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How does a harm reduction approach benefit clients? Can you share some stories?

Watch our Q&A video with harm reduction nurse practitioner Cristina Zaganelli

By Cristina Zaganelli
July 8, 2024

This video is part of the Canadian Nurse series, Harm Reduction Saves Lives.

Cristina Zaganelli is a primary care nurse practitioner with over 15 years’ experience working with complex, vulnerable populations with multiple co-morbidities, including substance use and mental health concerns. She completed her bachelor of nursing degree at the University of Calgary and her master of nursing degree and diploma in nurse practitioner studies at Dalhousie University. Cristina currently works at the Opioid Dependency Program at Alberta Health Services, where she helped develop the mobile opioid agonist therapy outreach team. She also works at the CUPS (Calgary Urban Project Society) health centre as a primary care provider for homeless and low income individuals.

In her video, Cristina mentioned that a client (who wished to remain anonymous) wanted to share their story in their own words.

“Treat us like humans, even if we’re not at our best.”

Harm reduction has been my lifeline, shifting my mindset from “fight or flight” to flourish. Without it, I wouldn’t be here today. Building relationships with my support team made me realize that someone genuinely cared about me. Accessing hydromorphone, a safer option, brought me relief because I knew it was safe and predictable. With it, I could finally stop resorting to sex work and stealing, allowing me to focus on rebuilding my life and that of my son’s.

Meeting the outreach worker who helped me was a turning point. His genuine care and credibility propelled me forward when I felt stuck. Before these connections, I was drowning in guilt and regret, and I truly believe I would have been dead by now. Time became a gift, and my worries diminished. Now, I can see a future where I can help others.

Navigating hospitals was terrifying; I feared judgment and being labelled as “drug-seeking.” It never felt safe, to be fully honest. But with iOAT (injectable opioid agonist treatment), I found a supportive environment. It’s what I like to say, “Come for the fix, stay for the relationship.” I cherished the wraparound care, even though the program was demanding.

The journey had its bumps, especially when changes in provincial regulations hindered my access to treatment. I almost relapsed. But harm reduction isn't just about preventing death; it’s about giving us the tools to step away from the flames.

My advice? It’s simple. We can tell within two minutes if someone’s an ally. Lead with love. Offer resources, not criticism. Treat us like humans, even if we’re not at our best. Don't discuss us without involving us. Our past experiences with health care shape our present fears. Soft boundaries won’t help us. And don’t give up; that one day might change everything.

Helping others isn’t easy, but it’s worth it. It takes persistence, perseverance, and presence. Non-judgmental compassion and firm boundaries are key. Remember, we’re not looking for pity; we just need support.