First, Do Less Harm: Harm Reduction as a Principle of Law and Policy

by Vanessa Gruben Associate Professor; Vice-Dean (Academic) (Editor), Chelsea Cox (Editor), Stephanie Arlt (Contribution by), Line Beauchesne Full Professor (Contribution by), Richard Elliott (Contribution by)

Overview

Readers will be able to gain a deeper understanding of how different approaches to harm reduction can create a stronger foundation for more effective policies and legislation. Scholars from law and social sciences collaborate with frontline organizations as well as with individuals with lived experience to reflect diverse perspectives, and transform how society addresses substance-related challenges.

Each chapter provides unique findings, drawing from examples of harm reduction strategies implemented for opioids, cannabis, and tobacco in Canada and beyond. While harm reduction has been a central aspect of the legal and policy responses to all three substances, its application has varied significantly.

First, Do Less Harm explores how the ongoing opioid crisis emphasizes the pressing need for safe consumption sites and life-saving tools like naloxone. Case studies on Canada’s legalization of cannabis highlight both the benefits and challenges of providing legal and regulated access to a drug. The volume further examines the evolving landscape of tobacco regulations where recent innovations such as vaping offer less harmful alternatives, yet raise significant concerns about youth uptake and public health.

Designed for policymakers, health professionals, academics, and anyone interested in creating safer communities, this collection not only presents thought-provoking ideas but also provides inspiration to take action.

Product Details

ISBN-13:	9780776641942
Publisher:	Les Presses de l'Université d'Ottawa/University of Ottawa Press
Publication date:	02/25/2025
Series:	Health and Society
Pages:	278
Product dimensions:	6.00(w) x 9.00(h) x 0.69(d)
Age Range:	15 Years

About the Author

Marewa Glover (Contributor)
Marewa Glover is a Māori (New Zealand Indigenous) behavioural scientist with over 30 years’ experience in public health and more than 100 research papers. Renowned for her advocacy on tobacco harm reduction, she became “Tobacco” Section Editor for the international Harm Reduction Journal in 2019. Glover was a finalist in the 2017 New Zealand Women of Influence Awards and in the 2019 New Zealander of the Year Awards. Previously a Professor of Public Health at Massey Universityand Chair of End Smoking NZ, she focused on designing pragmatic solutions to reduce smoking, especially during pregnancy, as well as addressing obesity and breastfeeding barriers for Māori.

Amelia Howard (Contributor)
Amelia Howard is a PhD candidate in sociology at the University of Waterloo studying vaping innovation and the politics of technological change.

Sam Halabi (Contributor)
Sam Halabi is Professor at Georgetown University’s School of Health, Director of the Center for Transformational Health Law, and Affiliate Researcher at the Center for Global Health Science and Security. He was previously Senior Associate VP for Health Policy and Ethics at Colorado State Universityas well as Professor and Director of the Center for Intellectual Property and Entrepreneurship at the University of Missouri, where he received the Husch Blackwell Award for Distinguished Teaching. Halabi has authored 5 books and over 80 publications on topics such as vaccine deployment, public health ethics, data sharing, and emergency response.

Sandra Ka Hon Chu (Contributor)
Sandra Ka Hon Chu is a lawyer and Co-Executive Director of the HIV Legal Network. She works on HIV-related human rights issues concerning prisons, drug policy and harm reduction, sex work, women, and immigration, and has helped guide the Legal Network’s litigation in key court cases in Canada and internationally, including lawsuits challenging the Canadian government’s failure to adopt prison-based needle and syringe programs and criminal laws governing sex work.

Ryan Pusiak (Contributor)
Ryan Pusiak is Ph. D. Candidate in the Biology Department at the University of Ottawa.

Joao Velloso (Contributor)
João Velloso has a multidisciplinary background in law, criminology, sociology, anthropology, and communication. He works in the areas of criminal law and sentencing, critical criminology, and socio-legal studies, more particularly sociology and anthropology of law. His empirical research deals with the penalization of protesters and migrants (deportation and detention), access to justice in detention, and the regulation of cannabis. Professor Velloso is a member of the University of Ottawa Human Rights Research and Education Centre and participates in different Canadian and international research networks and projects.

Vanessa Gruben (Editor)
Vanessa Gruben B.Sc.H (Queen’s), LL.B. (Ottawa), LL.M. (Columbia) is Vice Dean (Academic) and Associate Professor at the University of Ottawa, Faculty of Common Law and a member of the Centre for Health Law, Policy and Ethics. She also leads the Ottawa Hub for Harm Reduction – a multidisciplinary forum for scholars and community organizations who work on innovative harm reduction strategies. She is also co-editor of the 5th edition of Canada’s leading text on health law and policy in Canada, Canadian Health Law and Policy, co-edited with Joanna Erdman and Erin Nelson (LexisNexis, 2017). Professor Gruben teaches graduate and undergraduate courses in Health Law and a seminar on Access to Health Care.

Chelsea Cox (Editor)
Chelsea Cox is part-time Professor in the Common Law Section of the University of Ottawa’s Faculty of Law. She holds both a JD and a Master of Health Administration from Dalhousie University. Cox researches alternative regulatory models and evolving drug policy frameworks. Her main area of focus is on cannabis decriminalization, legalization, and policy development. She also conducts research on harm reduction and public health policy.

Read an Excerpt

The focus of [...] this book, is on three substances: opioids, tobacco, and cannabis. Harm reduction has been an element of the legal and policy response to all three but has manifested in very different ways. In regard to opioids, harm reductionists emphasize safe-consumption sites and anti-overdose drugs such as naloxone. For cannabis, the legalization and regulation of a product formerly subject to criminal sanction offers a powerful harm reduction case study of the merits and pitfalls of Canada’s pioneering approach. Harm reduction is also at the centre of a key debate regarding the use of tobacco, insofar as how to address new technology, such as e-cigarettes, that offer smokers a less harmful alternative but may also create new issues, such as how to address health concerns arising from their uptake by young people without discouraging their harm reduction potential.

Table of Contents

PART I: “Illicit Drugs”

Chapter 1: Decriminalizing simple possession of all drugs: developing harm reduction strategies
Line Beauchesne

Chapter 2: Decriminalizing Drug Possession for Personal Use: Harm Reduction as a Constitutional Imperative
Martha Jackman

Chapter 3: “PNEP”
Sandra Ka Hon Chu & Richard Elliott

Chapter 4: Ontario’s Consumption Treatment Services Model: Problematizing Conservative Safe Consumption Site Policy
Stephanie Arlt

PART II: Challenges and Opportunities for Harm Reduction and Cannabis

Chapter 5: Governance of Recreational Cannabis in Canada: Jurisdictional Shifts, Punitive Decriminalization and Challenges for Harm Reduction
Joao Velloso, Veronique Fortin and Marie-Eve Sylvestre

Chapter 6 : Criminality and Inequity under Canada’s Legalization of Cannabis: A study of Vancouver’s Downtown Eastside
Stephanie Lake and Margot Young

Chapter 7: Does the dose make the poison? A review of dosing and product testing of cannabis products
Ryan Pusiak

PART III: Reducing Harm in Tobacco Use

Chapter 8 : Preventing perverse effects of public health policy is also harm reduction. Potential risk in some tobacco control interventions for Indigenous peoples
Marewa Glover & Kyro Selkt

Chapter 9: Regulating Harm Reduction Claims under the Canadian Tobacco and Vaping Products Act and the US Family Smoking Prevention and Tobacco Control Act
Sam F Halabi

Chapter 10: From First Puffs to Policy: A Non-Apology for 32 Years of Substance Use