Substance Use and Harm Reduction


BC declared a public health emergency in April 2016 as a result of rising deaths due to overdose, which is now more aptly identified as deaths as a result of a toxic drug supply. This ongoing crisis has significant impact on people with lived experience (PWLE), who may be frontline first responders at PAN member and allied organizations, advocates at community tables, educators for better policy, or part of numerousefforts for harm reduction to save lives.  The resources provided here reflect resource requests from members and allies.

While these pieces are organized into sections, issues intersect, so please keep that in mind when scrolling through.  There is a lot of good and determined advocacy going on, and while we can’t represent it all here, we respect the many efforts for change.

For more information on PAN’s advocacy work, visit Policy Change and Collective Action


Explore sections

Substance Use News, PAN’s monthly collection of advocacy news and and resources
Voices of Lived Experience
Grief and Support
Decriminalization in BC: January 2023-January 2026
Harm Reduction and Decriminalization
Drug Poisoning Prevention, Care and Recovery
The Fight Against Stigma
Treatment Resources and Care
Reports, Recommendations, and Research


Substance Use News

Substance Use News is a monthly collection of advocacy news and resources on the social, medical and political responses to the toxic drug supply crisis. Following the public health emergency declaration in April 2016, PAN centred discussions on substance use and harm reduction at our member conference in the fall of that year. Coming from community requests, we developed two initial reports in 2016 and 2017, and Substance Use News, an ongoing publication. 


August 2023 | July 2023 | June 2023 | May 2023 | April 2023 | March 2023 | February 2023 | January 2023


December 2022 | November 2022 | October 2022 | September 2022August 2022 | July 2022 | June 2022 | May 2022 | April 2022 | March 2022 | February 2022 | January 2022


Visit the Substance Use News Archives page for additional issues and reports dating back to 2016.

Voices of  Lived Experience

People in British Columbia

BC and Yukon Association of Drug War Survivors: BCYADWS is a drug user group based on advocacy, education and support.

Coalition of Substance Users of the North (CSUN) is a BC alliance of people who use or have used currently illicit/illegal drugs.

Drug User Liberation Front: DULF was formed in response to the ever-mounting overdose deaths in BC and across Canada.

Rural Empowered Drug Users Network (REDUN) A program for current and former drug users, and their friends, family, and supporters.
We want to be a part of the structures that serve us.

SANSU (Surrey Surrey Area Network of Substance Users Society) is an organization of current and former drug users in Surrey, BC that provides advocacy, harm reduction and social justice to people who use drugs in this region.

SOLID is a Victoria, BC-based organization of current or former drug users that provides support, education and advocacy.

VANDU: The Vancouver Area Network of Drug Users (VANDU) is a group of users and former users who work to improve the lives of people who use drugs through user-based peer support and education.

Crackdown podcast: This podcast came out of Vancouver’s Downtown Eastside, and the production team describes it as “The drug war, covered by drug users as war correspondents.”


People across Canada

Canadian Association of People Who Use Drugs is a group of people with lived experience of drug use; they emphasize the need for direct involvement of PWUD in policy making.

CAPSA (Community Addictions Peer Support Association) is a national leader on the topic of stigma, its impacts on individuals who use substances or have a substance use disorder and on identifying and correcting instances of systemic stigma embedded in organizations.

ONPUD Ontario Network of People Who Use Drugs

Toronto Harm Reduction Alliance

Substance User Network of the Atlantic Region


Reading / To Watch

Connecting to Culture videos from First Nations Health Authority are teaching tools intended to support discussions in First Nations communities about harm reduction, substance use and stigma.

Peer to Peer: Starting a Local Group or Drug User Organization

The Opioid Chapters presents stories of 11 people living on the front lines of a constantly shifting opioid landscape in Ontario.

Engaging People Who Have Used Illicit Drugs in Qualitative Research

A Guide for Paying Peer Research Assistants – Challenges and Opportunities

From One Ally to Another – Practice Guidelines to Better Include People Who Use Drugs at Your Decision-Making Tables

Grief and Support



Creating Cultures of Wellness: This video series with Vikki Reynolds can be viewed in separate parts or altogether to help teams build resilence and rediscover their strengths.


Healing Indigenous Hearts. The Healing Indigenous Hearts Facilitators’ Guidebook was developed for Indigenous – First Nations, Inuit and Metis people who have lost loved ones as a result of substance-use-related causes – and wish to facilitate a support group with other Indigenous people who have suffered this kind of loss.

