THERE IS NO HARM IN HARM REDUCTION

The Toronto Harm Reduction Coalition held its annual general meeting
recently.

Harm reduction?

In its most visible form, it is the needle exchange; the provision of
condoms; advice about AIDS and information about safe crack use; it is
also the occasional warning about street drugs that might be cut with
harmful substances, like the coke available in town these days that
has been cut with veterinary medicine, and is likely to cause severe
skin damage.

In truth, harm reduction is not so very different than encouraging the
use of snow tires in winter, or installing red lights on problem
street corners.

The concept: if we cannot stop people from using drugs -- and we
certainly have not been able to do so since the discovery of drugs --
then how can we reduce the harm drugs do?

This city's harm reduction specialists are among our least-known and
hardest-working health care professionals; they are also the youngest,
the bravest, the worst-paid, the most precariously employed.

The bulk of the annual meeting was a presentation -- really, more of a
free-flowing discussion -- led by Tom Walker, of the Canadian Training
Institute.

He wanted to talk about the "selling" of harm reduction, and he hoped
that people working in the field might have some sort of agreement
about what harm reduction actually means.

His own concern was that users, and everyone else, ought to understand
the risks involved in the use of drugs or alcohol. This led to a
discussion about whether the goal of harm reduction was abstinence. I
got the sense from the people in the room that it emphatically is not;
this, in turn, led Walker to tell the story of a young alcoholic he
had been counselling:

The kid was putting away a case of beer a day, and getting into brawls
at night. The kid decided that he couldn't drink. The kid stopped drinking.

The kid relapsed.

Walker said that he asked what happened, and he admitted that he might
have asked the question with a little indignation. The kid said, with
equal indignation, "Me and a buddy got a case. We had 12 each. And we
didn't fight. You're an asshole."

Walker agreed that he sort of had been; the trouble is that we all
tend to get a little moral about drugs and alcohol from time to time.

Because, if some of us derive a little joy from a drink, we therefore
suspect that those who drink too much must be weak, or in pursuit of
too much joy.

If you know any alcoholics, you know there isn't much joy in it at
all, just as you also know that abstinence is not often in the cards.

A woman who works with addicts said, "Users come in with the idea of
abstinence, because that's the model they know. But we ask, 'Do you
mean abstinence tonight? Do you mean a drug holiday? Do you mean
abstinence the rest of your life?'"

And someone else said, "If you define abstinence as total abstinence,
you're setting up failure."

Walter Cavalieri spoke up. When he did, everyone listened. He is the
smartest guy I know. On the subject of a clear definition he said,
with quiet eloquence, "Harm reduction is about ending misery and
saving lives."

It is impossible to be clearer.

He also said, "A lot of people need their drugs -- they serve a
purpose." He's right.

He was even more blindingly right when he noted that Portugal --
Portugal! -- has decriminalized possession of small amounts of drugs.
And that there are needle exchanges in Iran, of all places.

The annual budget of the Harm Reduction Coalition is less than
$100,000 a year. It is the best money we spend.