The goal of the Four Pillars Drug Strategy is to reduce harm to individuals and communities from the sale and use of both legal and illegal substances. The principles of harm reduction require that we do no harm to those suffering from substance addiction and that we focus on the harm caused by problematic substance use, rather than substance use per se.

Harm reduction involves establishing a hierarchy of achievable goals which, when taken step by step, can lead to a healthier life for drug users and a healthier community for everyone. It accepts that abstinence may not be a realistic goal for some drug users, particularly in the short term. Harm reduction involves an achievable, pragmatic approach to drug issues.

A 2002 International Narcotics Control Board (INCB) legal opinion on harm reduction approaches noted that the concept of harm reduction had only emerged in the previous decade but aspects of the existing international drug control treaties addressed harm reduction issues. It pointed to a provision in the 1988 Convention: “Demand reduction policies shall: (i) Aim at preventing the use of drugs and at reducing the adverse consequences of drug abuse.” The legal opinion said it could be argued that this provision provides a mandate for harm reduction.

Harm reduction interventions have proven successful in decreasing the open drug scene, the spread of HIV/AIDS and hepatitis, overdoses and overdose deaths in countries such as Germany, Switzerland and Australia.

Vancouver’s harm reduction programs include the supervised injection site (SIS), needle exchanges and low-threshold community health services. Vancouver has 24-hour-a-day access to needles through low-threshold, peer-based needle exchanges, to mobile exchanges and needle exchanges attached to primary health care services.

North America’s first Supervised Injection Site (SIS), InSite, opened in Vancouver in September 2003.

InSite operates under a Health Canada drug law exemption. Legal status of Insite.

2009 User statistics