Subject Guide: Harm Reduction for Healthcare Practitioners

Madeleine Fyffe & Jill Henderson / LIBR 530 / November 25, 2025

Context

Audience

This guide centres on harm reduction, a practice that aims to reduce the harmful social, legal, and health impacts of substance use^[1]. The resources included are intended for those working in healthcare in British Columbia, including clinical practitioners who want to be informed about substance use and addiction and incorporate harm reduction into their practice.

Scope Note

This guide consists of information on harm reduction in British Columbia as it relates to healthcare, and encompasses background information about the intentions and applications of harm reduction. This includes information on substance use and people who use drugs, the history of the toxic drug crisis in British Columbia, academic and clinical research on substance use and addiction in healthcare, harm reduction services available in British Columbia, and the implementation of harm reduction in healthcare and clinical settings. This guide is for those working in healthcare and clinical settings in British Columbia who wish to implement harm reduction as both a practice and an ethos.

Subject Headings and Call Numbers

The following are subject headings and call numbers used to organize knowledge in this topic area. Please note that many of the terms used to classify knowledge around substance use are outdated and stigmatizing.

Subject Headings

Library of Congress Subject Headings

Drug addicts–Services for–British Columbia
Drug addiction
Drug addiction–Treatment
Harm reduction
Harm reduction–British Columbia
Substance abuse

Medical Subject Headings

Drug Users
Harm Reduction
Substance Abuse Treatment Centers
Substance-Related Disorders
Substance-Related Disorders / prevention & control

Call numbers

Dewey Decimal Classification

362.29 — Social sciences. Social problems and social services. Social problems of and services to groups of people. Mental illness. Substance abuse.
616.86 — Technology. Medicine & health. Diseases. Diseases of nervous system and mental disorders. Substance abuse, drug abuse.

Library of Congress Classification

HV5840 — Social sciences. Social pathology. Social and public welfare. Criminology. Social pathology. Social and public welfare. Drug habits. Drug abuse.
RC564 — Medicine. Internal medicine. Neurosciences. Biological psychiatry. Neuropsychiatry. Psychopathology. Personality disorders. Behavior problems.

National Library of Medicine Classification

WM 270 – Substance-related disorders.

Seminal Works


The Harm Reduction Gap: Helping Individuals Left Behind by Conventional Drug Prevention and Abstinence-only Addiction Treatment Sheila P. Vakharia Description: This book introduces readers to the concept of harm reduction, including its history, main tenets, and practical applications. By exploring the stigmatizing policies around substance use (both historic and current), Vakharia contextualizes harm reduction and makes a case for its implementation as an alternative to abstinence-based treatments. Justification: The Harm Reduction Gap is an excellent introduction to harm reduction, especially for those unfamiliar with the concept or its roots. The writing style is accessible and engaging, and the book provides practitioners with evidence on the effectiveness of harm reduction initiatives. Citation: Vakharia, S. (2024). The harm reduction gap: Helping individuals left behind by conventional drug prevention and abstinence-only addiction treatment. Routledge. Accessed: Digital (University of British Columbia Library)
Saving Our Own Lives: A Liberatory Practice of Harm Reduction Shira Hassan Description: Saving Our Own Lives is an anthology of essays by people who, after being neglected by the healthcare system, began to practice grassroots harm reduction. These types of frontline practices contributed to the development of the current model of harm reduction now practiced in clinical settings. Justification: This work covers the history of harm reduction from first-hand perspectives of those who first implemented harm reduction in their communities in order to keep each other alive. It is important to understand the roots of harm reduction and learn from those personally impacted by harm reduction. Citation: Hassan, S. (2022). Saving our own lives: A liberatory practice of harm reduction. Haymarket Books. Accessed: Print (Vancouver Public Library)
In the Realm of Hungry Ghosts: Close Encounters with Addiction Gabor Maté Description: Informed by his experience practicing medicine in Vancouver’s Downtown Eastside community, Maté recounts his patients’ life stories. A theme across those who experience the most hardship and debilitating drug addiction are experiences of trauma in early childhood development. Justification: This work is one of the first accessible sources on what we now refer to as the “Social Adaptation Model” of addiction from the perspective of a medical practitioner in Vancouver, BC. Citation: Maté, D. G. (2008). In the realm of hungry ghosts. Knopf Canada. Accessed: Print (personal copy)

