Among the many challenges faced by the homelessness sector during COVID-19, Harm Reduction is perhaps one of the biggest. The pandemic has highlighted and exacerbated the crisis of addiction and overdose-related fatalities

In response to this dual public health crisis, the Canadian Observatory on Homelessness partnered with Harm Reduction expert Bernie Pauly from the University of Victoria and the Canadian Institute for Substance Use Research to host two webinars: 

  1. Harm Reduction Policies and Interventions During COVID-19
  2. Creating Effective Organizational Harm Reduction Policies & Culture in the Context of COVID-19 

During these webinars, the audience asked several great questions. In fact, there were so many critical questions that we created a Harm Reduction Q&A series to respond to them. Below is the first in the series, which focuses on Harm Reduction in Shelters during COVID-19. 

Q: Where can smaller shelters get PPE equipment at this time? Is there a sample harm reduction policy and procedure available for shelters? Thank you - Shernett C

A: PPE is critical for responding to overdoses. It appears here that obtaining PPE through Health authorities has been limited. So, many have had to do their own sourcing through supply companies. Just be aware of whether or not the PPE available through such means meets standards (e.g. surgical grade masks). 

Q: I'm a front-line shelter worker. Any practical tips for working with individuals who are struggling with substance use issues? We try to tell our residents to use off site because they will get evicted if they use on site, but I almost feel like it's more harmful to ask them to leave. - Victoria K

A: You are correct, it is harmful to tell people to use off-site as it means they are being forced to use in public spaces. It’s also harmful to turn a blind eye. This is where having a compatible substance use and harm reduction policy comes into play. Creating a harm reduction culture in which everyone understands that the organization recognizes and accepts substance use is a way to keep people safe.

Q: What would you recommend for a shelter who is using leased space that has indicated substances are not to be used inside? They are willing to turn a blind eye to alcohol and drug use outside of the building. - Krista M

A: This is a challenging scenario and one that has few easy answers. I realize space is at a premium, so finding space is often difficult. But it is unsafe to have a space where you cannot provide Harm Reduction. I know how hard it is to find a landlord who is supportive. Is it possible to work with landlords to come to an understanding? Do they understand the harms of that? It’s important to point out these harms to the landlord and remind them of their accountability. The alternative is to outright purchase space. I wish I had the answer on this one, but wonder if there are others out there who do. 

Q: Are you aware of any policies for frontline staff in shelter settings when breaking the 6 foot physical distance to administer Narcan or administer First Aid? - Jennifer H

A: Naloxone is a life saving intervention and part of overdose responses. So, the same guidelines for providing healthcare during COVID apply. Here are some links to BC policies. 

Q: Any adaptations you would recommend paying attention to for youth shelters? Those who are 15 - 17 specifically? - Jessica D

A: Harm Reduction for youth is so important if they are actively using substances. If Harm Reduction services are not available, then they will either use unsafely or be pushed to adult services. So, if the shelter is serving youth who are actively using, the same kinds of interventions are relevant in relation to types and modes of use. 

This is the first of a Q&A series with Harm Reduction expert Bernie Pauly from the University of Victoria and the Canadian Institute for Substance Use Research. Look for the second blog coming next week! If you have any questions, don’t hesitate to post on the forum of the Homelessness Learning Hub and our experts will get back to you.