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Harm Reduction Supplies

The following is a list of common harm reduction equipment. In Ottawa, you can pick these supplies up free of cost from our SCS, the Trailer, which is open 24/7.

Alternatively, you can acquire free harm reduction supplies from:

Site Mobile Harm Reduction Van

Sandy Hill Community Health Centre

Ottawa Public Health

Somerset West Community Health Centre

Syringes

Around 1.2 million people who use drugs live with HIV, and another 10 million are infected with HCV(1). One of the major causes of infection transmission among this population is needle sharing1. Until recently, access to needle exchange and SITE distribution programs was not as widespread. The provision of sterile syringes has been a crucial part of harm reduction, and is associated with decreases in syringe sharing and infection rates (2). Syringes come either short-tipped or long-tipped, depending on user preferences.

Vitamin C

In order to break down certain drugs, such as crack cocaine, into an injectable liquid, an acidifier needs to be used. Vitamin C is by far the safest option for this purpose, as alternatives like lemon juice and vinegar can cause infection and vein damage.3 Though vitamin C is recommended, it is important to know that any acidifier can cause vein damage.3 Thus, using as little as possible is important in preparing drugs for injection.

Sterile Water

Sterile water is mixed with the drug to create an injectable liquid. It is crucial to use sterile water rather than other water sources (ex. saliva, tape water, puddles) to prevent infection.4 It is also important to know that using alcohol instead can increase the risk of overdose, especially when combined with sedatives like fentanyl (4). Thus, sterile water is the recommended liquid to use when preparing substances for injection.

Cookers

Metal cookers are used to prepare the drug for injection. Sterile water, the drug, and in some cases, vitamin C, are added to the cooker. The mixture is then cooked using a heat source, such as a lighter. In order to prevent infection, a new cooker should be used each time. If a cooker must be reused, it is important to cook the mixture for at least 10 seconds.5 Additionally, it is important to remember that even if you are not sharing needles, sharing cookers can also cause infection transmission (5). Therefore, you should only use a cooker once, and avoid sharing it with others.

Filters

Using filters can help mitigate various complications of injection drug use. After a drug is cooked and prepared for injection, it is important to use a filter when drawing the mixture into a syringe. These filters help reduce the risk of injecting impurities and foreign materials, which can cause infection and injury (6).

Straight Stem

A straight stem pipe can be used to inhale various substances, most commonly crack cocaine. It is safer than alternatives such as pipes made from copper, plastic, and soda cans, as these can emit toxic fumes when heated. It is also better than using glass pipes made from items like syringes or bulbs, as these are more susceptible to breaking and can cause injury.7 Though many are aware of the risks of sharing needles, it is equally important to not share pipes, as this can also cause infection transmission (8).

Brass Screens​

Brass screens are folded and pushed into a stem pipe to hold the drugs in place and prevent inhalation of drug fragments. Many people who smoke drugs still use commercial steel wool products, such as Brillo instead (9). It is important to know that these products can cause various health risks, including inhaling chemicals and bits of steel wool itself (9). As well, brass screens have been shown to retain more drugs than steel wool, meaning that less drugs are wasted (9).

Glass Bowl/ Bubble Pipe

These glass pipes are similar to straight stems, but have a bowl at the end that holds the drug being inhaled. These specialized pipes also reduce the risk of using unsafe alternatives that emit toxic fumes or can cause injury (7).

Hose/ Mouthpiece

These vinyl tubes are commonly referred to as hoses by people who smoke drugs. They are intended to protect the mouth from injury, burns, and infection (10). Using hoses also allows for more private and discreet use. The length of hoses varies depending on preference.

Wooden Push Sticks

Wooden push sticks are used to pack brass screens into straight stem pipes. Plastic syringe plungers are often used as an alternative, which poses the possibility of inhaling melted plastic and syringe misuse (10). Provision of wooden push sticks helps to mitigate these risks.

