma-Informed Practice Guide for Working with Children, Youth, and Families (January 2017)

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Stigma against those who use drugs is a barrier that prevents people from asking for help. Many people don't ask for help because they feel ashamed or scared of repercussions.

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Substance Abuse and Mental Health Services Administration (July 2014)

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Substance Abuse and Mental Health Services Administration (July 2014)

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1. Tell someone who doesn’t know my story of mental health or substance use problems, or help others tell their story

2. Seek direct contact by volunteering for a mental health or addictions organization, or find personal stories of recovery

3. Think about the words I use. Do I use people-centered language like, “A person living with…” or do I say, “A schizophrenic” or, “An alcoholic?”

4. Think about how I personally support and treat people around me who are living with a mental health or substance use problem

5. Speak up when I see discrimination or when I see a law or policy that unfairly excludes people

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About one in five people-over six and a half million Canadians-experience a mental illness or substance use problem in their lifetime. Unfortunately, many people don't ask for help because they feel ashamed or scared. People may judge them and treat them negatively based on a mental health or substance use problem. Others have trouble finding a place to live, finding a job, maintaining relationships and other important parts of life. In fact, most people living with a mental illness say that stigma is worse than the symptoms they feel.

Stigma originally meant a physical mark of shame. Now, it's an invisible mark that sets you apart from others. The problem with the word 'stigma' is that it puts the focus on the person's difference instead of on the people who are setting them apart. Using the word stigma makes it seem different than racism, homophobia or sexism. It isn't. So it's time to talk about stigma for what it really is: prejudice and discrimination. Prejudice is holding negative attitudes or beliefs about people who are viewed as different. Discrimination is acting on these ideas or beliefs.

"Layers" of stigma

Many people don't experience stigma for just one reason. They may experience discrimination based on many different prejudices, like sexual orientation, gender, culture or physical disability. Discrimination itself can lead to mental health or substance use problems. And people who already face discrimination for any reason may be even less able to find help for mental health or substance use problems or less able to find services that meet their needs.

How bad is it?

Research shows that over half of people living with mental illnesses said that they were embarrassed about their health problems, and over half felt like they had experienced discrimination. In one recent Canadian study, researchers found that:

Just under half of Canadians thought that a mental illness was just an excuse for poor behaviour

Only about one in three Canadians would continue to be friends with someone with an alcohol use problem

Only about one in four would continue to be friends with someone with a drug use problem

Causes and effects of discrimination

Many factors lead to discrimination. Major examples include:

Fear: Such as the fear of violence and the fear of the issues themselves because they affect our mind and behaviour. Some fears may be reinforced in the media

Untrue beliefs: Such as the belief that people can't recover or the belief that people can't participate in their communities

Blame and self-blame: People may be blamed for their conditions or problem substance use and viewed as weak. People with mental illnesses or substance use problems, and their loved ones, may also deeply blame themselves

Discrimination affects all areas of living. It can prevent people from getting or having basic things that most of us take for granted, like:

Getting hired, promoted or keeping a job

Finding or keeping a place to live in a safe, accepting community

Getting proper health care

Feeling loved, needed and accepted by family and friends

Contributing to communities and feeling productive

Getting insurance

Going to school

Immigrating to another country

Feeling positive about ourselves

Discrimination may also affect families and friends. Others may dismiss their concerns. In many cultures, the entire family carries their loved one's stigma because they strongly identify as a group. As a result, family members may not confide in friends or others in their support network.

What can we do about it?

Discrimination around mental health and substance use is a human rights issue. Human rights are rights and freedoms that all people should have. The United Nations says that, "All persons with a mental illness ... shall be treated with humanity and respect for the inherent dignity of the human person." This respect and dignity is a freedom that should not be taken away by. It's also a basic human right for all people with mental health and substance use problems, no matter where they live. Everyone has the right to live without discrimination of any kind. This includes discrimination based on a mental health or substance use problem.

But when we talk about discrimination, human rights laws meant to protect people from discrimination are only part of the solution. For these laws to really work and protect people, everyone has to embrace the spirit and intent of the laws.

