A Qualitative Study of User Experiences in Harm Reduction Programs

Abstract

The ongoing Canadian opioid crisis has resulted in alarming rates of overdoses and related harms. Harm reduction programs have emerged as a crucial public health strategy to mitigate these risks. The Nēwo-Yōtina Friendship Centre (NYFC) offers harm reduction programs that provide a safe injection site and clean supplies to reduce substance use-associated harm. Researchers have not extensively studied the effectiveness and user experience of this program. Studies have demonstrated the effectiveness of harm reduction programs in mitigating adverse effects of drug use, such as disease transmission and overdose. This in-depth study looked at what program users went through in the NYFC harm reduction program. This was done by looking at the program environment, unexpected outcomes, reasons for seeking services, and obstacles to access. The study used a phenomenological approach, utilising semi-structured interviews with 13 participants and analysing interview data using thematic analysis2 through NVivo. The motivations for seeking services were safety, access to clean supplies, and a non-judgmental environment. Findings revealed that users valued a safe and welcoming atmosphere fostered by friendly, supportive, and non-judgmental staff. The program's positive outcomes included reduced harm, access to resources, and emotional support. Nevertheless, limited operating hours, stigma, small space, and a lack of awareness were identified as barriers to access. The study recommends improving accessibility, enhancing support systems, and addressing unanticipated outcomes like drug use enablement to optimise the program's effectiveness. This study provides valuable insights into user experience within the NYFC program. The findings inform program improvements, enhance service delivery, and contribute to a broader understanding of harm reduction strategies for addressing the opioid crisis. It emphasises the importance of user-centred approaches in developing and implementing effective harm reduction programs.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The authors declare that they have no known competing financial interests that could have appeared to influence the work reported in this article

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The research presented in this manuscript involved human participants. In accordance with Article 2.5 of the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2), the research qualified for exemption status. The Behavioural Research Ethics Board at the University of Saskatchewan granted an exemption from ethics review. All research procedures were conducted in an ethical manner, adhering to the principles of informed consent, confidentiality, and respect for persons.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

The data underlying the findings in this manuscript are available upon request from Nēwo-Yōtina Friendship Centre, Regina, Saskatchewan, Canada due to ethical restrictions. The data contain potentially identifying and sensitive participant information that cannot be publicly shared. To protect participant confidentiality and comply with research ethics guidelines, access to the raw data will be granted to qualified researchers who agree to maintain data security and anonymity. Interested researchers can contact the corresponding author to discuss data-sharing agreements and procedures

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