At the core of harm reduction, Hobbs says, are relationships.

“It’s a way of being in a relationship with another human being that aims to come from a place, as much as possible, of non-judgement and of care—and really of love.”

Hobbs says in her experience, what works is having support workers meet people where they are on their journey of substance use while keeping them safe without fear-based messaging—a philosophy she has seen work especially well with teens.

“Youth are often trying to find out who they are and where they fit in the world and that’s a time when people are exploring their own independence, so really respecting that and coming to where they’re at works really well,” she says.

Alan Rycoft (right), community relations manager for the Victoria Cool Aid Society, a housing organization, agrees harm reduction options—including supervised consumption sites—are vital to keeping young people safe.

“There’s been a war on drugs forever, it’s been a total failure. People are going to consume their drugs whether we like it or not,” he says. “The current supply on the street can be extremely dangerous, in fact lethal, and so it’s very important that we recognize we have a health emergency and that we need to respond to every member of the community.”

Marnie Goldenberg, director of youth services for Family Services of Greater Vancouver and for Directions Youth Services, a Vancouver-based resource for at-risk and homeless youth,
says harm reduction is a critical tool for assisting youth.

“An abstinence-based approach is not a model of care that is most inclusive,” she says. “We see the value of offering care based around harm reduction every day.” Goldenberg recalls a “clarifying” moment relayed to her by a staff member, involving an interaction with a youth staying at a safe house being offered a clean needle.

“This young person said, ‘I never realized I was worth clean needles’,” she says. “When you think of that individual and what they’ve learned about their self-worth, stating that ‘you are of course worth clean needles’ is the baby step that might allow a person to then hear a message of ‘you’re worth so many things’.”

Goldenberg also points out that substance use is entwined with many other social issues, noting some youth experiencing homelessness use drugs to stay awake all night to stay alert and safe, and that almost all of the youth who access Directions Youth Services are coping with some form of trauma.

According to Time to Listen: Youth Voices on Substance Use, 86 per cent of youth who had a critical injury or died had experienced at least one traumatic incident in their lifetime. These include neglect, assault, domestic violence and/or sexual violence. What’s more, most of the youth (73 per cent) had a confirmed or suspected mental health diagnosis.

“It’s so easy to judge, but in some cases they’re making the choice [to use] because the alternative feels more dangerous,” Goldenberg says. “If you are experiencing pain, you look for ways to manage it. Until we as a society do a better job at addressing pain and having more holistic, long-term methods of supporting people through pain, I think we’re not going to see an end to illicit drug use.”

Help designed for youth, with youth

No matter what the reason for young people using drugs or alcohol, frontline workers agree: More support of every type is needed.