Visions Journal

Sharon Karsten, PhD and Christopher Hauschildt

Reprinted from the Don't Erase Me: Why culture matters in mental health issue of Visions Journal, 2026, 21 (3), pp. 37-39

Walk With Me is a social justice and research initiative designed to spur system change in relation to the toxic drug crisis. Below, Sharon and Christopher share lessons from their work with the initiative.

Sharon 

I’ve been part of the harm reduction movement for nearly a decade. I’ve joined the fight to instill harm reduction principles in healthcare settings, where people who use substances face ongoing discrimination. I was also an instigator of Walk With Me, an initiative that started as a group on Vancouver Island, and now operates as a non-profit society working throughout BC.

The lessons from my work within the harm reduction movement have been nothing short of humbling. I’ve learned the importance of:   

• meeting each individual where they’re at 
• honouring voices and stories of people with lived and living experience 
• building leadership by people with lived and living experience into each initiative and project 
• advocating for lifesaving interventions, such as a safe(r) supply, overdose prevention sites, naloxone distribution, witnessed consumption and decriminalization

Despite my commitment, I’ve struggled to reconcile the term harm reduction with the full range of interventions I’ve seen as characteristic of this movement. I’ve seen a component within this work that’s both powerful and underacknowledged—even downplayed: the radical, utopian, future-focused project of enabling wellness.

Is it possible that, in the focus on keeping people alive, something essential about harm reduction’s commitment to forms of wellness is being suppressed? This includes physical forms of wellness, but also cultural, spiritual and social forms.  I believe a new term is needed that makes room for a life beyond subsistence.

Beyond reducing harm   

Formed in 2019, the Walk With Me initiative consists of people with lived and living experience of the toxic drug crisis, Knowledge Keepers, community-engaged researchers and artists. The group’s approaches include policy-based research, education, community and arts development initiatives, and more. Walk With Me aims to:

• raise awareness about the importance of harm reduction; and 
• advocate for improvements in life-saving services and supports for people who use substances. 

Our team has had the privilege to host art exhibitions featuring the work of people who use substances. The artwork is, in every case, compelling and starts dialogue about issues like safe supply, but also about the artists’ visions for change.

For example, in our most recent exhibition at the Comox Valley Art Gallery, we set up couches in the middle of the gallery and hosted wide-ranging conversations with members of the public. People with lived and living experience who’d made the artwork held shifts. Some brought guitars. Others took on the role of docents (guides), providing insight into their art and creative practices.

These conversations were beautiful. They bridged previously unconnected worlds. People attending the exhibition asked the artists many questions—some about drug use, but also about how pinhole cameras work, how an artist chooses a particular shot or angle, and about the artists’ messages. A beautiful alchemy happened, a blend of genuine curiosity with an honouring of creative practice and lived experience.  

In another illustration, our team was invited by a participating community to witness a cultural tattooing ceremony and travel out on the ocean with the local community members. We engaged in a powerful connection with those whose land we were on, and with stories of place. We saw beaches that had become battlegrounds, and places where foods and medicines were gathered.

We bumped up against a rock full of sea lions and received cultural teachings about the power and role of this creature. In this space, I saw land, water and body-based practices as generators of meaning, belonging and purpose, and as ways to connect people in solidarity. 

Experiences like these have made me question what the most important focus should be for this movement. I see something beyond survival. It’s a quest for meaning, purpose, belonging and connection—the ingredients that cause human beings to thrive, not just survive. While these ingredients are woven into the harm reduction movement, they can be dampened by the movement’s focus on survival. 

From these observations I ask: is it enough to only help people get through another day? Can’t we do more?   

Christopher

My lived experience is rooted in a history of teen and adult suicide attempts, trauma, depression and polysubstance use disorder. For me, the question of finding meaning and purpose amidst the toxic drug crisis has profoundly shaped my journey of wellness and my search for more than just survival. 

Keeping people alive is essential. But without cultivating purpose greater than staying alive, harm reduction feels limited in bringing about its aim of sustained harm mitigation (beyond service delivery). The question of why a person would want to continue on—in spite of the unfathomable pain of losing loved ones frequently across decades—feels important to consider.

My journey has been one of creating a life I don’t need to escape from. I’ve found this life through honouring the memory of those I’ve lost, service to community and working to effect change surrounding the crisis.

The need for escape is a dire reality of the toxic drug crisis. There is a hopelessness amidst the sustained loss of loved ones due to poisoned substances, which people are also attempting to survive. I’ve needed purpose to do more than survive through a reliance on harm reduction, and I believe this is a necessary component for others to activate their own sustained wellness.

While the motives of meaning and purpose are unique to each individual, I’ve seen a common quest for these across many people who are entrenched in substance use but haven’t had equitable opportunities to imagine what this purpose might be. While harm reduction may offer people the essential means to stay alive, it feels important to ask—and to imagine—how this concept provides the meaning and purpose needed to do more than just survive another day.

Perhaps one method for harm reduction to become a space of opportunity for making meaning and purpose lies in the expansion of mentorship, skills development and paid opportunities to engage in service to others; the co-imagination of meaningful and purposeful tools to spark self-empowerment begins with curiosity, reflection and dialogue. 

As such, I pose these questions as a starting point for the reader to consider:

• How do we within the harm reduction movement give people more than just survival? 
• How do we address the essential need for meaning and purpose as a means to thrive? 
• What do meaningful opportunities look like to those deserving of equity? 
• How do we leverage our positions of power and knowledge to encourage leadership and self-empowerment in those we serve?