Health is about more than not having a disease or health problem. Health and well-being include things like human rights, community connections and access to opportunities. Discrimination promotes poor well-being because it denies human rights, prevents connections among community members and creates unequal access. When we support human rights and help everyone take part in our communities, we're also countering discrimination-and improving people's well-being. Here are some things we can do:

Address differences that prevent people from taking part in communities: Poverty, lack of affordable housing, lack of education opportunities and lack of meaningful work are a few of the social factors that affect well-being. These factors may be both a result of poor health and a cause of poor health. Addressing these inequalities among community members is good for both individuals and the community as a whole. We can challenge systems that create differences by encouraging our governments to form positive social policies and laws. We can also support people in our communities who are working to reduce differences.

Support everyone's right to work: It's no wonder that the right to employment is identified as a human right by the United Nations. Work gives us purpose and meaning. It's also tied to income, which is tied to other social factors. For example, if we have a good income, we can afford better housing and access more services. While full-time work may not be everyone's goal, we need to support people who want to find purpose and meaning through work. To do this, we need to make sure people have access to training, education or other workplace programs.

Promote direct personal contact: Meeting and interacting with people with mental health or substance use problems is one of the best ways to improve attitudes and behaviours. This works best when the people meeting each other have equal status, when there can be discussion, and when the presenters with personal experiences can counter major myths. Education efforts like this fact sheet can help us understand the challenges, but they don't change attitudes.

Look at mental health and substance use problems as a part of our shared humanity: Fear, prejudice and discrimination lessen when we talk about mental health problems as an understandable response to a unique set of circumstances-not just as biological problems.

Help people be heard: We need to encourage and empower people with experiences of mental health or substance use problems to be leaders in any efforts, such as anti-stigma programs and research. This includes supporting people and connecting them with peers. When people relate to each other's struggles and want to see changes, they're more likely to share their stories and protest when they see injustice.

Help media be a force for good: Media like TV, movies, newspapers and web sites influence how we see others. Media should be encouraged to show people for who they really are-capable and productive community members. Hearing the direct voice of people with mental health and substance use problems through the media can be incredibly powerful. And we need to challenge media that discriminates against a group of people.

5 small ways I can make a difference

1. Tell someone who doesn't know my story of mental health or substance use problems, or help others tell their story

2. Seek direct contact by volunteering for a mental health or addictions organization, or find personal stories of recovery

3. Think about the words I use. Do I use people-centered language like, "A person living with..." or do I say, "A schizophrenic" or, "An alcoholic?"

4. Think about how I personally support and treat people around me who are living with a mental health or substance use problem

5. Speak up when I see discrimination or when I see a law or policy that unfairly excludes people

Where do I go from here?

For more information about mental health and substance use issues, see the resources below:

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca. You can read many different personal stories written by people living with a mental illness or substance use problem. You can also find fact sheets to help you get help for mental health problems and substance use problems.

Mental Health Commission of Canada's Opening Minds Campaign
Opening Minds is a ten-year anti-stigma campaign. It helps organizations across Canada create programs that counter stigma and discrimination around mental health. For more information, visit
www.mentalhealthcommission.ca

The WHO Resource Book on Mental Health, Human Rights and Legislation, World Health Organization
Mental well-being is a human rights issue, and laws can help protect people and promote well-being. The WHO Resource Book on Mental Health, Human Rights and Legislation describes the human rights approach to mental health and discusses the role of laws in protecting people and promoting health. To read this resource, visit www.who.int/mental_health.

© 2014

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Stigma and Discrimination | CMHA Victoria Office (BC Division)

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About one in five people—over six and a half million Canadians—experience a mental illness or substance use problem in their lifetime. Unfortunately, many people don’t ask for help because they feel ashamed or scared. People may judge them and treat them negatively based on a mental health or substa…

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Resources, Education, Employment, and Support

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Resources, Education, Employment, and Support

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Welcome Back to the Newly Renovated DCC!