Alcohol Swabs

Alcohol swabs are an important harm reduction product that can be used to sanitize many items prior to drug use. This includes hands, pipes, syringes, and injection sites. It is important to not reuse alcohol swabs (7). Properly cleaning both the syringe and injection site prior to use is essential to prevent infection and injury, as licking the needle tip or injection site is linked to abscess and cellulitis (4). Drug supplies (pipes, syringes) should never be shared, even if they are sanitized with an alcohol swab. You should also avoid reusing gear whenever possible.

Foil

Foil can be used to smoke various drugs. Additionally, it can be used to make a makeshift bowl pipe with a straight stem. Foil is often distributed to encourage injection drug users to switch to inhalation, which is associated with less risks (11).

Tourniquets

Tourniquets are tightly wrapped around the arm using a slipknot to pop out veins, resulting in easier access and visibility (12). This helps to reduce the repercussions of regular drug use on the veins, and makes it easier for people with damaged and collapsed veins to safely inject drugs.

Condoms and Lubricants

While many people might not immediately think of condoms and lubricants as harm reduction, they have many important purposes. Provision of condoms helps to reduce the transmission of sexually transmitted infections, such as HIV, when used consistently and properly (13). Additionally, lubricant helps to prevent injury and improve sexual health and well-being (14). Condom and lubricant distribution is especially crucial for certain groups within the population of people who use drugs, notably sex workers and people living with HIV.

Intranasal Straws

Intranasal straws are used for snorting powdered drugs and/or inhaling vapors. They should be single-use and disposed of immediately to prevent the spread of blood-borne viruses like hepatitis C and bacteria such as MRSA, as sharing or reusing straws increases the risk of transmitting infections due to potential blood transfer from nasal cuts. Additionally, using straws instead of rigid devices can reduce the risk of injury to the nasal passages (15).

