May 29, 2002
Dear Colleague,
Attached is a paper entitled CAMH and Harm Reduction: A Background
Paper on its Meaning and Applications for Substance Use. This paper
and its Executive Summary were recently approved by CAMH's Board of Trustees
and represent the Centre's approach to harm reduction.
As you may be aware, public policy development is one of the Centre's
long-term priorities. Since October 1999, the Centre has dedicated resources
to public policy development, and with input from staff, clients, families
and stakeholders, has developed positions on key issues of importance
to our clients. Harm reduction is one of these key issues.
Because the meaning, practice and implications of harm reduction continue
to be matters of considerable discussion, Centre experts suggested that
establishing a CAMH evidence-based definition of harm reduction might
bring greater clarity to the public debate. Because there is a scarcity
of hard evidence in the field, a secondary objective was to make the case
for more research funding, to look at the effectiveness of harm reduction
strategies.
This paper was developed by a CAMH staff group. The group was made up
of experts representing every major area of the Centre's addiction activities,
to ensure that the perspectives of all parts of the organization, and
the stakeholders with which they work, were taken into account. The staff
group reviewed the literature on harm reduction and was also informed
by the work that Dr. Patrick Smith did with the City of Toronto's Harm
Reduction Facilities Working Group of the Homeless Health Strategy, a
process involving broad community input.
Guided by practical examples of the application of harm reduction in
their various programs, members of the group were able to reach consensus
on a definition and guiding principles for the concept. However, the group
acknowledged that harm reduction is not a "one size fits all"
solution to addiction and other problems associated with drug use, but
is one approach within a broader spectrum of client-centred services that
also includes programs with an abstinence-based philosophy.
There was general agreement about the need to clearly articulate that
harm reduction is not intended to encourage substance use, and that research
and evaluation of harm reduction programs need to ensure that the strategies
used are actually reducing harm.
We hope that this CAMH paper will help to inform the on-going debate
about harm reduction. The background paper is comprehensive and includes
a bibliography of available research. The executive summary is intended
for a more general audience.
If you have any questions or comments about the paper, please contact:
Dr. Patrick Smith
Vice President, Clinical Programs
416-535-8501, ext. 6567
or
Patricia Erickson, Ph.D.
Senior Scientist, Social, Prevention and Policy Research Dept.
416-535-8501, ext. 4497
or
Dr. David Marsh
Clinical Director, Addiction Programs
416-535-8501, ext. 4459
Yours sincerely,
Jean Simpson
Executive Vice President and Chief Operating Officer
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1-800-463-6273
