“You should put aloe vera on that. Vaseline isn’t as good for healing,” says Sara.
Sara and her partner Ed, who have been experiencing homelessness for the past five years, are debating the best treatment for frostbite. (Broadview is using pseudonyms to protect their privacy.) As the physician on duty, I’m kneeling in front of my patients on dusty carpet at a pop-up wound-care clinic. I help them roll up thick layers of long johns and snow pants as they ease calloused feet into basins filled with warm water and Epsom salts. The soothing of feet battered by street life is not our only purpose at Reconnects Pathways to Primary Care, a Calgary grassroots clinic organized by peer outreach workers. The foot baths are a symbol of our commitment to harm reduction. They’re meant to welcome, include and declare: “You matter to us here.”
While some family doctors might pay home visits to patients who otherwise could not access care, I do my home visits to people without homes through outreach programs like Reconnects. Outreach is a core tenet of harm reduction, a philosophy of care that centres relationship over efficiency, community over control, equity over policy and solidarity over charity. While that can mean offering a safe space to consume unregulated drugs, it can also mean providing wound care, hot meals, warm clothing and legal assistance.
Based in compassion, the harm reduction movement insists that unconditional access to care should apply to everyone. For as long as social problems like poverty and homelessness have existed, ultra-low-barrier programs like Reconnects have filled gaps for folks at highest risk of poor health outcomes. They play a critical role in patching up tattered care systems. Nevertheless, in Canada, these programs are currently under significant threat from antagonistic policy makers who incite moral panic by misrepresenting harm reduction.
Politicians who weaponize harm reduction only chip additional mortar from a care system already in deep disrepair.
When influential politicians like Conservative Leader Pierre Poilievre, Alberta Premier Danielle Smith and Ontario Premier Doug Ford endlessly repeat false narratives that homelessness, social disorder and addictions are enabled — and sometimes even caused by — harm reduction, it is difficult for the public to see the true value of this philosophy of care. Harm reduction interventions for drug use, such as safe consumption sites, have been proven in numerous studies to reduce disease transmission, public drug use and drug poisoning death, while saving money by reducing and redirecting emergency room visits.
More on Broadview:
- How harm reduction can help end the drug crisis
- How red tape is hurting efforts to tackle homelessness
- Tent cities are growing in Canada — so is the call for meaningful change
As Reconnects illustrates, harm reduction encompasses far more than simply decreasing the harms of substance use to individuals. Although that is one of its proven effects, it also has system-level impacts, such as increased access to health and social services and reduction in violent crime, that benefit everyone.
Politicians who weaponize harm reduction only chip additional mortar from a care system already in deep disrepair. The short-term gain of political favour unfortunately seems to count more than the many lives improved, even saved, by harm reduction.
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As a society, we must challenge the pervasive mischaracterization of harm reduction and reclaim its true meaning, rooted in the principles of acceptance and inclusivity. At Reconnects, we will continue to stock giant green tubes of aloe vera in order to reach folks like Sara and Ed. As harm reductionists, we know that sole care is soul care.
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Dr. Bonnie Larson is a Calgary family physician and community organizer.
This article first appeared in Broadview’s March 2025 issue with the title “Salve for the Soul.”
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