Organizing Our Grief: A Collaboration in Response to the Overdose Crisis This report was dewveloped as a case study / guide for organizations, organizers, and groups (in and beyond the visual arts) might meaningfully engage with people who use drugs. Wish You Were Here, Wish Here Was Better (WYWH, WHWB) was a weeklong public art project and program series organized by community organizer and scholar Zoë Dodd, artist and Plains Cree health promoter Les Harper, writer Theodore (ted) Kerr, and curator-scholar Ellyn Walker. The project created space for grief, solidarity, and mobilization amongst people affected by the ongoing overdose crisis and its related systemic impacts, including precarity, houselessness, and criminalization.

Psychological First Aid: Guide for Field Workers:  This resource from the World Health Organization explains a framework for supporting people in ethical ways that respect their dignity, culture and abilities. Despite its name, psychological first aid covers both social and psychological support.

Holding on with Letting Go – Vikki Reyolds

“Leaning In” as Imperfect Allies in Community Work – Vikki Reynolds

Resisting Burnout  – Vikki Reynolds

Stories to support grieving children: picture books to support kids 4-10 who are faced with the loss of a loved one from substance use as well as suicide.



Decriminalization in BC: January 2023-January 2026

Starting January 31, 2023, adults over 18 years old in BC will not be subject to criminal charges for the personal possession of small amounts of certain illegal drugs. Health Canada has granted an exemption from the Controlled Drugs and Substances Act to the Province of BC. until January 31, 2026. Visit BC Government site to learn more. People with lived experience lead the way in responding to the toxic drug poisoning crisis; see groups in section above. Our monthly Substance Use News will feature  updates on the impact of decriminalization as they evolve. 

Decriminalization: The Facts This information sheet from First Nations Health Authority breaks down some myths, about what decriminalization is and isn’t.

Drug Decriminalization in British Columbia – Know Your Rights. Pivot Legal Society has created a printable Know Your Rights Card with friends at the Vancouver Area Network of Drug Users (VANDU). If you’re a person who uses drugs (or a drug user-led group), feel free to contact Pivot Legal for some hardcopy cards.

Decriminalization in BC The BC Centre for Disease Control offers information and frequently asked questions (FAQs) for local governments on decriminalization of people who use drugs.

Decriminalization, safe supply already saving lives in BC, contrary to backlash claims: addictions Carolyn Bennett
July 2023: BC’s chief coroner, provincial health officer and representative for children and youth have attempted to debunk concerns raised by federal Conservative Leader Pierre Poilievre, local elected officials and some addiction specialists in recent months that safe supply is “flooding” B.C. with drugs and worsening the toxic drug crisis. Bennett said Thursday she fears the “anecdotal” attacks, like Poilievre’s defeated motion in the House of Commons to pull funding from harm reduction like safe supply, discourage people from accessing life-saving harm reduction.

No evidence decriminalization has led to increase in public drug use: BC addictions minister
July 2023: BC’s minister of mental health and addictions says there’s no evidence suggesting decriminalization has led to an increase in the consumption of illicit drugs in public spaces. Jennifer Whiteside held a series of meetings with politicians, harm-reduction organizations and local stakeholders in Nelson in early July to address community concerns about public drug use.

Decriminalization begins in BC as coroners service releases overdose death data:
January 2023: Dean Wilson, who started working as a peer facilitator at the BC Centre on Substance Use in 2017 as a heroin user, said decriminalization is a welcome change to prevent drug users’ interactions with police.

Decriminalizing hard drugs in BC will help reduce the stigma of substance abuse*
A recent study found that nearly half of respondents reported perceiving stigma because of their addiction from friends and family, from work colleagues and even from medical providers. In some cases, fear of negative opinions from people in their social circles is one reason people who know they need help with substance use do not pursue treatment.

* (sic)

As Decriminalization Begins in British Columbia, Activists Watch Warily January 2023: Now that BC’s decriminalization model has taken effect, the Vancouver Area Network of Drug Users (VANDU) is among those planning to watch closely how it plays out in practice.

It’s the ‘Eve of Decriminalization’ for Drug Possession in BC
January 2023: “There is a lot of uncertainty on this ‘eve of decriminalization,’” said Amber Streukens, a Nelson-based organizer with the Rural Empowered Drug User Network and harm reduction worker for ANKORS West (AIDS Network Kootenay Outreach and Support Society, which serves communities including Nelson, Trail, Castlegar and Kaslo). “The measure is lacking in a lot of ways and what’s going to happen feels unknowable.”