References
    1. Fernandes, R. M., Cary, M., Duarte, G., Jesus, G., Alarcão, J., Torre, C., Costa, S., Costa, J., & Carneiro, A. V. (2017). Effectiveness of needle and syringe Programmes in people who inject drugs – An overview of systematic reviews. BMC Public Health, 17(1), 309–315. https://doi.org/10.1186/s12889-017-4210-2
    2. Kerr, T., Small, W., Bucher, C., Zhang, R., LI, K., Montaner, J., & Wood, E. (2010). Syringe Sharing and HIV Incidence Among Injection Drug Users and Increased Access to Sterile Syringes. American Journal of Public Health (1971), 100(8), 1449–1453. https://doi.org/10.2105/AJPH.2009.178467
    3. Harris, M., Scott, J., Wright, T., Brathwaite, R., Ciccarone, D., & Hope, V. (2019). Injecting-related health harms and overuse of acidifiers among people who inject heroin and crack cocaine in London: a mixed-methods study. Harm Reduction Journal, 16(1), 60–15. https://doi.org/10.1186/s12954-019-0330-6
    4. Harris, M., Scott, J., Hope, V., Wright, T., McGowan, C., & Ciccarone, D. (2020). Navigating environmental constraints to injection preparation: the use of saliva and other alternatives to sterile water among unstably housed PWID in London. Harm Reduction Journal, 17(1), 24–11. https://doi.org/10.1186/s12954-020-00369-0
    5. Ball, L. J., Venner, C., Tirona, R. G., Arts, E., Gupta, K., Wiener, J. C., Koivu, S., & Silverman, M. S. (2019). Heating Injection Drug Preparation Equipment Used for Opioid Injection May Reduce HIV Transmission Associated With Sharing Equipment. Journal of acquired immune deficiency syndromes (1999), 81(4), e127–e134. https://doi.org/10.1097/QAI.0000000000002063
    6. Keijzer, L., & Imbert, E. (2011). The filter of choice: filtration method preference among injecting drug users. Harm Reduction Journal, 8(1), 20–20. https://doi.org/10.1186/1477-7517-8-20
    7. Interior Health. (n.d.). Harm reduction supplies: Safer smoking supplies. https://www.interiorhealth.ca/sites/default/files/PDFS/handout-safer-smoking-supplies.pdf
    8. Cheng, T., Wood, E., Nguyen, P., Montaner, J., Kerr, T., & DeBeck, K. (2015). Crack pipe sharing among street-involved youth in a Canadian setting. Drug and Alcohol Review, 34(3), 259–266. https://doi.org/10.1111/dar.12180
    9. Diak, B. J., Miskovic, M., Zurba, N., & Beaumont, D. (2023). Not all screens are created equal: examination of surface features and other physical properties of commonly used screen materials for smoking drugs. Harm Reduction Journal, 20(1), 68–68. https://doi.org/10.1186/s12954-023-00794-x
    10. Ti, L., Buxton, J., Wood, E., Zhang, R., Montaner, J., & Kerr, T. (2011). Difficulty accessing crack pipes and crack pipe sharing among people who use drugs in Vancouver, Canada. Substance abuse treatment, prevention, and policy, 6, 34. https://doi.org/10.1186/1747-597X-6-34
    11. Pizzey, R., & Hunt, N. (2008). Distributing foil from needle and syringe programmes (NSPs) to promote transitions from heroin injecting to chasing: an evaluation. Harm Reduction Journal, 5(1), 24–24. https://doi.org/10.1186/1477-7517-5-24
    12. Peckham, A. M., & Young, E. H. (2020). Opportunities to Offer Harm Reduction to People who Inject Drugs During Infectious Disease Encounters: Narrative Review. Open forum infectious diseases, 7(11), ofaa503. https://doi.org/10.1093/ofid/ofaa503
    13. CATIE. (2024, April 30). Condoms for the prevention of HIV transmission. https://www.catie.ca/condoms-for-the-prevention-of-hiv-transmission
    14. Kennedy, C. E., Yeh, P. T., Li, J., Gonsalves, L., & Narasimhan, M. (2022). Lubricants for the promotion of sexual health and well-being: a systematic review. Sexual and Reproductive Health Matters, 29(3), 2044198–2044198. https://doi.org/10.1080/26410397.2022.2044198
    15. BCCDC Harm Reduction Services. (2021, August 11). Harm reduction supply program – launch of paper straws. Toward the Heart. https://towardtheheart.com/update/harm-reduction-supply-program-launch-of-paper-straws

Dr. Simon Hatcher

Medical Director of Psychiatry

Dr. Simon Hatcher is a Psychiatrist at the Ottawa Hospital and Medical Director of Psychiatry at Ottawa Inner City Health, a Scientist at the Ottawa Hospital Research Institute, and a Full Professor and Chair of the Department of Psychiatry at the University of Ottawa. He has worked as a psychiatrist in clinical, research and leadership roles in non-mental health settings all his professional career starting in Leeds, UK followed by 20 years in Auckland, New Zealand before moving to Canada in 2012. Dr. Hatcher is not good at many things but one thing he does try to do well is to give a voice and meaning to people who are suffering from mental disorders. This is integrated into clinical care, teaching, and research through the Hatching Ideas Lab. Away from his professional work, he keeps bees and rides motorbikes, but not both at the same time.

Dr. Rakesh Patel

Medical Director

Dr Rakesh V. Patel is an Assistant Professor of Medicine. He is the past Program Director for the Adult Critical Care Medicine Residency and Fellowship Programs at the University of Ottawa. He is also the current Chair of the Pharmacy and Therapeutics Committee for The Ottawa Hospital (TOH). He completed his General Internal Medicine (GIM) residency in Ottawa (2001), his Masters in Health Research Methodology at McMaster University (2004) and his Adult Critical Care Medicine Residency training at U of Ottawa (2004). He has been practising adult critical care and internal medicine, at the U of Ottawa and TOH, since 2004. His research interests are varied and include; clinical pharmacology/therapeutics, and medical education. He loves caring for sick patients and teaching. He received the “Clinical Teacher of the Year” award from the GIM residents in 2007.

