Transcript Harm Reduction Practice: Substance Use Conversations Part

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
– Triggers re: violence for other survivors
– Young women users
– Using moms
• Dominant ideologies
• Broaching the subject of drug or alcohol
use
Transferable Skills
• Non-judgmental
• Unconditional positive regard
• Belief that she is deserving of safety
and support
• Safety planning
• Coping skills
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?
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)
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
Counselling Themes
• Advocacy
– Medical and health services
– Child welfare services
– Housing
– Income support
– Criminal justice system
– Internal policies that stigmatize drug users
Goals
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User, self-identified goals
Teasing out abstinence based goals
Plan A and Plan B
Strengths based
“Triggers”
Differences between trauma triggers and
using triggers
Triggers and Strategies
• Awareness and practical planning
“Things I Need”
An exercise to shift internalized shame
1)Ask her to make a list of positives connected using
her drug of choice (I usually write)
2)Be curious and reflect back your understanding of
each positive
3)Keep probing to make the list as long as possible
4)When she is done, write the actual title of the exercise
at the top of the page
5)Debrief her reactions and feelings
6)Use this exercise as a roadmap for goal setting
Resources
Mella and Bo Yih email contact:
• [email protected]
Canadian Harm Reduction Network:
• canadianharmreduction.com
Ontario Harm Reduction Distribution Program:
• http://www.ohrdp.ca/