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“We do it ourselves”: strengths and opportunities for improving the practice of harm reduction

BACKGROUND: Unprecedented increases in substance-related overdose fatalities have been observed in Texas and the U.S. since the onset of the COVID-19 pandemic and have made clear there is considerable need to reduce harms associated with drug use. At the federal level, initiatives have called for wi...

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Autores principales: Claborn, Kasey, Samora, Jake, McCormick, Katie, Whittfield, Quanisha, Courtois, Frederic, Lozada, Kyle, Sledge, Daniel, Burwell, Annie, Chavez, Sandra, Bailey, Jamie, Bailey, Chris, Pederson, Chelsea Dalton, Zagorski, Claire, Hill, Lucas, Conway, Fiona N., Steiker, Lori Holleran, Cance, Jessica, Potter, Jennifer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250854/
https://www.ncbi.nlm.nih.gov/pubmed/37296459
http://dx.doi.org/10.1186/s12954-023-00809-7
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author Claborn, Kasey
Samora, Jake
McCormick, Katie
Whittfield, Quanisha
Courtois, Frederic
Lozada, Kyle
Sledge, Daniel
Burwell, Annie
Chavez, Sandra
Bailey, Jamie
Bailey, Chris
Pederson, Chelsea Dalton
Zagorski, Claire
Hill, Lucas
Conway, Fiona N.
Steiker, Lori Holleran
Cance, Jessica
Potter, Jennifer
author_facet Claborn, Kasey
Samora, Jake
McCormick, Katie
Whittfield, Quanisha
Courtois, Frederic
Lozada, Kyle
Sledge, Daniel
Burwell, Annie
Chavez, Sandra
Bailey, Jamie
Bailey, Chris
Pederson, Chelsea Dalton
Zagorski, Claire
Hill, Lucas
Conway, Fiona N.
Steiker, Lori Holleran
Cance, Jessica
Potter, Jennifer
author_sort Claborn, Kasey
collection PubMed
description BACKGROUND: Unprecedented increases in substance-related overdose fatalities have been observed in Texas and the U.S. since the onset of the COVID-19 pandemic and have made clear there is considerable need to reduce harms associated with drug use. At the federal level, initiatives have called for widespread dissemination and implementation of evidence-based harm reduction practices to reduce overdose deaths. Implementation of harm reduction strategies is challenging in Texas. There is a paucity of literature on understanding current harm reduction practices in Texas. As such, this qualitative study aims to understand harm reduction practices among people who use drugs (PWUD), harm reductionists, and emergency responders across four counties in Texas. This work would inform future efforts to scale and spread harm reduction in Texas. METHODS: Semi-structured qualitative interviews were conducted with N = 69 key stakeholders (25 harm reductionists; 24 PWUD; 20 emergency responders). Interviews were transcribed verbatim, coded for emergent themes, and analyzed using Applied Thematic Analysis with Nvivo 12. A community advisory board defined the research questions, reviewed the emergent themes, and assisted with interpretation of the data. RESULTS: Emergent themes highlighted barriers to harm reduction at micro and macro levels, from the individual experience of PWUD and harm reductionists to systemic issues in healthcare and the emergency medical response system. Specifically, (1) Texas has existing strengths in overdose prevention and response efforts on which to build, (2) PWUD are fearful of interacting with healthcare and 911 systems, (3) harm reductionists are in increasing need of support for reaching all PWUD communities, and (4) state-level policies may hinder widespread implementation and adoption of evidence-based harm reduction practices. CONCLUSIONS: Perspectives from harm reduction stakeholders highlighted existing strengths, avenues for improvement, and specific barriers that currently exist to harm reduction practices in Texas.
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spelling pubmed-102508542023-06-10 “We do it ourselves”: strengths and opportunities for improving the practice of harm reduction Claborn, Kasey Samora, Jake McCormick, Katie Whittfield, Quanisha Courtois, Frederic Lozada, Kyle Sledge, Daniel Burwell, Annie Chavez, Sandra Bailey, Jamie Bailey, Chris Pederson, Chelsea Dalton Zagorski, Claire Hill, Lucas Conway, Fiona N. Steiker, Lori Holleran Cance, Jessica Potter, Jennifer Harm Reduct J Research BACKGROUND: Unprecedented increases in substance-related overdose fatalities have been observed in Texas and the U.S. since the onset of the COVID-19 pandemic and have made clear there is considerable need to reduce harms associated with drug use. At the federal level, initiatives have called for widespread dissemination and implementation of evidence-based harm reduction practices to reduce overdose deaths. Implementation of harm reduction strategies is challenging in Texas. There is a paucity of literature on understanding current harm reduction practices in Texas. As such, this qualitative study aims to understand harm reduction practices among people who use drugs (PWUD), harm reductionists, and emergency responders across four counties in Texas. This work would inform future efforts to scale and spread harm reduction in Texas. METHODS: Semi-structured qualitative interviews were conducted with N = 69 key stakeholders (25 harm reductionists; 24 PWUD; 20 emergency responders). Interviews were transcribed verbatim, coded for emergent themes, and analyzed using Applied Thematic Analysis with Nvivo 12. A community advisory board defined the research questions, reviewed the emergent themes, and assisted with interpretation of the data. RESULTS: Emergent themes highlighted barriers to harm reduction at micro and macro levels, from the individual experience of PWUD and harm reductionists to systemic issues in healthcare and the emergency medical response system. Specifically, (1) Texas has existing strengths in overdose prevention and response efforts on which to build, (2) PWUD are fearful of interacting with healthcare and 911 systems, (3) harm reductionists are in increasing need of support for reaching all PWUD communities, and (4) state-level policies may hinder widespread implementation and adoption of evidence-based harm reduction practices. CONCLUSIONS: Perspectives from harm reduction stakeholders highlighted existing strengths, avenues for improvement, and specific barriers that currently exist to harm reduction practices in Texas. BioMed Central 2023-06-09 /pmc/articles/PMC10250854/ /pubmed/37296459 http://dx.doi.org/10.1186/s12954-023-00809-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Claborn, Kasey
Samora, Jake
McCormick, Katie
Whittfield, Quanisha
Courtois, Frederic
Lozada, Kyle
Sledge, Daniel
Burwell, Annie
Chavez, Sandra
Bailey, Jamie
Bailey, Chris
Pederson, Chelsea Dalton
Zagorski, Claire
Hill, Lucas
Conway, Fiona N.
Steiker, Lori Holleran
Cance, Jessica
Potter, Jennifer
“We do it ourselves”: strengths and opportunities for improving the practice of harm reduction
title “We do it ourselves”: strengths and opportunities for improving the practice of harm reduction
title_full “We do it ourselves”: strengths and opportunities for improving the practice of harm reduction
title_fullStr “We do it ourselves”: strengths and opportunities for improving the practice of harm reduction
title_full_unstemmed “We do it ourselves”: strengths and opportunities for improving the practice of harm reduction
title_short “We do it ourselves”: strengths and opportunities for improving the practice of harm reduction
title_sort “we do it ourselves”: strengths and opportunities for improving the practice of harm reduction
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250854/
https://www.ncbi.nlm.nih.gov/pubmed/37296459
http://dx.doi.org/10.1186/s12954-023-00809-7
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