Kim Van Herk

Mental Health Nurse Coordinator Team Lead

As Team Lead for the Mental Health Nurse Coordinators at OICH, Kim combines extensive expertise, heartfelt leadership, and a deep commitment to compassionate care. She earned her Bachelor of Nursing from McMaster University and her Master’s degree from Ottawa University, where her research focused on improving access to care for pregnant and parenting Aboriginal women in urban settings. As another longtime OICH nurse, Kim is known for her empathetic leadership style and her ability to foster a culture of courage, inclusivity, and trust. With a wealth of experience in mental health care for vulnerable populations, she ensures that every individual feels seen, supported, and valued. Outside of her professional role, Kim finds joy in spending time with her kids, immersing herself in nature, and reading.

Christina Masters

Nurse Coordinator Team Lead

As Team Lead for the Nurse Coordinators at Ottawa Inner City Health, Christina Masters brings a sharp analytical mind, deep compassion, and extensive nursing expertise to her role. She earned her Nursing degree from the University of Ottawa and began her career in the emergency room, holding an emergency nursing certification from the Canadian Nurses Association. Christina is a dedicated harm reduction leader, passionate about education and development. Christina never shies from jumping into a complex, challenging medical situation. Her thoughtful approach ensures every client feels seen, valued, and supported. Within her team, Christina is the steadying force—the glue that holds everyone together. Outside of work, Christina enjoys spending time with her kids, caring for her chickens, cross-stitching intricate patterns, and baking delicious treats.

Louise Beaudoin

Nursing Manager

Louise Beaudoin has been a part of Ottawa Inner City Health since its early days when OICH was a pilot project. She earned her Bachelor of Nursing from the Université du Québec and brings decades of dedication and expertise to her role as RPN Manager. Passionate about working in the grey areas of harm reduction, Louise thrives on finding flexible solutions that meet the community’s unique needs. Outside of work, Louise is all about physical activity and sports! She keeps active and energized through skiing, cycling, and yoga.

Anne Marie Hopkins

Director of Operations

With a background in Social Work and a Master’s in Business Administration, Anne Marie combines compassionate, people-focused care with strategic leadership in her role as Director of Operations. Anne Marie began her journey with Ottawa Inner City Health in 2008 as a volunteer and has since held multiple roles within the organization. Anne Marie is passionate about building community and loves working in the mental health and substance use field, drawn to the complexity, nuance, and humanity of the harm reduction world. Anne Marie’s happiest moment in her career was being part of the team that launched OICH’s Supervised Consumption Site in 2017. Outside of her professional life, Anne Marie is passionate about dogs, reading her Kindle, being outdoors, and quilting.

Joanne Rousseau

Director of Human Resources

Joanne holds a Bachelor of Arts in Sociology from the University of Windsor and a Human Resources diploma. She is a Certified Human Resources Leader (CHRL). While she’s newer to the OICH team, Joanne brings extensive experience in HR leadership and managing large teams. After years in the corporate world, Joanne sought a role with purpose and heart where her work could make a meaningful impact on the community. In her spare time, Joanne enjoys reading Jane Austen novels, watching Doctor Who, puzzling, and musicals. If you’ve visited the OICH office, you’ve likely been greeted by Lily, Joanne’s friendly office dog.

Rob Boyd

Chief Executive Officer

Rob has worked at the intersection of homelessness, mental health and substance use health in Ottawa for the past 35 years, including over 20 years in senior leadership positions. He has extensive experience in developing programs and services centred on clients’ needs and responsive to the changing environment in which they live. Rob is a champion for the inclusion of people with lived experience in all aspects of the work being done, from systems advocacy to service delivery. Rob lives in the country and likes working around his property and spending time outdoors. He is known as the office dog whisperer, likely due to his calm nature and relaxed energy.