Resources


DULF Published Academic Research Drug User Liberation Front Description: The Drug User Liberation Front is a collective of people who use drugs, researchers, healthcare workers, and advocates that work to provide a safe supply of illicit drugs directly to people who use drugs at no cost in Vancouver, BC. This is an index of published academic research on the outcomes of their program. Justification: This index of published academic research provides a radical and evidence-based collection of resources to advocate for safe supply and demonstrate how it impacts the health of people who use drugs, including by curbing overdose. Citation: Drug User Liberation Front. (2025, March 12). Published academic research. DULF. https://dulf.ca/published-academic-research/ Accessed: Website
VANDU Reports and Research Vancouver Area Network of Drug Users Description: The Vancouver Area Network of Drug Users is a collective of people who use drugs who advocate for their specific needs in order to live healthy and productive lives. These resources, which include both academic and non-academic reports and articles about community-based harm reduction initiatives, are endorsed by those who use drugs. Justification: It is important for practitioners to have information from those with lived experience so people who use drugs can have agency over the information about their experiences, especially within the healthcare system. Citation: The Vancouver Area Network of Drug Users. (n.d.). Reports, case studies, and oral histories. VANDU. https://vandu.org/reports/ Accessed: Website
BCCDC Harm Reduction Clinical Resources British Columbia Centre for Disease Control Description: The British Columbia Centre for Disease Control is a division of the Provincial Health Services Authority that addresses diseases and treatment in British Columbia. This is a resource guide for clinical practitioners looking to learn about and implement harm reduction, and includes toolkits, reports, and guidelines. Justification: The BCCDC is the provincial government authority on health in the region. This guide is designed to be current and thorough and provides comprehensive information and best practices that can be implemented by clinical practitioners. Citation: Provincial Health Services Authority. (n.d.). Harm reduction clinical resources. British Columbia Centre for Disease Control. Retrieved November 20, 2025, from https://www.bccdc.ca/health-professionals/clinical-resources/harm-reduction Accessed: Website
VCH Harm Reduction Resource Guide Vancouver Coastal Health Description: Vancouver Coastal Health is the local health authority for Vancouver, Richmond, and the coastal regions of British Columbia. This is a consolidated list of harm reduction services offered in the region, such as currently offered Naloxone training sessions. Justification: VCH is the health authority that provides services to Vancouver. This includes the Downtown Eastside neighbourhood, which is an area people who use drugs rely on to provide unique harm reduction services, such as supervised injection sites. This guide is kept current with health information and local harm reduction services. Citation: Vancouver Coastal Health. (n.d.). Harm reduction. Retrieved November 20, 2025, from https://www.vch.ca/en/health-topics/harm-reduction Accessed: Website
BCCSU Healthcare Provider Resource Guide British Columbia Centre on Substance Use Description: This is a collection of resources designed specifically for healthcare workers. The British Columbia Centre on Substance Use is an evidence-based centre for research, conferences, and networking that informs clinical care and research on substance use and addiction. Justification: This guide is designed for healthcare workers looking to learn about harm reduction and implement it into their clinical practice, and includes practical links to services and programs in BC. Citation: British Columbia Centre on Substance Use (n.d.). Healthcare provider resources. Retrieved November 20, 2025, from https://www.bccsu.ca/resources/ Accessed: Website
Crackdown Podcast Garth Mullins & Crackdown Editorial Board Description: This monthly podcast is created by and told from the perspective of people who use drugs in Canada. It covers a wide array of topics around substance use, drug legislation, and activism, and includes narrative episodes that detail the first-hand experiences of those directly impacted by the current toxic drug crisis. Justification: Crackdown is engaging, well-researched, and award winning, and the podcast format offers an alternative to text-based resources. Many episodes are Vancouver-, BC-, or Canada-based, so it could be especially useful in helping healthcare practitioners understand the place-based dynamics of substance use. Hearing the personal stories of those on the frontline of the toxic drug crisis could encourage practitioners to provide treatment that is more empathetic and patient-led. Citation: Mullins, G. (Host). (2019–present). Crackdown [Audio podcast]. https://www.crackdownpod.com/episodes Accessed: Spotify, YouTube, website
Harm Reduction Journal BioMed Central Description: Harm Reduction Journal is a peer-reviewed academic journal that publishes research, case studies, and literature reviews. It aims to minimize the stigmatization and criminalization of marginalized communities. Volumes include articles on a broad range of harm reduction topics, but a large majority of them concern substance use. Justification: Harm Reduction Journal has 22 volumes, so it is comprehensive but not unwieldy or overwhelming to browse. It is an accessible entry point to academic scholarship, as it is an open access journal, and its ethos is one of social justice. Citation: Harm Reduction Journal. (n.d.). Articles. BioMed Central. Retrieved November 20, 2025. https://harmreductionjournal.biomedcentral.com/articles Accessed: Website (open access)
