Burnout and coping among professionals working in a drug consumption room: a qualitative study

Abstract Background Drug Consumption Rooms (DCRs) are central harm reduction services that provide supervised spaces for drug use and access to health and social support. Although these settings rely on highly demanding frontline work, the experiences of the professionals who sustain them remain understudied. Evidence suggests that DCR staff face chronic stressors related to structural constraints, emotional labour, and continuous exposure to individuals experiencing severe social and health vulnerabilities. This study explores the job demands, resources, and coping strategies of professionals working in an integrated DCR in Portugal. Objectives To investigate the drivers of burnout and coping strategies among professionals working in an integrated DCR, with a focus on context-specific stressors, protective factors, and differences across work areas and functions. Methods This qualitative descriptive study used in-depth semi-structured interviews with 13 professionals, including nurses, psychosocial technicians, psychologists, social workers, and cleaning staff. Interview data were analyzed using thematic analysis informed by the Shanafelt and Noseworthy burnout model and the Job Demands-Resources theory. Results Professionals reported significant emotional burden, physical insecurity, and systemic constraints, especially in socialization zones where unpredictability, agitation, and withdrawal symptoms were prevalent. Staff working mainly in the consumption room described fewer emotional challenges, highlighting the role of spatial and functional context in shaping stress exposure. Protective factors included strong team cohesion, peer support, and shared commitment to harm reduction values. However, institutional underinvestment in training, supervision, and decision-making autonomy generated moral distress and exacerbated burnout risks. Conclusion The interplay of workplace setting, role demands, and structural limitations influences staff well-being. Addressing these challenges requires context-sensitive interventions tailored to distinct work zones within harm reduction services to ensure the sustainability of both staff health and service provision.