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It’s important to think about the physical set-up and design of the space—be it a fixed site or mobile service—in order to minimize escalation. Harm reduction leaders and others identified two important lenses with which to view physical design and set-up:

  • Sensitivity to Trauma—“Trauma-informed” is basically a sensitivity to the fact that the population being served and the staff serving them are people who have experienced trauma, and that trauma experiences can be triggered in part by the physical set-up of a space/services.
  • Safety—This means being attentive to the physical safety of your participants and staff with regard to accessibility, injury, and violence prevention.

Harm reduction leaders made clear that all decisions made about the physical design and set-up of services should consider safety and sensitivity to trauma, and should err on the side of sensitivity to trauma when they are in conflict. This is because people who are in trauma response are often the least safe when they are agitated, so it’s essential that harm reduction organizations minimize trauma reactivity responses as much as possible.

These leaders also agreed that defining the parameters of the spaces was the most important first step in designing a harm reduction space.

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Medical gloves should be worn whenever handling exposed or used supplies, especially those that might be used to prepare or use injection drugs such as syringes, cottons, cookers, tourniquets, and ascorbic acid. Gloves should be changed often, especially between activities or participants.
These principles were developed over a period of about four years in the 1990s amid much debate among early harm reductionists, who came to consensus on these enduring principles of harm reduction.