All programming will resume at our Pandora location starting on December 5th. Until then:

November 21-25 - last week of programming at Anawim and REES

November 28-December 2 - no programming

December 5 - programming resumes at the DCC
November 21-25 programming as noted below: Queer Yoga
Details: Drop in to a guided yoga class for 2SLGBTQA+ folks and their allies, where all levels are welcome and all yoga supplies are provided

When: Starting Monday August 8

Where: Meet at Anawim House, 973 Caledonia Avenue

Time: Mondays from 10:30 am to 11:45 am
*Please note, Queer Yoga will not happen on Monday August 22 Community Arts
Details: Drop in to our art studio and have access to numerous art supplies to create independent pieces

When: Starting Monday, August 8

Where: Meet at Anawim House, 973 Caledonia Avenue

Time: Mondays from 1:00 pm to 3:00 pm
*Please note, Community Arts will not happen on Monday August 22 Board Games
Details: Join us to play games for free in a supported team environment

When: Starting Tuesday, August 9

Where: Meet at Interactivity Board Game Cafe, 973 Yates Street

Time: Tuesdays from 1:00 pm to 3:00 pm
*Registration is required Every Step Counts
Details: Join us for a walk or run as we use movement to foster community and confidence

When: Starting Wednesday, August 10 ( Please note: there are no ESC sessions on October 5th or October 19th)

Where: Meet at REES, 465 Swift Street

Time: Wednesdays and Thursdays 1:00 pm to 3:00 pm

We will likely host special one-off events including outings, gallery tours, movies, etc., We will reach out with these details as they happen!

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Resources, Education, Employment & Support

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All programming will resume at our Pandora location starting on December 5th.

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British Columbia Centre On Substance Use: 

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British Columbia Centre On Substance Use: 

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Suite 400 1045 Howe St, VANCOUVER BRITISH COLUMBIA V6Z 2A9 · ~90.6 km

(778) 945-7616

bccsu.ca

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Decriminalization refers to the repeal or removal of laws and policies that prohibit drug use and possession.

Legalization refers to a status wherein the production, possession, and consumption of particular drugs are legal under certain circumstances.

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What is decriminalization?

Decriminalization refers to the repeal of laws and policies that define drug use and/or the possession of drugs for personal use as a criminal offence. Trafficking and production are still considered criminal activities. Drug use becomes an administrative, rather than a criminal, offence and is moved to the jurisdiction of public health.

The harms associated with the criminalization of drugs are well documented, and include high rates of incarceration for nonviolent drug offences and the associated consequences, stigma and discrimination, and barriers to service provision. People are denied services or are afraid to use the services and supports they need. People are evicted from their housing and have their children taken away. They are also forced into unsafe spaces and behaviours, which can lead to overdoses and blood-borne infections like HIV and Hepatitis C (Shepherd & Caldwell, 2017).

Shifting Focus

Decriminalization is not about simply making drug use legal. Rather, it is about shifting focus to public health concerns that are more relevant to solving the problems associated with drug use. The use of controlled substances is not so much the cause of social ills as a symptom of them. Problematic substance use is motivated by emotional and physical abuse, loneliness, depression, trauma, poverty as well as genetic factors. While some substances certainly lend themselves to addiction more readily than others, it is difficult to claim that problematic use is a consequence of use alone. It is necessary to implement social programs that fill the care gaps left by punitive approaches to drug policy when adopting decriminalization. Ensuring access to social supports can address the conditions that lead to problematic substance use in the first place (CSSDP, n.d.).

What are the Benefits of Decriminalization?

Removing criminal penalties for drug possession and low-level sales would (Drug Policy Alliance, n.d.):

Save money and human lives by reducing prison costs and population size

Free up law enforcement resources to be used in more appropriate ways

Prioritize health and safety over punishment for people who use drugs

Reduce the stigma associated with drug use so that individuals are encouraged to seek healthcare, treatment and other support

Remove barriers to evidence-based harm reduction practices, treatments, and research such as drug checking, opioid-substitution therapy, medical marijuana, and psychedelic-assisted therapy research

Will Decriminalizing Drugs Increase Drug Dependency or Crime?

