Vancouver and Lisbon, while worlds apart, are both boasted for their global leadership in innovating progressive harm reduction policies and services.

A group of researchers from both cities partnered with a committee of young people who use drugs to share whether their respective cities were meeting young people’s needs in the context of unstable housing and homelessness.

This committee, the Youth Health Advisory Committee (YAC) at the BC Centre on Substance Use, collaborated with these researchers to identify ten essential calls to action related to harm reduction practices for youth that use drugs. The hope is that this resource can be shared and accessed broadly by law and policy makers, law enforcement, service providers, teachers, researchers, and larger communities.

At the forefront of these calls to action, there is a demand for youth empowerment and representation in all forms of decision-making. There is a shared sentiment that the creation and implementation of harm reduction services is dominated by adult voices, without the consideration that youth who use drugs have unique needs. This is compounded by the lack of diversity in the voices being represented. Many don’t feel represented in the media, laws, and policies that affect them, and fear negative consequences if they seek out help for their drug use.

An example of where such representation could have a positive impact is in the creation of non-judgemental and supportive education around drug use, including related components such as mental and sexual health. YAC members also said it is particularly important that these programs do not impose moral attitudes and abstinence approaches when connecting with youth.

The 10 calls to action are the following:

1. We oppose approaches to preventing drug-related harms that are premised on abstinence.
2. Young people’s engagement with harm reduction programs and sites should be kept confidential.
3. We demand investment in low-barrier and youth-led harm reduction programs and spaces, including safer consumption sites.
4. Youth-oriented programs and spaces must account for the needs of polysubstance-using youth, BIPOC youth, gender diverse and queer youth, and self-identified young woen.
5. Stop pathologizing young people who use drugs (YPWUD) and trying to “save” or “fix” us.
6. The services and systems that YPWUD traverse must be re-designed to foster youth’s self-determination in relation to their drug use, harm reduction, care, and families.
7. We add our voices to those demanding the decriminalization of drug use and an end to the war on drugs.
8. We add our voices to those demanding a safe supply of drugs via peer-led compassion clubs.
9. Youth voices should be better integrated into both bottom up, grassroots and top down, state-sponsored harm reduction movements.
10. YPWUD in the context of greater privilege and allies should focus energy on fostering and extending the activism of YPWUD in the context of street involvement.

Beyond harm reduction, there are many larger factors at play in supporting youth who are using drugs in the context of experiencing unstable housing and homelessness. Support in broader areas such as mental health and housing are vital in providing basic needs and safety amongst young people. Key priorities include removing any age restrictions or cut-offs, transitioning away from medicalized care to community care, which involves shifting away from police and pharmaceutical interventions within substance use care.

At the core of these requests, youth who use drugs are naming the same needs that everyone shares: housing, education, healthcare, and dignity.