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Harm Reduction Practice: Substance Use Conversations Part 3 of 3

Harm Reduction Practice: Substance Use Conversations Part 3 of 3. Challenges, strategies, and resources. Challenges. Myths and assumptions Harm reduction enables/supports drug use Drug users are not concerned with health Safety of other residents/women

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Harm Reduction Practice: Substance Use Conversations Part 3 of 3

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  1. Harm Reduction Practice: Substance Use ConversationsPart 3 of 3 Challenges, strategies, and resources

  2. Challenges • Myths and assumptions • Harm reduction enables/supports drug use • Drug users are not concerned with health • Safety of other residents/women • Triggers re: violence for other survivors • Young women users • Using moms

  3. Dominant ideologies • Broaching the subject of drug or alcohol use

  4. Transferable Skills • Non-judgmental • Unconditional positive regard • Belief that she is deserving of safety and support • Safety planning • Coping skills

  5. Counselling Themes • Trauma • chaotic, long term, unwanted use is most often linked to surviving complex childhood trauma and/or trauma in adulthood • Self medication, managing emotional pain • Building safety by developing a range of grounding and flashback management skills • Resolving childhood trauma, addressing self worth and making sense of what has happened Can you work through trauma while using drugs?

  6. Counselling Themes • Grief and loss • Long term or chaotic drug use often results in a number of losses • The overlay of stigma creates further barriers in getting support to work through these losses • Support a woman to talk about her grief and loss, normalize, acknowledge and sit with the emotions • Storying memories can be helpful and can be done informally. • Support to do or access rituals, spiritual rites • Themed user positive groups (ie. child welfare)

  7. Counselling Themes • Health • Physical and emotional health while using (OD prevention, safety planning, auto injection) • Access and education re: safer use supplies “Works” • Access to non-judgemental health services to address abcesses, cellulitis, vein care, lung health • Advocacy within medical systems and services

  8. Counselling Themes • Advocacy • Medical and health services • Child welfare services • Housing • Income support • Criminal justice system • Internal policies that stigmatize drug users

  9. Goals • User, self-identified goals • Teasing out abstinence based goals • Plan A and Plan B • Strengths based

  10. “Triggers” Differences between trauma triggers and using triggers

  11. Triggers and Strategies • Awareness and practical planning

  12. “Things I Need” An exercise to shift internalized shame • Ask her to make a list of positives connected using her drug of choice (I usually write) • Be curious and reflect back your understanding of each positive • Keep probing to make the list as long as possible • When she is done, write the actual title of the exercise at the top of the page • Debrief her reactions and feelings • Use this exercise as a roadmap for goal setting

  13. Resources Mella and Bo Yih email contact: • harmreductionconsultants@gmail.com Canadian Harm Reduction Network: • canadianharmreduction.com Ontario Harm Reduction Distribution Program: • http://www.ohrdp.ca/

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