A common fear is that decriminalizing drugs will lead to more drug dependency and crime. There is no indication this is true. Data from Canada and around the world suggests that treating problematic drug use as a health issue, instead of a criminal one, is a more successful model for keeping communities healthy and safe.

Portugal decriminalized drug possession in 2001. More than a decade later, drug use has remained about the same - but arrests, incarceration, disease, overdose and other harms are all down (Drug Policy Alliance, n.d.):

Portugal's drug use rates (which used to be high) remain below the European average and far lower than rates of drug use in Canada and the U.S.

Between 1998 and 2011, the number of people in drug treatment increased by more than 60%.

The number of new HIV diagnoses dropped dramatically - from 1,575 cases in 2000 to 78 cases in 2013 - and the number of new AIDS cases decreased from 626 in 2000 to 74 cases in 2013

Drug overdose fatalities also dropped from about 80 in 2001 to just 16 in 2012

The number of people arrested and sent to criminal courts for drug offences annually declined by more than 60% following decriminalization.

The percentage of people behind bars in Portugal for drug law violations also decreased dramatically, from 44% in 1999 to 24% in 2013

Decriminalization models

Decriminalization is implemented in a variety way around the world. So far there are 21 countries that have adopted models that fit one of the following descriptions (CSSDP, n.d.):

De Jure (by law):
No Offence: Police Discretion: Administrative Decision:

Possession is an administrative offence

Police can detain people for possession and refer them to an administrative body. Only intent to supply is a criminal offence

Applicable sanctions: confiscation, warning or fine, referral to treatment (states can implement "dissuasion committees" comprised of legal, health and social work professionals)

Example: Portugal, Czech Republic

Criminal Justice Decision:
De Facto (by non-enforcement of laws):
No Sanction: Criminal Justice Diversion:
(Canadian Students for Sensible Drug Policy [CSSDP], n.d.)

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Decriminilization & Legalization - Harm Reduction TO

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Decriminalization refers to the repeal of laws and policies that define drug use and/or the possession of drugs for personal use as a criminal offence. Trafficking and production are still considered criminal activities. Drug use becomes an administrative, rather than a criminal, offence and is moved to the jurisdiction of public health.

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Trauma-Informed Practice Guide (May 2013)

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Trauma-Informed Practice Guide (May 2013)

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Getting sober is hard and can be expensive, Cedars treatment center is a well known and effective location but unfortunately not an exception when it comes to cost.
The programs offered are reflected in this though! Cedars offers unique treatment plans to each individual and realizes that sobriety is only the first step in a true recovery and offers paths towards staying clean after you've left the center

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Addiction is a treatable illness

At Cedars, we recognize that addiction is a treatable illness. With precise care properly applied, abstinence and long-term recovery from addiction can be expected. Our drug and alcohol treatment facility is located near Victoria on beautiful Vancouver Island, British Columbia. Our centre in Cobble Hill provides a picturesque landscape and a tranquil treatment setting. Vancouver Island is renowned for spectacular West Coast scenery and features a vast network of recovery communities.

If you or someone you love needs help with addiction or is suffering from a Drug Addiction or Substance Abuse, Alcohol Addiction, Trauma, OSI, PSI, or a Process or Behavioural Addiction, there is help available. Cedars is committed to doing everything possible to ensure that our patients receive the best treatment for a full recovery and a renewed ability to lead a meaningful and rewarding life.

Our residential addiction treatment facility provides a complete network of support to help you in your path to recovery, along with individualized treatment plans to address unique needs to help with success. Our Residential Addiction Programs help to provide full recovery outcomes, including improving self-esteem, repairing relationships with self and others, and setting goals to build the foundation for lasting change.

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Addiction is a treatable illness At Cedars, we recognize that addiction is a treatable illness. With precise care properly applied, abstinence and long-term recovery from addiction can be expected. Our drug and alcohol treatment facility is located near Victoria on beautiful Vancouver Island, British Columbia.