Emergency Care Team Comfort and Experience with Harm Reduction for Opioid Use Disorder

Introduction: Harm reduction strategies are effective in mitigating risks associated with substance use. However, their implementation in emergency department (ED) settings has been limited. This study explored ED care team members’ experiences and comfort with harm reduction provision. Methods: We conducted a cross-sectional study to assess ED care team members’ experiences and comfort levels (0–10 scale) with providing harm reduction resources to patients. An electronic survey was distributed to 446 care team members at a Level 1 tertiary care ED. Domains included prior harm reduction practice, comfort levels, perceived barriers to harm reduction provision, and perceived importance of various factors in harm reduction provision. Results: Of 92 care team members (21.1% response rate), 52 (58%) reported having provided naloxone (mean comfort 8.06). Fifty (56%) had provided wound care supplies (mean comfort 8.32), whereas only 11 (13%) reported providing safer use supplies. Comfort varied for individual supplies, with the lowest for glass pipes (mean 4.9) and the highest for alcohol swabs (mean 8.33). Barriers to providing harm reduction resources and role-based differences were identified, highlighting the need for patients and clinician education. Discussion: Despite relatively high comfort levels, ED care teams face barriers to harm reduction provision, including insufficient knowledge, limited access to resources, and time constraints, particularly among nurses. These barriers hinder the widespread adoption of harm reduction practices in the ED. Conclusion: Although ED care team members were generally comfortable with harm reduction strategies, practices were inconsistently translated into patient care. Addressing knowledge gaps, resource access, and time limitations is crucial to improving harm reduction resource provision in EDs.