Harm Reduction Hacks in Focus: Space Hacks
Essential Policies and Procedures for All Harm Reduction Sites and Services
There are 7 hacks in this section
Clarity, Consistency, Care
Fair systems build calm spaces
There are a number of basic policies and procedures that nearly all harm reduction leaders regarded as essential to providing chill and safe services to participants. The most important is consistent service and supply management, and next are policies around community agreements, participant agreements, procedures, and misconduct processes for when people step out of bounds.
Hacks for Service and Supply Management
Many of the harm reduction leaders that were interviewed for Space Hacks talked about how critical it is to effectively manage services, supplies, and inventory in order to maintain community tranquility. It may not feel intuitive, but OGs report that ineffective management of supplies is the number one potential flashpoint for escalated situations during harm reduction services.
Hacks for Service and Supply Exceptions
There are always going to be exceptions to the rule of thumb about consistency regarding service provision. At times, certain participants will need to be treated differently than other participants. For example, people who are pregnant may be treated differently, elderly people may be treated differently, people who are providing satellite exchange services to large community groups may also be an exception or have special privileges.
Hacks for Service and Supply Interruptions
As with exceptions, supply interruptions can be handled with the same transparency and communication. Be explicit with people about why the interruption is happening and tell them when it might be over. Be sure to remain equivocal if you aren’t sure about things. Authentic ambiguity is preferable to disingenuous certainty.
Hacks for Community Member Agreements
Community member agreements are shared agreements regarding behavior expected of everyone who participates in a harm reduction site or service. The primary rule all harm reduction leaders talked about was the need to treat everyone with respect.
Hacks for Participant Grievance Processes
At their most basic, grievance procedures provide a formal mechanism for your participants to have their concerns, grievances, and voices heard and taken seriously. Too often, participants are re-traumatized by the provider/participant power imbalance when provider perspectives are given deference—in other words, when providers are automatically believed.
Hacks for Misconduct Processes
Misconduct procedures must be equitable and consistent with clear mechanisms for appeal, ensure that all parties are heard, and that issues, when they do arise, are dealt with individually as much as possible.
Hacks for Overdose, Overamp, & Medical Emergencies
In addition to the necessity for policies for service and supply management, community agreements, grievance, and misconduct processes, another essential set of policies harm reduction leaders consistently recommended were protocols for dealing with potential overdose, overamp, and medical emergencies such as heart attack or stroke.
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“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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"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 -
"Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
Martin Luther King Jr. -
"We have to be ready and able to reach clients where they are, not where we want them to be”
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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 -
"We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
Jules Netherland -
"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 -
"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 -
“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 -
"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. -
"Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
Dominique de Villepin -
“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 -
"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 -
"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 -
“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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“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.”
-
“Boundaries help me to give all that I can and still come back tomorrow.”
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"There isn’t a way things should be. There’s just what happens, and what we do."
Terry Pratchett -
“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 -
"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 -
"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. "
-
"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 -
"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 -
“As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
-
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 -
“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
- “In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
- "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"
- "Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
- "We have to be ready and able to reach clients where they are, not where we want them to be”
- “One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
- "We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
- "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."
- "The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
- “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.”
- "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."
- "Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
- “The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
- "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."
- "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."
- “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.”
- “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.”
- “Boundaries help me to give all that I can and still come back tomorrow.”
- "There isn’t a way things should be. There’s just what happens, and what we do."
- “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."
- "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.”
- "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. "
- "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."
- "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."
- “As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
- 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.”
- “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.”