Street Health is a community-based health care organization in Toronto that provides services to address a wide range of physical, mental, and emotional needs for people who are homeless, poor, and socially marginalized. Street Health’s program areas include nursing care, mental health support, street outreach, HIV/AIDS prevention, Hepatitis C support, and identification replacement and storage.
The Crack Users Project (CUP) is a capacity-building initiative, developed by Street Health and Regent Park Community Health Centre, with the goal of reducing the harms associated with the use of crack cocaine among users in southeast downtown Toronto.
The project’s objectives are to:
increase communication with and among marginalized crack users; build capacity among crack users to develop and implement peer-led, crack-specific harm reduction strategies; and to improve access to physical and mental health services for this group.
CUP began in October 2005 with its first drop-in specifically for crack users. In less than two years CUP had created a unique and welcoming space for crack users in southeast downtown Toronto who face social marginalization, extreme poverty, housing instability and severe health problems. CUP has already had a positive impact for participants who report an improved sense
of self-worth, greater awareness of crack issues and safer crack use practice, increased sense of
community, a reduction in crack use, and a more positive outlook on life, since they began participating in the project.
The purpose of this manual is to share what we have learned in our experiences of the CUP project thus far and to provide other community-based organizations who are working with marginalized drug users with a starting place from which to replicate this project.
While we realize that across Canada, harm reduction programs with marginalized drug users are immensely varied in terms of structure, resources, underlying assumptions and values, and because programs are diverse in terms of level of peer involvement, setting, political context and other factors; what may work in one context may not be successful or even possible in another. Still, we hope that in the following guidelines, offered based on our experiences of running the CUP program, there will some common understandings and central elements from which others can learn, and adapt to their own situations.
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