Exploring attitudes toward acceptability of harm reduction: a comparative study of South African and Swedish addiction care professionals

Background and Objective Working from a harm reduction (HR) approach underscores that addiction care professionals (ACPs) serve people with substance use disorder in a non-judgmental environment, encouraging people to seek intervention without abstinence as the ultimate goal. This study aims to explore and compare the attitudes toward the acceptability of harm reduction among ACPs in South Africa and Sweden.Methods Participants (N = 208), 84 in South Africa and 124 in Sweden, were recruited through non-probability sampling, via gatekeepers. Data collection comprised a web-based survey with Goddard’s Harm Reduction Acceptability Scale. Analysis included independent samples t-tests. Cronbach’s alpha coefficients showed good reliability.Results The Swedish ACPs demonstrated significantly greater acceptance of harm reduction than their South African counterparts (M = 4.03vs 3.47, t(206)=−8.56, p < .001, d = 1.21). The difference was significant across 18 of the survey’s 25 items, with Swedish ACPs consistently reporting higher attitudes toward HR acceptance. Most ACPs in both countries were positive about attending HR training.Conclusions South African ACPs hold a more negative attitude toward HR than their Swedish counterparts. Zooming in on specific items of the scale, several practical implications for policymakers and practitioners in addiction treatment and public health are outlined.