BC takes action to save lives, build new connections of care with drug decriminalization
January 2023: Statement from BC’s Ministry of Mental Health and Addictions. The Province is taking a critical step to end the shame and stigma that prevents people with substance-use challenges from reaching out for life-saving help as B.C.’s decriminalization of people who use drugs comes into effect on Tuesday, Jan. 31, 2023.

It’s Time for Drug Decriminalization – Done Right – Now
January 2023: From HIV Legal Network: This week, we are watching with great interest as the possession of some drugs in small amounts will finally be decriminalized in the Province of British Columbia. While in theory a positive step forward in the quest to end an escalating drug poisoning crisis that is driven by bad drug policy, we remain deeply concerned that this “decriminalization” model neglects the lived realities of those most at risk for drug poisoning and will continue to criminalize many people who use drugs in the province.

Police given 45-minute training video and infographics as decriminalization set to begin in BC
January 2023: During a technical briefing Monday January 31, 2023, reporters learned the province has developed a 45-minute recorded presentation on the decriminalization pilot project as part of the first phase of training for the province’s more than 9,000 officers on the streets.

BC Decrim Threshold Was Set for Police, Not People Who Use Drugs
January 2023:  British Columbia is about to become the first Canadian province to decriminalize personal possession of some state-banned drugs—a move that media and government officials are widely touting as progressive. As drug users who work in frontline harm reduction, we do not share this view. the threshold of personal possession at a cumulative 2.5 grams, which doesn’t reflect true buy-in from the people it purports to serve.


Harm Reduction and Decriminalization


The groups listed above in People with Lived Experience are leaders in harm reduction and decriminalization advocacy. Other groups include:

Moms Stop the Harm is is a network of Canadian families impacted by substance-use-related harms and deaths that advocates for the change of failed drug policies, provides peer support to grieving families, and assists those with loved ones who use or have used substances.

HIV Legal Network is “committed to reducing the harms associated with drugs and the harms caused by harsh, misguided drug laws. Instead of prohibition and punishment, drug policy must be grounded in sound public health evidence, and in the principle of the universality of human rights.” Read about their drug policy work.

The Canadian Drug Policy Coalition is a non-partisan, evidence-based policy advocacy organization comprised of more than 50 organizations and over 7,000 individuals striving to end the harms of drug prohibition. It operates as a project within Simon Fraser University in the Faculty of Health Sciences.

National Safer Supply Community of Practice (NSS-CoP) is a knowledge exchange initiative led by London InterCommunity Health Centre, in partnership with the Canadian Association of People who Use Drugs and the Alliance for Healthier Communities. Its goal is to scale up safer supply programs across Canada.

Drug Policy Alliance: US-based non-governmental organization promoting drug policies that are grounded in science, compassion, health and human rights.

Harm Reduction International is dedicated to reducing the negative health, social and legal impacts of drug use and drug policy. The organization is an NGO in Special Consultative Status with the Economic and Social Council of the United Nations.


Watch, Read, Listen

Prescribed Safer Supply Programs: Emerging Evidence (National Safer Supply Community of Practice)

Harm Reduction Clinical Resources (BC Centre for Disease Control)

Watch: How to Spot Someone So They Never Use Alone Canadian Association of People Who Use Drugs

Reframing Diversion for Health Care Providers: Frequently Asked Questions (National Safer Supply Community of Practice)

Harm Reduction is not a Metaphor: Living in the 21st Century with Drugs, Intimacy, and Activism

Crackdown podcast: “The drug war, covered by drug users.” Voices from the Downtown Eastside in so-called Vancouver.

Narcotica podcast. This podcast from the US is about “drugs and the people who use them.”

Substance Use Patterns and Safer Supply Preferences Among People Who Use Drugs in British Columbia
This report presents the findings of a multiyear study which aimed to understand the needs and preferences of people who use drugs from the illegal market and safer supply.

Harm Reduction Fundamentals: A toolkit for service providers This CATIE toolkit was developed in partnership with a pan-Canadian working group of organizations and individuals with expertise in harm reduction.

Men in Trades: The opioid overdose crisis in Canada. In Canada, 3 out of 4 opioid related deaths are men, and 30 to 50% of those employed worked in trades at the time of their death. Information for communities and resources for employers.

