Best Practice Recommendations for Canadian Harm Reduction Programs that Provide Service to People Who Use Drugs and are at Risk for HIV, HCV, and Other Harms: Part 1 & 2


Key Questions: How can we improve the effectiveness of harm reduction programs among drug users? How can we evaluate and improve these programs?
The goal of the Best Practice Recommendations is to improve the effectiveness of harm reduction programs that deliver prevention services to people who use drugs and are at risk for human immunodeficiency virus (HIV), hepatitis C (HCV), hepatitis B (HBV), and other harms. These recommendations aim to assist programs and communities to:
  • Improve effectiveness of harm reduction programs
  • Reduce transmission of HIV, HCV, HBV, and other harms
  • Improve the quality and consistency of harm
  • reduction services
  • Inform decisions about the use of resources for
  • effective and efficient practice
  • Advocate for better resources in harm reduction services
  • Provide benchmarks to evaluate their services
  • Identify targets for improvement at the individual
  • program and systems levels


Overview of the Best Practice Recommendations: Part 1

  • 1. Needle and syringe distribution
  • 2. Cooker distribution
  • 3. Filter distribution
  • 4. Ascorbic acid distribution 
  • 5. Sterile water distribution
  • 6. Alcohol swab distribution
  • 7. Tourniquet distribution
  • 8. Safer crack cocaine smoking equipment distribution
  • 9. Disposal and handling of used drug use equipment
  • 10. Safer drug use education
  • 11. Opioid overdose prevention: education and naloxone distribution
  • Appendix A – Methods: Overview of Research Evidence Review and Synthesis
  • Appendix B – Other Injection-related Equipment Supporting Evidence
Overview of the Best Practice Recommendations: Part 2
  • Sexual Health Promotion for People Who Use Drugs – A comment 
  • Chapter 1: Program delivery models 
  • Chapter 2: Needle distribution for anabolic steroid injection, hormone injection, piercing and/or tattooing
  • Chapter 3: Foil distribution
  • Chapter 4: Safer crystal methamphetamine smoking equipment distribution 
  • Chapter 5: Injection-related complications – prevention, assessment, and treatment 
  • Chapter 6: Testing services for HIV, hepatitis C, hepatitis B, and tuberculosis
  • Chapter 7: Vaccination services for hepatitis A and B, pneumococcal pneumonia, influenza,
  • tetanus, and diphtheria 
  • Chapter 8: HIV and/or hepatitis C treatment referrals 
  • Chapter 9: Substance use treatment referrals 
  • Chapter 10: Mental health services referrals 
  • Chapter 11: Housing services referrals
  • Chapter 12: Relationships with law enforcement
  • Chapter 13: Education and other services for the prison context
  • Appendix A – Methods: Overview of Research Evidence Review and Synthesis
Contact Person/Organization: 

Working Group on Best Practice for Harm Reduction Programs in Canada

Type of Tool:

Publication Date: