Case Study: Harm Reduction at Covenant House Vancouver

Covenant House Vancouver initiated a two-year harm reduction pilot project within our Street Outreach and Drop-in Centre, to prepare for our new Sanctuary Program and to create an avenue to better support youth requiring exceptionally complex care.

British Columbia has been amid a public health emergency as a result of the increasing deaths due to opioids. Since the public health emergency was declared in 2016, over 7,760 individuals in BC have died of opioid overdose

The BC Centre for Disease Control, in a position statement published in 2018, endorsed harm reduction practices in “preventing and reducing undue health, social, cultural and economic harms of substance use.” Harm reduction practices have been endorsed by all levels of government. 

In BC, there are only 124 treatment beds for youth. There is a promise for an additional 123 beds by 2022; however; this falls far short of the need, which is estimated to be closer to 1,000 beds. Until the supply meets the demand, there will be a need for services like Covenant House Vancouver to engage and maintain connections with youth, supporting them until they are able to access treatment.  

It is important to include those youth who are pre-contemplative and have not made the decision to address their substance use. Developing services to support youth with addiction/substance use issues is challenging because there is not a coordinated system for the provision of substance use services. This can lead to significant gaps and differential services between health authorities and communities. 

“Harm reduction practices have been endorsed by all levels of government”

Covenant House Vancouver’s approach to harm reduction is and will continue to be about engaging with youth to move from one stage of change to another in the safest way possible. The introduction of harm reduction practices does not mean we will encourage or support youth to remain in active addiction. Our programming will remain focused on supporting youth to make healthy choices about their substance use, and to take the steps necessary to support a healthy and successful future.

Covenant House Vancouver currently provides: 

  • Monitoring, individual case management and emergency aid; 
  • On-site clinical support to youth with concurrent disorders; 
  • Training on the provision and use of naloxone which is used in the treatment of opioid toxicity; 
  • Referrals to treatment programs for youth ready for treatment; 
  • Support for prescription alternatives to illicit drug use for young people that qualify for this support as determined by their prescriber; 
  • Support for youth to make healthy decisions around their substance use. 

The model of service at Covenant House is well suited to effectively support the use of harm reduction practices. Evidence informed practices and strong theoretical approaches such as attachment theory and Trauma-Informed Practices are very effective for working alongside harm reduction practices.  

Our one-size-fits-one approach, utilizing strength-based and positive-youth-development practices, support the ability to build trusting relationships with youth, which is fundamental to successfully applying harm reduction practices.  

We are focused on supporting youth as individuals to move towards health and wellness.