A COMMUNITY’S PERSPECTIVES OF HARM REDUCTION STRATEGIES

Background: Approximately 22% of Canadians meet the criteria for substance use disorder in their lifetime. Rural and remote Indigenous communities, such as Cumberland House, Saskatchewan, face unique challenges in accessing essential healthcare services to address substance use. The nearest opioid replacement therapy, detox, and treatment centers are located 3.5 hours away, creating significant barriers to timely care. In response, a federally funded, community-led harm reduction program was established in 2019, including the hiring of a harm reduction nurse. Objectives and Methodology: This secondary data analysis examined the impact of substance use in Cumberland House and explored community perspectives of harm reduction. Data from semi-structured interviews with twenty-one community members were utilized. This analysis utilized Willie Ermine’s Ethical Space as a framework, which integrates Indigenous and Western perspectives. Findings: Methamphetamine was identified as the primary substance of concern, with its rising use linked to trauma, isolation, and economic hardship. Substance use has disrupted family relationships through overdose-related losses, strained connections, and heightened fear and stigma within the community. The study revealed widespread misconceptions and limited understanding of harm reduction. Most participants were unaware that the harm reduction nurse provided a broad spectrum of services including recovery-based treatment referrals. Conclusion: This study highlighted the urgent need for education about harm reduction in order to build sustainable, community-led, and culturally appropriate initiatives for substance use. A comprehensive approach integrating harm reduction within Saskatchewan’s new Recovery-Oriented-Systems of Care (ROSC) is essential. Without integration of harm reduction strategies, risks of reinforcing stigma, increasing disease transmission, and limiting access to life saving care will continue. Moving forward, policymakers must commit to long-term investments that support evidence-informed harm reduction strategies that are community-led.