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"The use of illegal drugs is a serious health and social problem in Canada," Rebecca Jesseman, a research and policy analyst with the Canadian Centre on Substance Abuse, writes today in her Comment Page article Beyond harm reduction
Ms. Jesseman argues that Globe columnist Margaret Wente's recent four-column series "demonstrated that 'harm reduction' has become a polarizing term that divides those with a common interest — the reduction of harm associated with drug use.
"Rather than being guided by evidence, the debate over harm reduction is often based on ideology, with opposing sides seeing harm reduction as either a way to help those who continue to use drugs to minimize the associated harms, or as an approach that encourages use and implicitly supports more liberal drug policy.
"These polarized interpretations of harm reduction create a false dichotomy: in truth, interventions such as needle exchange programs and supervised injection facilities do not preclude abstinence-based programs or interventions . . . "
Rebecca Jesseman
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Although debate tends to focus on individual, high-profile programs, the evidence clearly illustrates that no single intervention can be relied on to address the broad spectrum of risks and harms associated with substance use.
"What we need is a broad continuum of services and supports that encompasses the abstinence-based programs highlighted in Ms. Wente's final article as well as harm reduction programs such as needle exchange and methadone maintenance."
Ms. Jesseman concludes by urging: "Perhaps those involved in Canada's debate on drug policy can . . . agree to set ideology aside in favour of advancing evidence-based programs, policies and interventions regardless of the label applied to them, and to work together toward a common goal of providing a comprehensive approach to substance use."
Whether you agree or not, it's a provocative argument, so we're pleased that Ms. Jesseman was online earlier today to take your questions on her Comment article and the broader issues it raises.
Your questions and Ms. Jesseman's answers appear at the bottom of this page.
Rebecca Jesseman is a research and policy analyst at the Canadian Centre on Substance Abuse, where she is currently involved in monitoring harm-reduction initiatives, and in the ongoing development of a national treatment strategy under the National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada.
Ms. Jesseman obtained her MA in criminology from the University of Ottawa, where she continues as a sessional lecturer.
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Jim Sheppard, Executive Editor, globeandmail.com: Welcome, Ms. Jesseman, and thanks for joining us today to take questions from the readers of globeandmail.com.
You made a strong argument in your Comment Page article today for a "common goal of providing a comprehensive approach to substance use." But as you and Ms. Wente also noted separately, ideology often gets in the way of this goal.
How practical do you think this is? What are the first steps that should be taken toward this goal?
Rebecca Jesseman: I think that reaching common ground on the need for a comprehensive approach to substance use is a very practical goal. As I mentioned in my column, the precedent for consensus exists on the international stage.
I think that the first step to be taken is creating dialogue — which is already happening through venues such as the media, public forums, and both online and print publications. We — as an organization and as a field — need to continue to create and promote these opportunities to bring people together and to exchange knowledge and ideas.
I think that the starting point for advancing dialogue is finding common ground. Most people will agree that there are harms associated with substance use. Most people will also agree that there is no silver bullet that will resolve all of these harms.
