My Harm Reduction Story

By Hannah Boyle

Last week I took post as Women’s Harm Reduction Coordinator. I started with Simon Community Scotland just prior to the pandemic as a Support Worker in women’s services. As my first job in social care, I have had to learn on the job and through experience, which has given me the privileged position of embracing harm reduction within my practice. In March 2020, due to the shutdown of the majority of necessary interventions, we were fearful that crisis centres and Injecting Equipment Provision services may be forced to close, putting our women in a higher state of risk than they already are. We believe in bringing services directly to people wherever possible, and so began to operate Injecting Equipment Provision within our women’s projects. 

As Claire Longmuir (Policy and Practice Lead for Harm Reduction) came into post, the culture towards drug use began to shift. The people we support face some of the most oppression in society today, and regularly endure stigma and discrimination which prevents the right support being accessed and effectively, lives being saved. 

By beginning to move towards a harm reduction model in the services, the therapeutic relationships we have with the people we support began to blossom in a whole new direction. Suddenly, the women were not afraid to be open and honest about their drug use for fear of punitive action being taken against them. We heard stories of women being “chucked out” of services or threats of police action being taken against them. We heard of how women who inject drugs were forced to use on the streets, susceptible to all forms of exploitation, bacteria and increased levels of vulnerability. We heard of how women would use drugs in accommodation services but rush for fear of staff interrupting and be more at risk of overdose. We heard of women using drugs in bathrooms, behind closed doors, aware that the risk of death was severe if they were to overdose – but feeling it was their only option.

Hearing these stories and having the privilege to be trusted with the treatment that women who use drugs have faced for far too long, it moved me to do more to challenge stigma against drug use and promote an empowering culture of tolerance and acceptance. 

At Simon Community Scotland, our values are what drive forward our practice. Our staff teams are passionate, empathetic individuals who put people first and ensure their voices are at the centre of everything we do. By embracing the harm reduction model, we accept the whole parts of a person, not separating them from their drug use and deeming them “too hard to engage” or “too difficult to support”. We believe in human rights and everyone being treated with warmth and regard, dignity and respect. 

Our staff have the privilege of building therapeutic, trauma-informed relationships with the people we support and empowering them to achieve the best possible outcomes. We have seen firsthand the power of these therapeutic relationships and the comfort and connection they provide to people experiencing homelessness. This is why we’re so good at what we do.

The opposite of addiction isn’t sobriety – it’s connection Johann Hari

Over the last year we have been working hard to embed and build harm reduction more into our policies and practice in order to prevent drug-related harm. Through this approach, we have seen these relationships grow and the people living in our services feel more comfortable discussing and accessing support for their drug use without fear of discriminiation and punitive action being taken.

I have seen firsthand the impact of this shift within our services. The women we support feel able to be open and honest about their drug use and in turn, access support that benefits their lives. Staff are more confident identifying risks, for example concerning injecting related wounds or signs and symptoms of overdose and how to manage this. In my time spent working in women’s services, I have seen firsthand the number of fatal overdoses decline. Whether that is due to the power of these therapeutic relationships or staff being confident to manage overdose and save lives, who is to say… All I know is that what we are doing is working. 

We provide a home, a safe place to live, but we also provide life changing relationships, giving the people we support the respect they deserve, having them directly feed into policies to ensure their voice is truly at the centre of everything we do.

Not why the addiction, but why the pain? — Gabor Mate 

Within my new role, I will have the opportunity to co-produce harm reduction resources with the women using our services that will directly benefit their lives. Recently, I supported one of the women living in our services to meet with Scottish Government representatives and discuss our Digital Response to Harm Reduction and the impact it has had on her life (which you can hear Jodie speaking about in the new SCS podcast!) These are Jodie’s words:

“It gave me a wee bit of relief because I’m a recovering addict, so it’s helped me get to online meetings, it’s helped me when I’ve been struggling and I’ve been down.

I can get connected to fellowship and I’ve been able to use Zoom, Whatsapp, Facebook, even say hello to a friend online has helped my mental health. It’s helped my whole wellbeing. It’s gave me a whole new outlook. It makes me feel wanted, it makes me feel needed and that as a homeless addict, that’s all we want, is to feel wanted and feel needed in other people’s lives and this is what the digital scheme gives.”

This project has a vital part to play – not only in tackling drug-related deaths and drug-related harm, but also in challenging the stigma and discrimination people who use drugs face, specifically women. At the heart of our Digital Approach to Harm Reduction, are the voices of the women we support. This will provide them the opportunity to input directly into resources that will benefit them and in the long run, work to save lives. I am so excited for the year ahead and the wonderful things the people we support will produce. 

– Written by Hannah Boyle, Women’s Harm Reduction Co-ordinator