Harm Reduction

What is Harm Reduction?

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Harm reduction activities aim to reduce the harm associated with a specific behaviour.

The principles of harm reduction include:

Needles Exchange/Supplies

Project X-Change

Project X-Change is a harm reduction program dedicated to protecting the general public from contamination caused by indiscriminate disposal of needles in public areas and infection in substance users who use unsterile equipment.  The program provides access to sterile needles and other sterile equipment such as water, alcohol swabs, Vitamin C, cookers and filters as well as condoms and latex-free tourniquets. 

Referrals to healthcare services and addiction treatment programs are available upon request, along with information on safer injection/inhalation/snorting and safer sex for people engaging in at-risk activities.

Project X-Change is funded by the Durham Region Health Department and operated by the John Howard Society of Durham Region. It has satellite site partnerships with the AIDS Committee of Durham Region and Pinewood Centre and Mental Health Service.

Where to go for supplies


AIDS Committee of Durham Region
22 King Street West - Suite 202
Oshawa, ON L1H 1A3
(905) 576-1445
Monday to Friday 9am-5pm

Pinewood Community Treatment Services
419 King Street West
Oshawa, ON L1J 2K5
(905) 571-3344 ext. 115
Monday to Friday 8:30am-4:30pm

Pinewood Addiction Support Services
300 Centre Street South
Oshawa, ON L1H 4B2
(905) 668-1858
7 days a week 9:00am-5:00pm

Project X-Change, John Howard Society
75 Richmond Street West
Oshawa, ON L1G 1E3
(905) 579-8482
Monday to Thursday 8:00am-5:00pm, Friday 8:00am-4:00pm


John Howard Society of Durham Region
114 Dundas Street East - Suite 200
Whitby, ON L1N 2H7
(905) 666-8847
Monday, Wednesday, Thursday 8:00am-5:00pm
Tuesday 8:00am-7:00pm
Friday 8:00am-4:00pm


John Howard Society of Durham Region
136 Commercial Avenue
Ajax, ON L1S 2H5
(905) 427-8165
Monday to Thursday 8:30am-4:30pm
Friday 8:30am-4:00pm

Pinewood Community Treatment Services
95 Bayly Street West - Suite 406
Ajax, ON L1S 7K8
(905) 683-5950 ext. 222
Monday to Thursday 9:00am-5:00pm
Friday 9:00am-12pm


John Howard Society of Durham Region
132 Church Street
Bowmanville, ON L1C 1T5
(905) 623 6814
Monday to Thursday 8:30am-4:30pm
Friday 8:30am-12pm & 1:30pm-4:00pm

Pinewood Community Treatment Services
200 King Street East
Bowmanville, ON L1C 1P3
(905) 697-2746
Monday to Thursday 8:30am-4:30pm
Friday 8:30am-12pm

Port Perry

Pinewood Community Treatment Services
180 Mary Street
Port Perry, ON L9L 1C4
(905) 985-4721
Monday to Thursday 9:00am-5:00pm
Friday 9:00am-12pm

Mobile Outreach

Project X-Change, John Howard Society Go to external website
(905) 440-5410 Alternate phone: (905)440-5387
Monday to Friday 6:00pm-11:00pm
For more information, contact: Beth Whalen, Coordinator, Harm Reduction Services

Opioid Patch Return Program

Did you know?

There is an opioid patch that relieves pain.

It’s called Duragesic®. A common generic form is called fentanyl or mylan. This is a very powerful opioid medication that is prescribed for individuals that have severe chronic pain. The patch is placed on the skin and releases a steady amount of medicine over a three day period. After three days, the patch is removed and is replaced with a new one.

The fentanyl patch is much stronger than other opioids.

Fentanyl is about 80 times stronger than morphine. Although the fentanyl patch is only meant to be given to individuals who have a prescription, these patches are also being distributed illegally on the streets. Illegal misuse of fentanyl patches is done in many ways including smoking, chewing or injecting the medication. When misusing patches in this way, the dose ingested or injected is unknown. This leads to a high possibility of overdosing.

Not only new but used patches are also being distributed and abused. There is about 50% of the medication on the patch even after wearing it for three days, so there is potential to overdose when misusing a used patch.

Using fentanyl patches without proper medical care and follow-up is very risky and can easily result in an overdose.

Working together to reduce access to new and used fentanyl patches is one way to help reduce the amount of fentanyl available to those who misuse it or illegally sell it. Patch return programs are being created across Ontario to meet this goal.

What are we doing to prevent opiate overdose?

In an effort to combat the abuse, misuse, and diversion of prescription fentanyl patches, the Ontario government has passed a law which requires patients who receive a prescription for fentanyl to return their used patches to a pharmacy before receiving new ones. Click here for more information.

