Harm Reduction Hacks in Focus: Space Hacks
Hacks for Specific Types of Escalated Events
There are 8 hacks in this section
Matching The Response To The Situation
Because not all escalation looks the same—and not all responses should either
Some escalated situations go beyond shouting or pacing. From bathroom blockades and psychotic episodes to stimulant overamp and opioid overdose, harm reduction staff encounter a wide spectrum of crises. This chapter dives into targeted approaches for handling specific high-risk events with empathy, skill, and clarity. Whether it’s managing a quiet standoff or responding to a life-threatening emergency, these hacks help frontline workers navigate unpredictable realities while keeping dignity, care, and safety at the centre.
Hacks for Bathroom and Other Blockades
Posted in Hacks for Specific Types of Escalated Events.
What is a bathroom blockade? That’s when somebody refuses to leave the restroom. Bathroom blockades happen for many different reasons, mostly because people become agitated and confused and/or they are in desperate need of privacy.
Hacks for Extreme Non-Rational Agitation
Posted in Hacks for Specific Types of Escalated Events.
Because participants experiencing psychosis aren’t in touch with consensual reality, they may be easily confused and frightened. For this reason, it is important to be as concrete and clear with the participant as possible.
Notes About Mental Health First Aid
Posted in Hacks for Specific Types of Escalated Events.
Mental health first aid is a set of techniques developed by mental health providers in Australia in the early 2000s. They developed this methodology as a way of diffusing basic mental healthcare techniques to the general population so that they could be better equipped to respond to emotional problems—especially depression, anxiety, and suicidality.
Hacks for Continuing Services During an Escalated Event
Posted in Hacks for Specific Types of Escalated Events.
The decision as to whether or not you are able to continue services during an escalated event is incredibly important and should be given thought before such an event takes place.
Hacks for OD & Response
Posted in Hacks for Specific Types of Escalated Events.
Your protocol for dealing with overdose will vary depending on the physical layout of your site and variables like how far you are from the nearest hospital.
Hacks for Overamp & Response
Posted in Hacks for Specific Types of Escalated Events.
Though less common at harm reduction sites than opioid overdose, overamp can happen to people who use stimulants at any time in any place, so it’s important that you first recognize and know how to respond in case it comes up at your site.
Hacks for Dealing with Medical Emergencies
Posted in Hacks for Specific Types of Escalated Events.
Your staff should be trained in basic CPR and first aid including identifying common medical emergencies like seizures, heart attacks, or strokes. Space Hacks can not list every potential scenario in which someone might need to have 911 called or go to the hospital.
Hacks for Service Management During an Escalated Event
Posted in Hacks for Specific Types of Escalated Events.
It can be difficult or impossible to manage services during an escalated event. Therefore, it is important for everyone on the team to understand that they have a role when there is an escalated event…
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“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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“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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"Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
Martin Luther King Jr. -
"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 -
"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 -
“Boundaries help me to give all that I can and still come back tomorrow.”
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"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 -
“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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"Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
Dominique de Villepin -
“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 -
"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 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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"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 -
"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 have to be ready and able to reach clients where they are, not where we want them to be”
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“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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“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Audre Lorde -
"There isn’t a way things should be. There’s just what happens, and what we do."
Terry Pratchett -
"Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
Gabor Maté -
“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 -
"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 -
"We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
Jules Netherland -
“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 -
"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 -
"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 -
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 -
"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.
- “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.”
- “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.”
- "Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
- "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."
- "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."
- “Boundaries help me to give all that I can and still come back tomorrow.”
- "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."
- “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.”
- "Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
- “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.”
- "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 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. "
- "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."
- "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 have to be ready and able to reach clients where they are, not where we want them to be”
- “As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
- “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
- "There isn’t a way things should be. There’s just what happens, and what we do."
- "Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
- “The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
- "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."
- "We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
- “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.”
- "The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
- "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.”
- 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.”
- "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."