https://www.infirmiere-canadienne.com/blogs/ic-contenu/2025/08/05/changer-le-recit-sur-la-reduction-des-mefaits
When confronted with a negative opinion, focus on the facts first
By Dianne Dyer
August 5, 2025
istockphoto.com/monstArrr_
Harm reduction is a vital step in the often-complex journey toward the choice of treatment and recovery. The goal is to keep people alive until they are willing and able to take the first step toward their choice of treatment.
“Harm reduction promotes drug use!!”
“Addicts make our communities unsafe and should be in jail!”
“People can stop using drugs if they want to. It is just a matter of willpower!”
“Supervised injection sites are drug dens and promote drug use!”
“We must focus on abstinence and recovery alone. It is the only answer.”
Have you heard these comments from politicians, social media and perhaps your neighbours, colleagues and friends? These comments are often based on fear, confusion, emotions, myths, hearsay, some real-life experiences, religious beliefs and some politically motivated ideologies. So what can you, as a nurse, do to change the messaging toward a compassionate, evidence-based, respectful view compliant with your role under the CNA Code of Ethics for Nurses?
Courtesy of Dianne Dyer
“Changing the minds and perspectives of those who oppose harm reduction and believe the misinformation is not easy. However, accurate information in your hands as a nurse can be a powerful tool,” Dianne Dyer says.
It is not an easy task. Some people will change their views with facts, knowledge and increased understanding. Some people have views that are deeply ingrained over years, and, sadly, you may never change their minds. As an RN working for 44 years in emergency, public health, trauma, inner-city communities and addictions work and as a nurse leader, I know that changing perspectives on any topic can be tough, really tough. I worked on the initial distribution of take-home naloxone kits, the establishment of a supervised consumption site (SCS) in Calgary and, two injectable opioid agonist treatment (iOAT) sites in Alberta. In addition, I wrote a provincial policy on harm reduction.
The backlash and naysayers were quite common and discouraging, but my goal was powerful and inspiring. The goal was to try to save lives based on the evidence. At the time, I was surrounded by courageous leaders who acknowledged that this work was difficult and controversial and supported my efforts. For example, one member of our health-care board heard our harm reduction policy presentation. His words were simple: “This policy is really about being kind to others.” Such a beautiful, unpretentious perspective and at the heart of this work!
Weaponizing harm reduction work in favour of abstinence-only treatment, recovery or enforcement alone is not based on the evidence. To elevate only one focus area over another can be futile and may be harmful. Harm reduction is a vital step in the often-complex journey toward the choice of treatment and recovery. The goal is to keep people alive until they are willing and able to take the first step toward their choice of treatment. Stigma against people who use substances can prevent them from seeking the help they may desperately need and can be deadly for some. As nurses, developing a harm reduction attitude in therapeutic relationships can be compelling to reduce risks and avoid policies, practices and rules that may shun and shame the people in your care.
So, once again, what can you do as a nurse? Nurses have a unique opportunity as truly trusted professionals. They engage directly with patients, families, health-care professionals and the public every day. Yes, people use substances for many reasons. Many will have unimaginable stories of childhood or adult trauma, pain and loss. Yes, some people will choose to move toward abstinence only, whereas others may seek medically supervised treatment that evolves over time as they adapt to the treatment offered. Yes, the care of patients in methamphetamine psychosis or patients in acute withdrawal can be challenging, but, like every patient you care for, they deserve the best compassionate expert care you can offer while ensuring your safety.
To initiate this conversation, listen to their perspective and find out the source of their information and why they believe as they do. Focus your response on their response, the facts and the evidence. Do not assume that you can change their view. Here are the facts:
- Addiction is not a choice. It is a serious illness, such as heart disease or diabetes. Using substances changes the brain’s physiology. These changes drive repeated use to avoid the pain and suffering of withdrawal. Treatment takes time and can be difficult and frightening for some. Relapses are common, and the individual should be supported and encouraged to begin treatment once again without judgment or shame. Treatment should be regulated and medically supervised and include a pathway to wrap-around services to address previously unresolved trauma and to support life changes that might need to occur (e.g., social services, counselling, housing, case follow-up).
- The SCS or overdose prevention site (OPS) is a harm reduction initiative that provides an open, welcoming door with compassion, without judgment or stigma. Individuals use the substances they have acquired outside the site, use them under the supervision of trained staff, and can often build relationships with staff over time. Staff “meet people where they are at.” Referrals for social services, housing and treatment should occur every day from an SCS or an OPS. The referral may be the one opportunity to change a life toward recovery. Lives are saved at these sites.
- Research has shown that harm reduction measures reduce public substance use, substance-related litter, the risks of HIV and hepatitis C, and robbery and property crimes. To stigmatize and/or criminalize an individual’s substance use behaviour can lead them to unsupervised use in a world that can be rife with shame, serious crime and disorder. Harm reduction should be one step on the continuum of care toward recovery.
Changing the minds and perspectives of those who oppose harm reduction and believe the misinformation is not easy. However, accurate information in your hands as a nurse can be a powerful tool. You can make a difference. Every individual struggling with addiction is a sister/brother, mother/father, daughter/son or aunt/uncle. They matter and belong to someone. Show that you care and that everyone struggling with addiction matters to you.
Dianne Dyer, BN, MN, is a retired RN based in Calgary. She has extensive experience in addictions and mental health and currently volunteers with SafeLink Alberta, Mustard Seed, and the Calgary Seniors’ Resource Society.
#opinions
#addictions
#advocacy
#harm-reduction
#nurse-patient-relationship
#opioids
#substance-use