Filter Harm Reduction Journal, run by a non-profit whose mission is to advocate through journalism for rational and compassionate approaches to drug use, drug policy and human rights.

BC Coroners Service Death Review Panel: A Review of Illicity Drug Toxicity Deaths (2022)

Canada’s Guidance on Alcohol and Health Canada’s Guidance on Alcohol and Health provides people living in Canada with the information they need to make well-informed and responsible decisions about their alcohol consumption. (2023)

Decriminalization for Simple Possession of Illicit Drugs: Exploring Impacts on Public Safety & Policing: The Canadian Association of Chiefs of Police (CACP) announced that the association is recommending that all police agencies in Canada recognize substance abuse and addiction as a public health issue to help reduce drug overdoses and is endorsing the decriminalization of personal possession of illicit drugs.

Practical Drug Decriminalization in British Columbia. “While the possession of illicit drugs for personal use (“simple possession”) is a criminal offence, individual provinces still have significant powers to redress some of the harms of drug prohibition.In light of the federal government’s failure to meaningfully reform drug policy, provinces like B.C.can and must take legal steps to effectively (“de facto”) decriminalize simple possession by re-directing police resources away from its criminal enforcement.” Pivot Legal Society

The Nurses and Nurse Practitioners of British Columbia (NNPBC) and the Harm Reduction Nurses Association (HRNA) call for the decriminalization of people who use drugs in BC. “As nurses who work in B.C. and provide frontline care in the midst of this public health emergency, we see firsthand the impact of criminalization on our clients, on their families, on our practice and our communities.”

Response to the Opioid Overdose Crisis in Vancouver Coastal Health. Vancouver Coastal Health Chief Medical Health Office Dr. Patricia Daly calls for decriminalization of personal possession of illegal drugs. “It is an acknowledgement that psychoactive substances, including opioids, will continue to be used by people for a variety of reasons, and the illegal nature of these substances is the primary risk factor for overdose death” (p. 29).

Stopping the Harm: Decriminalization of People Who Use Drugs in BC. In presenting this 2019 report, Provincial Health Officer Dr. Bonnie Henry cites two provincial mechanisms that could allow for de facto decriminalization of personal drug use. The first would use the Police Act to allow the minister of public safety and solicitor general to set broad provincial priorities with respect to people who use drugs (Stopping the Harm, p. 5). The second option, which also would use the Police Act, would add a provision preventing any member of a police force in BC from using resources for enforcement of simple possession offences (Stopping the Harm, p. 38).

Harm Reduction Satellite Sites: A Guide for Operating Harm Reduction Hubs from the Homes of People Who Use Drugs
This guide from CATIE was developed to be helpful for community-based service providers who would like to develop this kind of programming, or explore other models of providing health and harm reduction services to people who use drugs, particularly in residential and other community settings where they are most needed. (2020)

Operational Guidance for Implementation of Managed Alcohol for Vulnerable Populations, BC Centre on Substance Use (2020)

The Harm Reduction Model of Drug Addiction Treatment TED talk with Dr. Mark Tyndall. This is a great piece on harm reduction that’s scientific, compassionate and realistic. (15 minutes)

Explaining Harm Reduction with Hardhats, Seatbelts, and Sunscreen: Two minute stick-figure animation explains harm reduction principles and benefits.

Indigenizing Harm Reduction: The First Nations Health Authority Indigenous Wellness team explores what harm reduction looks like from an Indigenous perspective, and how they facilitate dialogue with First Nations communities around the province. Scroll to bottom of page for video and slides.

What is Harm Reduction?  This explains the set of strategies and philosophies about reducing harm related to drug use and building a community of respect and support for people who use drugs.

Drug Checking as a Harm Reduction Intervention – Evidence Review Report (BC Centre on Substance Use, 2017)

Harm Reduction Saves Lives (Report, 2017)



Drug Poisoning Prevention, Care and Recovery


Toward the Heart: This website was developed by the Provincial Harm Reduction program. It provides Naloxone information (and other drugs), training, and information on becoming a Take Home Naloxone site.

Provincial Episodic Overdose Prevention Service (eOPS) Protocol

The Safer Bathroom Toolkit
Even when supervised consumption or overdose prevention site services are available, some people will use substances in bathrooms. There are ways of making bathrooms safer for people who use substances. This toolkit will help you to do that.

Addiction Practice Pod is a podcast focussing on substance use care for health care providers in British Columbia and Yukon.