Harm Reduction Treatment for Substance Use (Guide) Susan E. Collins and Seema L. Clifasefi Description: This guide is evidence-based and written specifically for practitioners. It outlines the specific components of harm reduction treatment, and includes empirical evidence, case studies, and practical tools. Justification: The resource was written by a psychologist and a social worker in collaboration with community members, so it provides a complementary perspective to the more medically-oriented resources in this guide. It is backed by evidence, but written from a compassionate lens. It provides example scripts and handouts which can be used in daily practice. Citation: Collins, S. E. & Clifasefi, S. L. (2023). Harm reduction treatment for substance use. Hogrefe. Accessed: Digital (Google Books)
FNHA Courageous Conversations on Substance Use Toolkit First Nations Health Authority Description: This toolkit was written by Indigenous people, several of whom who have lived experience with substance use. It aims to give community members and health care providers practical tools to approach substance use from a culturally sensitive perspective, and provides step-by-step guidance on having compassionate conversations about the topic. It also illuminates how settler colonialism continues to exacerbate substance use harms for Indigenous communities. Justification: One of the factors contributing to the toxic drug crisis’s disproportionate impact on Indigenous communities is a lack of culturally sensitive harm reduction services. Providing culturally safe substance use services to Indigenous communities is a vital component of both harm reduction and reconciliation, and practitioners should know how to discuss these issues with Indigenous patients compassionately and in an informed manner. Citation: First Nations Health Authority & British Columbia Centre on Substance Use (n.d.). Courageous conversations on substance use toolkit. https://www.fnha.ca/Documents/FNHA-Courageous-Conversations-Tool-Kit.pdf Accessed: Online PDF, via website
BCCDC Unregulated Drug Poisoning Emergency Data Dashboard British Columbia Centre for Disease Control Description: The British Columbia Centre for Disease Control’s interactive data dashboard provides various statistical datasets relevant to the toxic drug crisis, including paramedic attended events, unregulated drug deaths, naloxone use, and opioid agonist treatments. It allows users to filter for specific years and health authorities. It also includes explanatory notes about what the BCCDC is measuring and why. Justification: These datasets, created in collaboration with the Ministry of Health, help to give practitioners context and perspective on the impact of the toxic drug crisis, as well as on harm reduction initiatives. It may be important to have access to current statistical data to justify harm reduction initiatives to employers and stakeholders. Citation: British Columbia Centre for Disease Control. (2025). Unregulated drug poisoning emergency dashboard [Data set]. Retrieved November 20, 2025, from https://www.bccdc.ca/health-professionals/data-reports/substance-use-harm-reduction-dashboard Accessed: Website
FNHA First Nations Toxic Drug Crisis Data First Nations Health Authority Description: This resource includes annual reports about the impact of the toxic drug crisis on First Nations people in BC, as well as data about existing Indigenous harm reduction initiatives and impacts on First Nations youth. It also includes current information about the First Nations Health Authority's ongoing responses to the toxic drug crisis. Justification: The First Nations Health Authority is recognized as an authoritative source for First Nations health data in BC, and this comprehensive and accessible collection of data tangibly demonstrates the disproportionate impact of the drug crisis on First Nations communities. This information can help practitioners ensure they are providing relevant and useful services, and justify implementing Indigenous harm reduction initiatives in their practice. Citation: First Nations Health Authority. (n.d.). Toxic drug crisis data. Retrieved November 20, 2025, from https://www.fnha.ca/what-we-do/mental-wellness-and-substance-use/harm-reduction-and-the-toxic-drug-crisis/toxic-drug-crisis-data Accessed: Website
CEWH & CPHA Public Health Approach to Substance Use Handbook Centre of Excellence for Women’s Health & Canadian Public Health Association Description: This handbook discusses harm reduction, trauma-informed practice, and stigma, and is intended to serve many different types of service providers. It includes discussion questions, tools for practice, a glossary, and a comprehensive list of resources for further reading. Justification: This resource emphasizes how race and gender are intertwined with inequities in substance use treatment, which is a nuance not always acknowledged. Its interactive elements, including discussion questions and activities, enrich the more static, textual components of the rest of the guide. It is versatile, as it can be completed individually or in groups, and encourages practitioners to think critically about their own positionality. Citation: Centre of Excellence for Women’s Health & Canadian Public Health Association. (2023). A public health approach to substance use handbook. https://www.substanceuse.ca/public-health-approach-substance-use-handbook Accessed: Online PDF, via Substance Use Resource and Knowledge Exchange Centre (SURE) website

Links to Other Subject Guides

↑ Harm Reduction International (n.d.). "What is Harm Reduction?".

[1] Harm Reduction International (n.d.). "What is Harm Reduction?".

[1]