Last month, United Way hosted its quarterly agency gathering with guest speaker Jeannie Coe, a nurse practitioner in Saskatoon. Coe spent much of her early nursing career in Canada’s north but more recently has been (to borrow Zak Vescera’s description in a 2021 Star Phoenix article) “a roving clinic, moving between NGOs in Saskatoon and treating some of the most vulnerable people in the city.”

Coe’s special interests are in mental health and addictions, harm reduction and trauma informed care, and she could provide an insightful and engaging presentation on any of those topics. But we asked her for insights into harm reduction: Why we should care and what we need to know about this health care strategy gaining traction at all levels of government and within the community.

Coe very graciously – despite endless demands on her schedule and an intense inability to sit still – offered those insights. Here are a few nuggets from the talk.

Why care about harm reduction

Coe started by commenting on how the conversation around harm reduction is gaining traction in the media, community and all levels of government. She did not sugar coat why this is happening.

“One of the reasons is because this opioid epidemic is steamrolling us and our death rates are going up,” she said.

Evidence of a problem is also all around us, she says, and interest in finding a solution is a “good human” response.

But, while that is a positive “humanistic” response, that’s “just the tip of the iceberg” because our community is struggling to deal with more than is being reported by the media, says Coe. Our healthcare system is buckling under the weight of multiple challenges, and the opioid crisis is adding tremendous pressure to this already fragile infrastructure both short and long term.

Opioid crisis is putting pressure on an ailing healthcare system

“We have a lot of people that survive overdoses and end up in long term care facilities because they’ve lost too much of their ability to care for themselves, and we don’t see much reporting on that,” she said.

That’s a serious problem for a health care system already stressed by numerous other factors, she suggests. But Coe is starting to see change, and like many things related to harm reduction, this shift is starting in BC.

“BC has started to report a little bit on how overwhelmed their long-term care facilities are and how able they are to provide good care for younger people who are coming with all the vulnerabilities that they were often living on the street with,” Coe said. “And that’s experienced in Saskatoon too, although we’re not really seeing that described.”

Harm reduction is cost-effective

The distinct harms to our community’s social infrastructure due to the opiate crisis are important reasons to care about harm reduction. Coe says it’s also cost effective.

“It’s well recorded that for every two dollars we invest in harm reduction, we save five to seven dollars in health care in the acute care system,” Coe said.

So, even if a person has not been impacted directly by the crisis, indirectly they would still benefit from harm reduction.

Saving tax dollars should also appeal to everyone, she suggests.

Harm reduction can be culturally competent

While the adoption of harm reduction practices and strategies by governments has been slow, many health practitioners have been using them for years. They are familiar and effective. But there’s more to harm reduction than simply being effective, saving tax dollars, and reducing pressure on emergency services, she says.

“If we just look at overdoses, Indigenous people are five times more likely to overdose, and they’re three times more likely to die,” said Coe. “And we see that in our city, in our community. And so, we have to think really critically about that, because we have significant investments in harm reduction. And I think that most people that practice [harm reduction] feel better about their practice because they’re using harm reduction with old methodology, but there’s way more work to do.”

Coe says we need to adopt broader frameworks in our approach to harm reduction.

Being culturally safe requires a wider worldview

“The Indigenizing of the harm reduction model takes it from that very focused methadone program, very focused, syringe or needle exchange program, and it really makes us acknowledge that substance use disorder is a symptom of poverty and the effect of colonization in our community,” said Coe. “That’s where we have to start working. It gives us a framework for that, and the worldview for that and it’s empowering.”

Join us in supporting harm reduction efforts in Saskatoon and area

In 2023, United Way provided $50,000 in unrestricted funding to Prairie Harm Reduction in support of its numerous programs for people working through the challenge of substance use. To help us provide further support to effective and dynamic strategies like harm reduction and housing first that make our community stronger and safer for everyone, please consider donating to United Way today.

More to come!

We have two more synopses of Coe’s presentation coming. The next one covers two examples of harm reduction in practice and the last includes examples of harm reduction being culturally safe for Indigenous peoples. Watch for them later this month.

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