Find Take Home Naloxone kits in your area

List of overdose prevention and supervised consumption services in BC

How to Use Naloxone (3-minute video)

Take Home Naloxone Training

First Nations Health Authority Harm Reduction Information



The Fight Against Stigma


There are ongoing conversations and events to fight stigma. All of the people listed in sections above are fighting stigma, and we encourage you to look at their work and resources. The select reading below is just a sampling; we encourage you to use search term “stigma against people who use drugs” for more.

Stigma (Canadian Centre on Substance Use and Addition)

Stigma Primer for Journalists (Canadian Centre on Substance Use and Addition)

The Way We Depict Drugs, and People Who Use Them, Must Change

Stigma, Drug Addiction and Treatment Utilisation: PWUD Perspective

The World Drug Perception Problem: Countering Prejudices About People who Use Drugs

Why We Should Say Someone Is A ‘Person With An Addiction,’ Not An Addict

How the Stigma of Drug Addiction Hurts All of Us

Northern Health’s Stop Stigma videos

The World Drug Perception Problem: Countering Prejudices About People who Use Drugs


Treatment Resources and Care


BC Centre on Substance Use Care Guidance:

“Working Together to Reduce Harm” is the motto of the Toward the Heart site from the provincial harm reduction program includes information on finding overdose prevention sites, what different drugs do, support for people who use drugs and how to report bad dope.

HealthLink BC provides free, non-emergency information including substance use or mental health. Alternate is a call to 811.


Research Centres and Reports


Research Centres

BC Centre on Substance Use

Toward The Heart Research Projects (BC CDC Harm Reduction Services)

Canadian Institute for Substance Use Research

Canadian Society of Addiction Medicine

Canadian Centre on Substance Use and Addiction


Reports and Updates

Data, surveillance and research on opioids and other substances Public Health Agency of Canada

Statistical Reports on Deaths in British Columbia

BC Coroners Service News – ongoing updates

BC Government page on substance use resources

The BC Centre for Disease Control provides Harm Reduction Reports that include coroners reports and maps showing overdose response from first responders.


Provincial Government Reports

2022: Closing Gaps, Reducing Barriers: Expanding the Response to the Toxic Drug and Overdose Crisis (Select Standing Committee on Health)

2022: BC Coroners Service Death Review Panel: A Review of Illicity Drug Toxicity Deaths

2019: Stopping the Harm: Decriminalization of people who use drugs in BC

2018: Responding to B.C.’s Illegal Drug Overdose Epidemic. Progress Update

2017: Fifth Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency:

2017: BC’s Opioid Overdose Response One-Year Update

March 2017: Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency

January 2017: Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency

November 2016: Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency

September 2016: Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency 


Community Recommendations and Reports

Decriminalization for Simple Possession of Illicit Drugs: Exploring Impacts on Public Safety and Policing, 2020
Special Purpose Committee on the Decriminalization of Illicit Drugs

The Global State of Harm Reduction, 2020
Now in its the seventh edition, the Global State of Harm Reduction 2020 is the most comprehensive global mapping of harm reduction responses to drug use, HIV and viral hepatitis. Visit Harm Reduction International site.

Findings and Analysis for Overdose Prevention Society Data for Good Vancouver, 2018

Close to Home: Families & Caregivers Set priorities for addressing substance use addiction in BC BC Centre on Substance Use, April 2018

The Opioid Crisis in North America (2017)

Responding to the Overdose Crisis in British Columbia: A Rapid Assessment of Frontline/ Community-Based Organizations’ Capacity-and-Skills-Building Needs  (PAN, 2017)

Canadian Drug Policy, Supervised Consumption Sites & Provincial Response to the Public Health Crisis of Overdose Deaths (PAN, 2016)

Opioid epidemic causing rise in hepatitis C infections and other serious illnesses (2017)

World Drug Report 2017

Harm Reduction Saves Lives (2017)

The Good Samaritan Drug Overdose Act – what you need to know (2017)

BC Overdose Action Exchange II Report BC Centre for Disease Control, August 2017

The-Opioid-Crisis-The-Need-for-Treatment-on-Demand-VPD-2016 , Vancouver Police Department, May 2017

Recommendations of the Mayors’ Task Force on the Opioid Crisis May 2017

The Overdose Crisis – Where To Next? AIDS Vancouver Island, 2017






Image: Focus by Andrew, Flickr (Creative Commons)
Last reviewed and updated September 6, 2023.