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Indigenous people who use drugs in northern Ontario have high rates of precarious sleeping situations and polysubstance use, with strong awareness of harm reduction and cultural practices influencing harm reduction behaviors.

Among 356 Indigenous participants across three northern Ontario cities, 39.0% slept on the street, 28.3% in shelters, and 92.1% smoked drugs. Despite high substance use, 84.0% knew what harm reduction was, 82.3% had HIV testing, and 71.3% engaged in cultural ceremonies, with 22.2% reporting cultural teachings affected their harm reduction practices.

Last updated: Jul 28, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Cohort profile: Walking for harm reduction through street engagement (WHiSE 2.0).

observational

Verma G, Aden M, Hartman M, Walker JD, Pelland K, Mushquash C, Persaud S, Young M, Gauvin H, Benoit AC · PloS one (2026)

Participants: 356
Duration: Cross-sectional baseline data (prospective cohort ongoing)
Intervention: Community-based, culturally grounded cohort study with interviewer-administered questionnaire (no experimental intervention)
Outcome: Substance use patterns, harm reduction knowledge, HIV/hepatitis C testing uptake, cultural engagement, precarious sleeping situations
Effect Size: N/A
Population: Indigenous people who use drugs in Thunder Bay, Sudbury, and Sault Ste. Marie, Canada (n=356)

Result: Among 356 Indigenous participants across three northern Ontario cities, 39.0% slept on the street, 28.3% in shelters, and 92.1% smoked drugs. Despite high substance use, 84.0% knew what harm reduction was, 82.3% had HIV testing, and 71.3% engaged in cultural ceremonies, with 22.2% reporting cultural teachings affected their harm reduction practices.

PubMed: 42497183DOI: 10.1371/journal.pone.0354477

Mechanism Graph

Indigenous community leadership guided study design
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Participants completed structured questionnaire on demographics, substance use, and harm reduction
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Descriptive statistics stratified by city summarized key patterns
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Results highlight high polysubstance use and housing instability alongside strong harm reduction awareness and cultural engagement

Limitations

  • ⚠Cross-sectional descriptive design limits causal inference
  • ⚠Convenience sampling may not represent all Indigenous people who use drugs in the region
  • ⚠Self-reported data subject to recall and social desirability bias

Frequently Asked Questions

What proportion of participants slept on the street?▼

39.0% of participants reported sleeping on the street across all study sites.

How many participants had heard of harm reduction?▼

84.0% of participants knew what harm reduction was.

Did cultural practices influence harm reduction behaviors?▼

22.2% of participants reported that cultural teachings affected their harm reduction practices.

What was the most common route of drug administration?▼

Smoking was the most common, with 92.1% of participants reporting smoking drugs.

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References

  1. 1.Verma G, Aden M, Hartman M, Walker JD, Pelland K, Mushquash C, Persaud S, Young M, Gauvin H, Benoit AC. "Cohort profile: Walking for harm reduction through street engagement (WHiSE 2.0).." PloS one, 2026. PMID: 42497183 DOI: 10.1371/journal.pone.0354477
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.