Harm Reduction in Practice

Harm reduction is often described as a philosophy. In daily work it is closer to a set of habits, and this page describes the habits rather than the theory.

Meeting the person who is actually in front of you

The first habit is to plan for what someone is going to do, not for what you wish they would do. A person who has decided to take a substance this weekend is not made safer by being told not to. They are made safer by knowing what interacts with what, what a dangerous dose looks like, what the early signs of trouble are, and who to call.

That is not permission. It is the difference between an outcome you can influence and one you cannot.

The habits

Ask without flinching. People withhold when they expect judgement, and what they withhold is usually the thing that matters — the supplement, the second substance, the dose they actually took.

Assume the list is incomplete. In pharmacy this is a reflex. It transfers directly.

Name the real risks, not the loudest ones. Public fear has historically pointed at the wrong things — chromosome damage, holes in the brain, blindness from staring at the sun. The actual risks in this field are more boring and more manageable: interactions, cardiac history, unscreened psychiatric vulnerability, an unsupported setting, and a person left alone afterwards.

Say what the evidence does not show. The fastest way to lose a person's trust is to overclaim, then be found out. Evidence for psychedelic-assisted therapy in some conditions is genuinely encouraging. That is not the same as proven, and it is nowhere near the same as a cure.

Plan the after, not just the during. Integration is where the change either holds or evaporates, and it is the part most often left unresourced.

Where I have practised it

In community pharmacies across British Columbia, Alberta, Saskatchewan, Manitoba and the Northwest Territories, including in remote and northern communities where the nearest alternative was hours away.

Most concretely, I was central to launching the community take-home naloxone programme in a British Columbia town consistently ranked among the highest in the province for per-capita overdose deaths, and led the training behind it.

In June 2023 I completed, by invitation, a review of the provincial Opioid Agonist Treatment Support Program for the BC Centre on Substance Use and the University of British Columbia.

Through Responsible Empowered Living, a Canadian harm reduction non-profit I founded (2022–2025), whose educational work is preserved on this site. It was donation-based, with structured intake, risk screening, scope-limited practice and referral onward to physicians and psychiatrists.

Through volunteer work with MAPS Canada, TheraPsil and the Psychedelic Association of Canada, and through the published education listed elsewhere on this site.

Why it belongs in a counselling practicum

A harm-reduction stance and a counselling stance rest on the same footing: the person is the authority on their own life, the clinician's job is to widen what they can see rather than decide for them, and the relationship is what makes any of it work.

Education, not medical advice.