Harm Reduction Hacks in Focus: Space Hacks
Hacks for Addressing Escalation
There are 7 hacks in this section
Navigating Escalated Moments
De-escalation isn’t silence—it’s a skilled, active form of care
Harm reduction leaders offered a lot of their hacks on dealing with escalated situations, and a lot of knowledge emerges from existing literature in medicine, social work, psychology, and so on.
The following is an overview of steps to take, and tips for dealing with escalated situations. In addition, there is a section on specific protocols for incidents that are particular to, or common in, harm reduction service sites; hacks for managing services during an escalated situation, or deciding to discontinue them; group responses that are unique to harm reduction; and finally a few notes about mental health first aid; altogether a set of tools that can be exceptionally useful in escalated situations at harm reduction sites.
Hacks for Empathetic Active Listening
Posted in Hacks for Addressing Escalation.
Once you have grounded yourself during an escalated situation, next engage in active listening with the person who is agitated. This can seem counterintuitive or difficult when you are dealing with somebody who is, for example, screaming at you, and it may feel like you’re rewarding them for being completely irrational. But it is key to getting them more centered and grounded so they’re less agitated and less likely to become a danger to themselves or others.
Reflective vs. Directive Responses
Posted in Hacks for Addressing Escalation.
Obviously, this reflective technique is not always appropriate to the circumstances and to your needs or purposes. At times you may want to be more directive and less reflective in your interactions. You may want to argue, advise, or confront.
Hacks for Non-Verbal Active Listening
Posted in Hacks for Addressing Escalation.
When someone is agitated or in distress, how we carry ourselves can make a huge difference. Non-verbal cues—like posture, breathing, and personal space—can either calm a situation or escalate it further. The following tips offer guidance on using body language to reduce tension, show respect, and create a safer, more grounded interaction.
Hacks for Verbal Active Listening
Posted in Hacks for Addressing Escalation.
In terms of verbal communication, it is most important that harm reduction staff or volunteers remain as calm and centered as possible during the event. Remember the primary purpose of de-escalation is to make the exchange safe for everyone by reducing agitation and tension.
Hacks for Reaching Affirmation & Accord
Posted in Hacks for Addressing Escalation.
One of the main goals of active listening with an agitated person is reaching affirmation and accord. You are looking to try and find ways to agree with the person who is agitated. Even if you don’t entirely agree with the person, try to find at least a small way in which they may be right, or in which you can be on the same page, or team, with them.
Hacks for Enforcing Boundaries and Consequences
Posted in Hacks for Addressing Escalation.
It’s essential that if boundaries need to be enforced or reiterated, they should be addressed in a calm and clear way.
Group Response Hacks: “Show of Power” / The 5cc Method
Posted in Hacks for Addressing Escalation.
Though no one knows exactly where this practice originated, this group response to escalated situations seems to have emerged somewhere in the radical health scene on the West Coast. Both nascent harm reduction workers in the San Francisco Bay Area and harm reduction workers in Seattle have been using this method to diffuse escalated people successfully since at least the 1960s at the Berkeley Free Clinic.
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"Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
Martin Luther King Jr. -
"Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
Fred Rogers -
"Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
Gabor Maté -
"Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
Dominique de Villepin -
"We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
Jules Netherland -
"There isn’t a way things should be. There’s just what happens, and what we do."
Terry Pratchett -
"What should young people do with their lives today? Many things, obviously. But the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured."
Kurt Vonnegut Jr. -
“When another person makes you suffer, it is because he suffers deeply within himself, and his suffering is spilling over. He does not need punishment; he needs help. That's the message he is sending.”
Thich Nhat Hanh -
"Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
Fred Rogers -
“Identify five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell and one thing that you can taste.”
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"The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
Judith Lewis Herman -
“The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
Mayor Jim Kenney -
“As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
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“People who cause harm are often also survivors of harm. If we want to address the roots of violence, we have to honour both truths.”
Danielle Sered -
"I describe my experiences as a nurse volunteer at the overdose prevention site as “being in the right place at the right time doing the right thing.” And that’s exactly where I want to be as a nurse: working outside the system to make a real difference in people’s lives, showing up in the community when it matters most and challenging rules that directly contribute to the overdose crisis, and exposing government inaction by being part of the solution on the ground. For me, this is what nursing is all about."
