The purpose of the report is to present the results of a harm reduction needs assessment survey among the most at-risk homeless youth in Toronto, identify barriers to appropriate health services, and based on the youth’s voices, make recommendations, and advocate for better programs to serve this vulnerable population.

The study was designed with three components. First we surveyed 100 poly-substance using homeless youth screened for recent (past 6 month) histories of crack (n=71), methamphetamine (n=51), non-prescribed opioid (n=53) and/or injection drug use (n=33). Then, based on the survey results, we conducted five focus groups with 27 street-involved youth to discuss their reactions to the survey findings; these groups provided many quotes on various topics. As well, four young people took part in an arts-involved segment, creating pictures of street life used to illustrate this report. The survey sample of 100 street-involved youth consisted of 75 young men, 21 young women and 4 transgendered/transsexual individuals aged 16 to 25, the majority of whom were in the older age range. Nine out of ten were Canadian born and nearly 2/3 identified their ethno-racial background as White/Caucasian.