CBC White Coat, Black Art: From zero tolerance to open dialogue: How harm reduction is shifting the conversation on drug use

Nick Jakubiak speaks with peers at Skylark, a Toronto-based charity that helps children and parents struggling with mental health and developmental needs. (Submitted by Nick Jakubiak)

Enid Grant got the kind of phone call many parents dread. Her teenage son was “freaking out” after trying psychedelic mushrooms with friends.

She was scared for her son’s safety, but relieved he reached out to her for help.

“I couldn’t prevent that from happening, but I could be there when it happened,” said Grant, senior director of children’s mental health at Skylark, a Toronto-based charity.

“I could make sure that we talked about it afterwards.”

Grant’s kids have since grown up to be “wonderful, caring adults.” She credits harm reduction strategies — making it easier for them to talk about oft-taboo topics — with getting through the challenging years of their adolescence.

Harm reduction focuses not on abstinence, but minimizing harm and potential danger. The number of such initiatives in Canada has grown in recent years, including some high-profile safe injection sites in B.C. to help curb the deadly opioid crisis in that province.

But it hasn’t come without pushback.

“We have been, you know, living in a society where abstinence or zero-tolerance policies have been the ones that have, I think, politically felt the most comfortable,” said Sally Jenkins, an assistant professor at the University of British Columbia School of Nursing.

“And so we don’t have a lot of information for parents about how to do this differently.”

Teens respond to harm reduction over abstinence: study

A recent study led by Jenkins interviewing 83 teens in B.C., found that many responded more positively to harm reduction approaches than a don’t-do-drugs edict.

Abstinence-based approaches didn’t reflect the lived experiences of many youth, who either have already tried drugs, or encountered it among their peers or even their own family circles, she explained.

Emily Jenkins an assistant professor at the University of British Columbia School of Nursing. (Shobhit/Submitted by Emily Jenkins)


In one community they surveyed, she added, many teens told her the zero-tolerance rule was “assumed” without a discussion of any sort.

“Kids just knew it wasn’t accepted. End of story,” she said.

“They didn’t engage in discussions about it. And it was a missed opportunity, and it led to family fragmentation and kids just feeling like they didn’t have somebody to go to.”

‘Harm reduction is just drug education’

Dr. Brian Goldman shared his own story about harm reduction in November, when he revealed on Twitter that he bought a pack of cigarettes for his teenage son, who has fetal alcohol spectrum disorder.

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The opinions expressed in this post are those of the authors. They do not purport to reflect the opinions or views of the FASD Prevention Conversation Project, its stakeholders, funders or its members.

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