Harm reduction is an approach based on liberal views and the assumption that substance users are free to choose using opioids, alcohol, or other drugs. This tactic was introduced in the 1980s, and many countries have developed various harm reduction incentives, although these efforts remain rather insufficient (Moreira et al., 2019). Treatment centers tend to be regarded in the United States as the only option for drug users, while those who do not seek treatment or help do not receive any harm reduction services. Kulikowski and Linder (2018) note that community-based harm reduction programs are beneficial for communities as drug users receive care and educational services that contribute to safer behaviors and less harm to themselves and the community. However, it has also been acknowledged that the development and implementation of such initiatives are taking place at a low pace and associated with the lack of evidence-based data (Moreira et al., 2019). Therefore, it is important to pay more attention to the present topic and analyze diverse aspects of the potential use of community-based harm reduction programs available from treatment centers.
Substance use has been acknowledged as one of the central public health issues to be addressed in the USA (as well as many other countries). It was estimated that almost 775 thousand American adults and adolescents injected illicit drugs in the USA, and such users account for 22% of Americans living with HIV (Kulikowski & Linder, 2018). It has also been estimated that such a drug user transmits HIV to approximately ten people. The recent criminalization and stigmatization of drug users have led to these people’s reluctance to seek help, which has a negative impact on communities (Dubois, 2017). Moreover, healthcare professionals (including nurses) often have negative attitudes towards drug users, which makes harm reduction incentives less common and less effective (Palumbo, 2019). An insufficient number of healthcare facilities provide harm reduction services or implement the associated programs. At the same time, recent research shows that such initiatives can be instrumental in addressing some of the issues related to substance use.
The purpose of the present research is to evaluate the effectiveness of a community-based harm reduction program provided at a treatment center. This quantitative study will examine the effects of a harm reduction incentive aimed at reaching substance users living in the community but not seeking help. The major goal of the suggested program is to bridge the gap between drug users who receive harm reduction services and those seeking treatment. It is critical to obtain quantitative data that will display the exact impact of community-based harm reduction programs on a community and the target population.
The following hypothesis will guide the proposed study:
Treatment centers initiating community-based harm reduction programs will bridge the gap between substance users who receive harm reduction services and those who seek treatment.
This quantitative study is based on the use of a quasi-experimental research design. A local treatment center will be the setting for the present study. The rate of the people receiving harm reduction services before and after the proposed treatment will be estimated. The community-based program will involve a syringe exchange incentive and the provision of educational services to the participants regarding potential harm and methods to minimize it. The substance users addressing the treatment center and the existing patients will take part in the project that will last three months. The program will involve several community-based events involving the spread of materials concerning harm reduction and the ways to destigmatize substance users. Before the start of the program, the rate of people seeking treatment and those willing to participate in a harm reduction program will be identified. A week after the termination of the harm reduction project, the rate of help seekers and those willing to take part in a harm reduction program will be estimated. The rates before and after the implementation of the program will be compared to evaluate the effectiveness of the proposed community-based program.
As mentioned above, harm reduction programs have been in place for several decades, and researchers have paid certain attention to these incentives. Moreira et al. (2019) identify three major trends regarding substance use that have affected the development and implementation of harm reduction programs. These trends are associated with prohibitionist, conservative, liberal, and critical paradigms circulating among policymakers as well as healthcare professionals. The first two frameworks are mainly related to stigmatization, punitive measures, and the view of a substance user as a patient to be treated (Moreira et al., 2019). According to the liberal paradigm, substance users are people having the right to choose whether they will or will not use drugs or any other substance. The critical framework involves the provision of assistance to drug users but heavy punitive measures to those trafficking or distributing drugs. The liberal framework is often gaining momentum in the USA, but criminalization and stigmatization of substance users are still persistent in American society (Dubois, 2017; Palumbo, 2019). The spread of harm reduction programs, however, shows a certain change in the existing paradigm.
Although different types of harm reduction incentives have appeared, community-based incentives are now regarded as the most effective initiatives. Dubois (2017) notes that such projects reach the target audience effectively, which has a positive effect on communities. Substance users tend to be more willing to seek help and shape their behaviors, trying to minimize potential harm. Kulikowski and Linder (2018) also place emphasis on the benefits of community-based programs. The researchers argue that the U. S. government is still lacking the necessary flexibility, while communities have acknowledged the degree of the issue and the positive outcomes of harm reduction initiatives (Kulikowski & Linder, 2018). At that, the authors add that such harm reduction projects as syringe exchange initiatives and educational services provision are viewed positively while safe injection sites are still viewed negatively in American society. Nevertheless, the positive shifts in the adoption of harm reduction programs are apparent in diverse communities across the country.
An important aspect that receives little attention is the perspectives of healthcare professionals. Palumbo (2019) argues that nursing professionals should play a more active role in the process of the development and implementation of harm reduction programs. The researcher stresses that the provision of education and training to the medical staff will be beneficial for communities. Dubois (2017) has a similar view and stresses that healthcare professionals should educate themselves to be able to provide high-quality care to this population. It is noteworthy there is a lack of studies on the effectiveness of such educational initiatives. Importantly, the effectiveness of community-based harm reduction programs is also under-researched, so more studies addressing this aspect are needed.
Dubois, T. M. (2017). Harm reduction. Journal of Addictions Nursing, 28(1), 42-42. Web.
Kulikowski, J., & Linder, E. (2018). Making the case for harm reduction programs for injection drug users. Nursing, 48(6), 46-51. Web.
Moreira, C. R., Soares, C. B., Campos, C. M. S., & Laranjo, T. H. M. (2019). Harm reduction: Trends being disputed in health policies. Revista Brasileira De Enfermagem, 72(suppl 3), 312-320. Web.
Palumbo, R. (2019). A call to action: Defining the acute care nurse’s role in harm reduction for persons with substance use disorder. Journal of Addictions Nursing, 30(4), 236-237. Web.