With the patch return program, individuals who are prescribed patches need to return them to the pharmacy before receiving new ones. For each used patch returned, a new one will be provided. For example, if 10 used patches are returned, 10 new patches will be provided. Patients that find it difficult to return all their patches are encouraged to speak with their pharmacist.

Used patches are an environmental concern. They should not be put in the garbage or flushed down the toilet. If used patches are not disposed of correctly, they can end up in our environment where they pose a danger to children and animals. This also creates an opportunity for illegal reselling and distribution of used patches.

When patches are returned to the pharmacy, the pharmacy staff will take the used patches and dispose of them in a safe and environmentally friendly way.

More Information and Resources:

Methadone Clinics

Methadone and Suboxone

Methadone and Suboxone are prescription medications that are used to treat withdrawal symptoms in those using narcotics, and to help to stop the use of narcotics.

What is Methadone?

Methadone belongs to the opioid family of drugs. Methadone is a “synthetic” opioid, which means that it is made from chemicals in a lab. It is used to treat addiction to other opioid drugs such as heroin, oxycontin, percocet, codeine, etc.

How does Methadone work?

Methadone works by decreasing drug cravings, while preventing physical withdrawal symptoms. Methadone is typically dissolved in a fruity drink which the patient swallows. Methadone maintenance treatment works best when combined with other substance use services and interventions.

What is Suboxone?

Suboxone is a combination of two medications - buprenorphine and naloxone. Suboxone is an opioid and is effective in reducing opiate cravings and withdrawal symptoms. Suboxone is used to treat addiction to other opioids, for example codeine, oxycodone, hydromorphone, fentanyl, morphine and heroin.

How does Suboxone work?

Suboxone works by decreasing opiate cravings and withdrawal symptoms. Suboxone is a tablet taken once a day under the tongue. Suboxone is useful to prevent withdrawal because it has a long duration of action. For most people, a single dose prevents withdrawal for more than 24 hours.

Access a Program in Durham Region

First Step Medical Clinic
32 Simcoe Street South
Oshawa, ON L1H 4G2

South Oshawa Clinic - Pharma Trust Pharmacy
777 Simcoe St. South
Oshawa, ON

Oshawa Ontario Addiction Treatment Centers (OATC) Clinic
45 Bloor Street East, Unit 2
Oshawa, ON L1H 3L9
Monday, Tuesday, Thursday, Friday 8:00am-4:00pm (Closed Friday from 12:30pm-1:00pm)
Wednesday 8:00am-12:00pm
Saturday 9:00am-12:00pm
Closed: Sunday

New Direction Addiction Clinic
540 King St. W.
Oshawa, ON L1J 7J1
Monday to Friday 9:00am-6:00pm
Saturday 9:00am-3:00pm
Sunday 9:00am-1:00pm

Parkwood Clinic
11 Colborne St. E
Oshawa, ON
Phone 905-728-5147
Fax 905-728-3916
Saturday 11:00am-1:00pm
Tuesday 2:00pm-5:00pm

True North Clinic at Scott’s Pharmacy
1000 Simcoe St N
Oshawa, ON L1G 4W4
Monday 10:00am-12:00pm
Wednesday 9:30am-10:30am

Beaverton OATC
371 Simcoe Street
Beaverton, ON, L0K 1A0
Tuesday and Friday 8:30am-1:00pm
Closed: Monday, Wednesday, Thursday


What is Naloxone?

Naloxone is a drug that temporarily reverses the effects of opioids. It is used in situations where a person who has overdosed on opiate drugs stops breathing. When given properly, Naloxone will quickly reverse the effects of the opiate and the person will start breathing again and regain consciousness. Naloxone's effects are only temporary, meaning the overdose symptoms will likely return. Emergency medical services are still required. Naloxone buys time that is needed until medical help can arrive.

Where can I get Naloxone?

Naloxone can also be accessed for free, without a prescription, from participating pharmacies. Contact your local pharmacy to inquire about the availability of naloxone.

The Carea Community Health Centre Hepatitis C Team provides people who are active opioid users with naloxone and overdose prevention training. The Hepatitis C Team consists of a social worker, outreach worker, coordinator, mental health and addictions counsellor and treatment nurse. In addition to supplying naloxone and overdose prevention training, they can provide hepatitis C education, resources and support (1 on 1 and group), testing and treatment, and assistance with forms and referrals. Carea services are confidential and provided at no cost.

To access the naloxone distribution program or overdose prevention training, please call 905-723-0036 ext. 206.

Video Resources

What is an Opioid Overdose? Video Link
A short clip explaining what an opioid overdose is and how naloxone works.

Eyes Wide Open Video Link
Eyes Wide Open recalls the experiences of people affected by an accidental opioid overdose and the emergency medicine naloxone. Based on true stories from 2 Canadian cities, this short documentary highlights the need for expanding overdose prevention.

