Clinician Experiences and Comfort with Providing Harm Reduction Resources to People Who Use Drugs

Introduction: Although there is extensive evidence supporting harm reduction strategies for managing substance use disorders, wide implementation in clinical settings has been limited. In this study, we examined clinicians’ harm reduction experiences and comfort with providing harm reduction resources. Methods: In this cross-sectional study, we distributed surveys electronically to clinicians employed in our institution’s outpatient and inpatient settings. We measured comfort using a 10-point scale and practices by asking participants if they had prescribed or provided specific harm reduction resources. We measured perceived importance of various factors in providing harm reduction resources using a 5-point Likert scale. Results: Of the 1210 clinicians who received the survey, 126 participants responded (10% response rate). Most felt comfortable with providing naloxone and referring to syringe services programs (both 8.3/10). In practice, many participants had provided naloxone (71 [56%]) or wound care supplies (71 [56%]), or referred patients to syringe services programs (57 [45%]). However, fewer participants had provided safer drug use supplies (26 [21%]) or syringes (16 [13%]). Responses included the desire for more harm reduction education and system standardization. Discussion: Although many participants reported being comfortable with harm reduction strategies, fewer provided harm reduction resources in practice. Barriers to improving harm reduction strategies include insufficient provider education and lack of system standardization. Conclusions: Participants were comfortable with providing harm reduction resources, but less likely to translate this comfort into practice. It is necessary to address barriers to implementation to support greater uptake of harm reduction strategies.