Toronto is now home to world's first harm-reduction workers' union

Please chip in to support more articles like this. Support for as little as $5 per month!

Image: THRWU

Toronto is home to the world's first ever harm-reduction workers' union: THRWU.

On November 11, workers at South Riverdale and Central Toronto Community health centres told their employers that they had joined the Toronto Harm Reduction Workers Union (THRWU) and demanded recognition.

With 50 members and counting, the union represents a wide range of professions including HIV/AIDS workers, workers involved in the distribution of safe usage tools, overdose prevention workers, peer workers, Hepatitis C workers, and nurses -- to name only a few.

While some THRWU members work in paid positions, others work as volunteers or are unemployed. 

Foregoing Labour Board certification and a conventional collective bargaining process, the THRWU is developing a distinct organizing model.

Innovative organizing suits innovative public health model

Developed in the early 1980s in response to the AIDS epidemic, harm reduction refers to a public health methodology that encompases many different types of programs and policies designed to reduce drug-related harms, such as communicable diseases, without necessarily requiring drug users to stop using drugs.

"Harm Reduction is underpinned with the knowledge that many drug-related problems are not the result of the drugs themselves; rather they are the consequences of the unregulated manufacture and trade of drugs and the enduring commitment to failed policies and ill-thought-out and inequitably applied laws," according to the Canadian Harm Reduction Network.

With these structural issues in mind, harm reduction efforts seek to minimize the risks associated with drug use by distributing safe use supplies and information, while also targeting the stigma and discrimination faced by drug users and street-involved people.

There are over 30 agencies that offer harm reduction supplies and services in Toronto. They are public health organizations, shelters, non-profits, community health centres, and AIDS/HIV organizations, and they offer a variety of services including needle exchanges, opioid substitution, overdose prevention, testing and vaccination.

Across Canada, evidence has borne out the efficacy of these programs in curbing the rate of drug-related deaths and the spread of communicable diseases. At just over 4 per cent, Toronto has maintained one of the lowest HIV infection rates in the developing world, due largely to the city's early adoption of harm-reduction programs.

And like other forms of preventative medicine, harm reduction also helps to reduce health-care costs.

In large part, these successes can be attributed to the former and current drug users who make up the frontline staff of many harm-reduction programs.

The harm-reduction workforce is made up of both trained health-care professionals and street experts, hired for their lived experience with drug use and homelessness.

The workers at THRWU are adamant that the workers in these "peer positions" were inexpendable to the harm reduction project.

"At some point it was recognized that these people know what's up," said one worker. "We need them in order to do this work with any integrity. They know how to talk to people, they are going to be trusted," they added.

Though many harm-reduction workers are hired for their "lived experience" they are also stigmatized for it, and that stigma keeps workers from being recognized as such.

The problem, as THRWU members identify it, is that many aspects of harm reduction aren't considered work because they are being performed by current or former drug users.

Several THRWU members noted that their workplaces would not give building access to peer workers, who were still burdened by the stigma associated with drug use. 

"People have worked in the same places for years and they're still not seen as workers," said one THRWU member. "Even though they are on payroll or they work, they don't get in the mix. They aren't seen as part of the workforce."

Many of the peer support workers, such as the safer crack use kit makers, work for honoraria or volunteer their time. They may not have regular schedules and the pay scales vary wildly: at one agency they might be getting $15 dollars an hour; at another they are given $10 dollars for three hours of work; while at other organizations compensation comes in the form of tokens and pizza.

Workers also says that management depends on Ontario Disability Support Program (ODSP) to provide benefits for many of the people they are employing, several of whom have complex health needs, such as HIV treatments and Hep C treatments. 

As THRWU members explain, the drop-in model works in many cases, given that some harm reduction workers are dealing with homelessness and other issues that make it difficult to commit to a regular schedule.

"To be hired for lived experience is an amazing thing," said one THRWU member. "But there are still struggles with it. Workers are workers and they need to be seen that way. They don't need to be made to feel that they are lucky to have a job. We're lucky to have them saving lives and reducing transmissions of HIV and HEP C and that seriously needs to be acknowledged."

So they decided to form a union.

A union unlike any other

THRWU is meant to encompass a multiplicity of work statuses, job titles and workplaces. Instead of forming bargaining units or dividing into locals based on workplaces or trade, the union creates a looser affiliation, which allows them to cover territory that traditional unions cannot.

