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Controlled Substances

Harm Reduction in nursing practice

CNO recognizes and acknowledges the devastating impact of the opioid crisis. The COVID-19 pandemic heightened the crisis, while at the same time street supply has become progressively more harmful, leading to an increase in opioid related overdoses and deaths.

Nurses provide critical support to individuals impacted by this crisis. They are practicing in emerging and alternative areas of care to reduce risk, improve health and connect individuals with key health and social services.

Harm reduction refers to policies, programs and practices to reduce adverse health, social and economic consequences of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction practices are fundamental competencies for all nurses upon entry-to-practice.

CNO recognizes that nurses incorporate principles of harm reduction with respect to substance use and misuse into plans of care in the context of a comprehensive treatment plan or as a standalone harm reduction strategy. These practices enable nurses to take action and support better outcomes by providing the necessary client-centered care. 

CNO encourages nurses to seek and use the best available evidence to inform their practice.  There may be situations where nurses cannot provide optimal client care due to circumstances beyond their control. These situations often require a systems approach for resolution. It is important to remember that even in situations where nurses cannot provide optimal client care (such as working with limited resources or increased client load), they remain accountable to the Code of Conduct

As with all nursing care, nurses must use their knowledge, skill and judgement in considering the client’s safety and unique needs. CNO is committed to protecting the public by supporting nurses in maintaining their accountability towards their continued competence within each of their individual practice settings.

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Page last reviewed November 10, 2023