911 Naloxone Video Link
The short film 911 Naloxone brings a police chief, a paramedic and a physician together to discuss initiatives intended to save lives, reduce injuries and ease the financial burden on the health care system.


Sex Trade Workers

The Sex Trade Worker Support Circle of Durham Region

The Support Circle is a committee made up of various social service agencies and organizations that are dedicated to providing services and support to women working in sex work or directly affected by sex work in Durham Region. The Support Circle delivers education on health needs of sex workers and effective strategies to engage sex workers in their health. It acts as an advisory to the Durham Referrals Education Advocacy Mentorship & Support (D.R.E.A.M.S.) Program which is a weekly drop-in program for sex workers. Some committee members attend the D.R.E.A.M.S. Program to provide access to their services.

Durham Referrals Education Advocacy Mentorship & Support (D.R.E.A.M.S.) Program

This program is designed to support women involved in sex trade work within Durham Region. This service provides a weekly drop-in centre for sex workers.

The Drop-in services include:

For further information contact the John Howard Society of Durham Region 905-579-8482 or 905-244-2602.


HIV Post Exposure Prophylaxis (PEP)

HIV Pre-exposure Prophylaxis (PrEP)

How to access PEP or PrEP?

Strategies for Prevention

Durham Statistics

Local Services/Resources

Local Services

Pinewood Centre for Addiction Go to external website

One of Ontario's largest treatment programs, helping thousands of people cope with substance use, concurrent disorders and problem gambling. Many of the counsellors have specialized training to work with youth, women and those with mental health issues.

Staff work with people to develop treatment plans that reflect their strengths, concerns and preferences.  Sites are located in the community, not in a hospital setting, offering a safe, supportive environment to work towards treatment goals.

For crisis support and withdrawal management services at 300 Centre St. S, call 905-723-8195 or 1-888-881-8878

For general information, to discuss concerns and/or to book an appointment for assessment:

AIDS Committee of Durham Region (ACDR) Go to external website

A community-based, non-profit, charitable organization. ACDR staff work in partnership with many individuals and organizations that support, in principle or in practice, their mission and goals.

They create an inclusive environment for a collaborative approach to education, support and outreach.  Staff build on the strengths and abilities of people living with HIV, AIDS and related co-infections, those at risk and their support networks in Durham Region.

22 King Street West, Suite 202
Oshawa, ON L1H 1A3
Tel: 905-576-1445
Toll free: 1-877-361-8750

Carea Community Health Centre Hep C Team Go to external website

The Hep C Team provides programs and services to people of all ages affected by hepatitis C including support for those at-risk, pre-treatment assessment, treatment and post-treatment follow-up). Programs and services can be accessed throughout the Central East LHIN (Durham, Peterborough, and the 4 Counties).

Programs and services include: screening, treatment, fibro scan clinics, counseling, support groups, community outreach, harm reduction strategies and education.

Phone 1-855-808-6242 Press 4, then 5

Positive Care Centre Go to external website

The Positive Care Clinic is designed to be a "one stop shop" for clients seeking HIV, AIDS and hepatitis C support and treatment. Staff work closely with people to give them the information and care they need to manage their health and live full and happy lives.  The clinic is staffed by an interdisciplinary team that includes Infectious Diseases Specialists, Registered Nurses, a Social Worker, Dietitian, Pharmacist and Administrative Support. The Positive Care Clinic provides individual assessments, counselling, nutrition, medication, onsite laboratory work (blood work), a retail pharmacy, educational opportunities and follow-up.

Phone 905-668-6831 ext. 3127 or 1-866-303-2420
Lakeridge Health Whitby
300 Gordon Street, Whitby ON L1N 5T2

Durham Region Health Department

Durham Region Sexual Health Clinics provide sexual health information, education, counselling and referrals in a supportive and confidential environment. Free STI testing and treatment, point of care and anonymous HIV testing, and free condoms are available. Clinics are staffed by RNs, Nurse Practitioners and physicians.

Oshawa 905-433-8901 or 1-800-314-8533
Pickering 905-420-8781


Durham Harm Reduction Coalition Go to external website

The Durham Harm Reduction Coalition (DHRC) is a regional advocacy and capacity-building organization that promotes the health and dignity of individuals and communities. The DHRC advances policies and programs that help address the risks and stigma associated with substance use, unsafe sex practices, and mental health issues. Such risks include, but are not limited to: overdose, HIV, hepatitis, addiction, STIs, and incarceration. We recognize that the structures of social inequality impact the lives and options of the affected communities differently, and work to uphold every individual's right to health and well-being, as well as in their ability to protect themselves, their loved ones, and their communities.

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