Patient and Staff Perspectives on the Impacts and Challenges of Hospital-Based Harm Reduction

Leah Fraimow-Wong
Marlene Martín
Laura Thomas
Ro Giuliano
Oanh Kieu Nguyen
Kelly Knight
Leslie W. Suen
Peer-Reviewed Article
February 2024
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Patient and staff interviews highlight the promise of hospital-based harm reduction programs.


As deaths from drug-related overdoses continue to rise, harm reduction strategies have emerged as a promising practice to mitigate the risks of overdose and facilitate improved treatment outcomes. Implementing harm reduction strategies in hospital-based settings have been shown to increase engagement with treatment, among other positive outcomes. This study evaluates the impacts and challenges of implementing a harm reduction program delivered by an interdisciplinary addiction care team at an urban, safety-net hospital.


Through semi-structured interviews conducted with 20 patients and 20 staff members, the authors identified three key impacts of the harm reduction program: (1) increased access both to safer use supplies and counselling on safer use; (2) improved trust between patients and staff, leading to increased likelihood of future engagement with the health care system; and (3) decreased staff stigma toward patients with substance use disorder (SUD). Concerns among staff about regulatory and legal constraints, as well as the need for greater staff education on SUD, were identified as key challenges.  


These findings highlight both the potential impact and operational feasibility of integrating harm reduction principles into hospital-based SUD care. The program successfully engaged patients with limited previous exposure to harm reduction treatment, underscoring the potential for hospital-based programs to reduce gaps in access to community-based harm reduction interventions. Additionally, the authors suggest that clearer guidance from policymakers may help to reduce staff hesitancy in engaging in harm reduction activities.

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