THRWU plan to deal with employee concerns on an issue by issue basis rather than have a collective agreement. They won't have a steward system either, using worker councils at each workplace to fulfill that role.

Given their history of unconventional unionism and organizing the unemployed, it is no surprise that that the harm-reduction workers chose to affiliate with the Industrial Workers of the World, known for more than a century's worth of radical unionism.

One potential obstacle facing the new union is the issue of double unionism. At some harm-reduction workplaces, staff are already represented by unions and thus the existence of THRWU could potentially violate Section 73 of the Ontario Labour Relations Act. 

THRWU is not interested in bargaining collective agreements, so it remains to be seen if they would even qualify as a union in the eyes of the Labour Board. But since the union intends to engage volunteers and occasional staff -- many of whom could not afford the dues of a traditional union, and would not fit easily into traditional labour classifications -- it is safe to say that THRWU will cover a very different jurisdiction from the existing unions. 

Kelly O'Sullivan is the president of CUPE Local 4308, which represents workers at Street Health, a non-profit agency that provides some harm-reduction programming in the southeast core of Toronto. She believes that THRWU will only compliment her union's efforts.

"CUPE 4308 welcomes THRWU and knows that by working together and jointly representing workers when needed, we will be a stronger advocate with and for our members," said O'Sullivan. "Having another union in our workplaces that shares that commitment can only strengthen both of our abilities to support and represent ourselves and our co-workers."

In many ways, THRWU intends to apply the harm-reduction methodology to their labour organizing, by addressing both the individual needs of workers -- like job security and wages -- while also taking on the structural issues, such as budget cuts, that frame their working conditions.

Most of Toronto's harm-reduction programs are funded by the city's Urban Health Fund. Due to recent mergers in funding organizations, harm-reduction workers say they are forced to compete with much needed organizations for fewer dollars.

"On a municipal, provincial, or federal level, these cuts actually cost lives. They also cost our jobs, and we lose workers from the field. We can't afford to lose harm reduction programs," said one worker.

"If we are all going to go in there and fight each other for whatever scraps we can get, we are not going to get anywhere. We need to be able to advocate together."

What THRWU really intends to do is provide a network of support for workers who are doing very difficult, and very draining work.

"We work with a lot of people who die suddenly and often," said one THRWU member.

"Workers have experienced an incredible amount of trauma, especially those people who have been street-involved. And that also takes a toll. These are brave solid awesome workers who deserve so much."

Though THRWU does collect a small amount of dues from their members, they are also accepting donations here: .

Editor's note: Because of the ongoing campaign to form the Toronto Harm Reduction Workers’ organizing campaigners asked to remain anonymous.

Further Reading

Thank you for reading this story…

More people are reading than ever and unlike many news organizations, we have never put up a paywall – at rabble we’ve always believed in making our reporting and analysis free to all, while striving to make it sustainable as well. Media isn’t free to produce. rabble’s total budget is likely less than what big corporate media spend on photocopying (we kid you not!) and we do not have any major foundation, sponsor or angel investor. Our main supporters are people and organizations -- like you. This is why we need your help. You are what keep us sustainable. has staked its existence on you. We live or die on community support -- your support! We get hundreds of thousands of visitors and we believe in them. We believe in you. We believe people will put in what they can for the greater good. We call that sustainable.

So what is the easy answer for us? Depend on a community of visitors who care passionately about media that amplifies the voices of people struggling for change and justice. It really is that simple. When the people who visit rabble care enough to contribute a bit then it works for everyone.

And so we’re asking you if you could make a donation, right now, to help us carry forward on our mission. Make a donation today.


We welcome your comments! embraces a pro-human rights, pro-feminist, anti-racist, queer-positive, anti-imperialist and pro-labour stance, and encourages discussions which develop progressive thought. Our full comment policy can be found here. Learn more about Disqus on and your privacy here. Please keep in mind:


  • Tell the truth and avoid rumours.
  • Add context and background.
  • Report typos and logical fallacies.
  • Be respectful.
  • Respect copyright - link to articles.
  • Stay focused. Bring in-depth commentary to our discussion forum, babble.


  • Use oppressive/offensive language.
  • Libel or defame.
  • Bully or troll.
  • Post spam.
  • Engage trolls. Flag suspect activity instead.