Harm Reduction Fundamentals: A toolkit for service providers

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Harm reduction is an important part of supporting the rights and health of people who use drugs. There is a growing demand for harm reduction information by all types of organizations that provide services to people who use drugs in Canada. This toolkit provides foundational information on harm reduction for service providers working with people who use drugs (including support workers, outreach workers, nurses and workers with lived and living experience). The toolkit is free to access and is available to anyone to use or share for personal learning, organizational trainings and/or other capacity-building efforts.

The toolkit contains four units that can be accessed individually or completed together for a more comprehensive overview of harm reduction fundamentals. Organizations and individual learners can decide which parts of the toolkit are most appropriate for them.

Each unit should take approximately one hour to complete; however, there will be variability depending on the unit and the level of engagement with content, videos, reflection questions and external links. We suggest setting aside four hours total if you plan to complete all four units.

Unit 1: Setting a foundation for harm reduction


  • Substance use
  • Prohibition and criminalization of drug use
  • Stigma and discrimination

Launch Unit 1

Unit 2: Harm reduction principles and practices


  • What is harm reduction?
  • Indigenous harm reduction
  • Harm reduction programs
  • Meeting community harm reduction needs
  • Organizational policies and culture that support harm reduction

Launch Unit 2

Unit 3: Drug use, health and harm reduction


  • Effects of drugs
  • Holistic approaches to health and wellness
  • Potential harms from injecting, smoking or snorting drugs
  • Responding to drug poisonings and overdoses
  • Safer substance use

Launch Unit 3

Unit 4: Supporting harm reduction service provider capacity


  • Delivering harm reduction services and engaging service users
  • Harm reduction worker wellness
  • Supporting the engagement of people who use drugs
  • Visions for the future of harm reduction

Launch Unit 4


The information in this toolkit is based on decades of strong evidence about harm reduction. We wish to honour the instrumental roles that people who use drugs have played in building harm reduction practice, programming and policies and the related evidence base. Harm reduction exists because of people who use drugs’ bravery, creativity, care and commitment to their communities.

Canada is in the midst of a drug poisoning crisis. We mourn the lives that have been taken by bad drug policies and grieve alongside families, friends and other loved ones who have lost people. We hope that the information within this toolkit can play a small role in supporting people who use drugs today and in working toward a more just future.  

This toolkit was developed in partnership with a working group of organizations, agencies and networks across Canada that have expertise and leadership experience in harm reduction. We are grateful to all members of this working group for their guidance, for sharing their decades of grounded expertise and for all the energy and knowledge they contributed to the development of this resource.

Cactus CAPUD Dr. Peter Centre HRNA
SRCHC Streetworks TTH Dalla Lana

National working group partners

AIDS Committee of Newfoundland and Labrador (ACNL)

Association des intervenants en dépendance du Québec (AIDQ)

Blood Ties Four Directions Centre

Communities, Alliances and Networks (CAAN)

CACTUS Montréal

Canadian Association of People Who Use Drugs (CAPUD)

Dr. Carol Strike, professor at the Dalla Lana School of Public Health, University of Toronto

Dr. Peter Centre  

Harm Reduction Nurses Association (HRNA)

Harm Reduction Services, BC Centre for Disease Control

Manitoba Harm Reduction Network (MHRN)

Ontario Harm Reduction Distribution Program (OHRDP), Kingston Community Health Centres

Ontario Harm Reduction Network (OHRN)

South Riverdale Community Health Centre (SRCHC)


Toward the Heart and Professionals for Ethical Engagement of Peers (PEEP), BC Centre for Disease Control Harm Reduction Services

Land acknowledgment

CATIE’s work, including the development of this toolkit, takes place across Indigenous lands on what is now known as Canada.

Historical and ongoing colonial policies, laws and practices are inextricably linked to the harms caused by prohibition and criminalization today – harms that are disproportionally felt by Indigenous peoples and communities. We must strive to support Indigenous communities’ self-determined efforts to challenge these systems and support one another, always following their lead.

We invite you to recognize the lands that you are on, consider your relationships to those lands and reflect on how these relationships shape how you come to harm reduction.

Funding acknowledgment

Production of this resource has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada or our partners. CATIE endeavours to provide the most up-to-date and accurate information at the time of publication. However, information changes and users are encouraged to ensure they have the most current information.