Marilou Gagnon -
"We have to be ready and able to reach clients where they are, not where we want them to be”
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"Letting go gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything - anger, anxiety, or possessions - we cannot be free."
Thich Nhat Hanh -
“One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
Charles M. Blow -
“In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
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“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Audre Lorde -
"One of the most important things we can do as advocates is to define & make concrete the vague terms used by politicians. What does it mean to “take a public health approach”? What you mean when you say “treatment”? Politicians rarely know. Our job is to make it plain for them."
Jonathan Giftos -
“Many of the harm reduction leaders interviewed talked about the importance of not having too many policies and involving your participants in the development of policies—especially those that impact them directly.”
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"Opponent’s of syringe service programs and harm reduction in general typically remark that it “sends the wrong message.” The message they are referring to is, “We love you and want you to be safe.”
Christopher Abert -
“Boundaries help me to give all that I can and still come back tomorrow.”
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We need to play that game where we require politicians to finish every sentence denouncing supervised injection facilities with the phrase, “and that is why I think injecting alone in a McDonald’s bathroom is better.”
Jonathan Giftos -
"One of the problems that arises with the term “people who use drugs” is that it is intentionally pluralistic in its embrace of ALL people who use drugs—from recreationally to deeply problematically. This makes using it to talk about the things that especially impact people who are using drugs problematically very difficult. "
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"If you question harm reduction works, I can’t help but wonder if you have ever actually seen what happens in these spaces. We promote health safety and dignity, and it works. It is simple, beautiful and changes peoples lives."
Haven Wheelock -
"We live in a world in which we need to share responsibility. It's easy to say "It's not my child, not my community, not my world, not my problem." Then there are those who see the need and respond. I consider those people my heroes."
Fred Rogers
- "Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
- "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
- "Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
- "Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
- "We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
- "There isn’t a way things should be. There’s just what happens, and what we do."
- "What should young people do with their lives today? Many things, obviously. But the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured."
- “When another person makes you suffer, it is because he suffers deeply within himself, and his suffering is spilling over. He does not need punishment; he needs help. That's the message he is sending.”
- "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
- “Identify five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell and one thing that you can taste.”
- "The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
- “The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
- “As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
- “People who cause harm are often also survivors of harm. If we want to address the roots of violence, we have to honour both truths.”
- "I describe my experiences as a nurse volunteer at the overdose prevention site as “being in the right place at the right time doing the right thing.” And that’s exactly where I want to be as a nurse: working outside the system to make a real difference in people’s lives, showing up in the community when it matters most and challenging rules that directly contribute to the overdose crisis, and exposing government inaction by being part of the solution on the ground. For me, this is what nursing is all about."
- "We have to be ready and able to reach clients where they are, not where we want them to be”
- "Letting go gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything - anger, anxiety, or possessions - we cannot be free."
- “One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
- “In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
- “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
- "One of the most important things we can do as advocates is to define & make concrete the vague terms used by politicians. What does it mean to “take a public health approach”? What you mean when you say “treatment”? Politicians rarely know. Our job is to make it plain for them."
- “Many of the harm reduction leaders interviewed talked about the importance of not having too many policies and involving your participants in the development of policies—especially those that impact them directly.”
- "Opponent’s of syringe service programs and harm reduction in general typically remark that it “sends the wrong message.” The message they are referring to is, “We love you and want you to be safe.”
- “Boundaries help me to give all that I can and still come back tomorrow.”
- We need to play that game where we require politicians to finish every sentence denouncing supervised injection facilities with the phrase, “and that is why I think injecting alone in a McDonald’s bathroom is better.”
- "One of the problems that arises with the term “people who use drugs” is that it is intentionally pluralistic in its embrace of ALL people who use drugs—from recreationally to deeply problematically. This makes using it to talk about the things that especially impact people who are using drugs problematically very difficult. "
- "If you question harm reduction works, I can’t help but wonder if you have ever actually seen what happens in these spaces. We promote health safety and dignity, and it works. It is simple, beautiful and changes peoples lives."
- "We live in a world in which we need to share responsibility. It's easy to say "It's not my child, not my community, not my world, not my problem." Then there are those who see the need and respond. I consider those people my heroes."