Meeting people where they are: implementing hospital-based substance use harm reduction

Harm Reduction Journal

Robert Hoffman¹  Louise Stephan²  Ro Giuliano³  Rachel Perera⁴  Marlene Martin⁴  Paula Lum⁵  Ayesha Appa⁵ 

[1] Drug User Community Health, San Francisco, CA, USA;Frank H Netter MD School of Medicine, Quinnipiac University, North Haven, CT, USA;San Francisco AIDS Foundation, San Francisco, CA, USA;San Francisco General Hospital, San Francisco, CA, USA;Department of Medicine, University of California San Francisco, 1001 Potrero Avenue, 94110, San Francisco, CA, USA;San Francisco General Hospital, San Francisco, CA, USA;Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, CA, USA;

关键词: Harm reduction;    Hospitals;    Addiction;    Safer use supplies;    Community engagement;    Health systems;   

DOI  :  10.1186/s12954-022-00594-9

来源: Springer

【 摘 要 】

BackgroundHospital-based addiction care focuses on assessing and diagnosing substance use disorders, managing withdrawal, and initiating medications for addiction treatment. Hospital harm reduction is generally limited to prescribing naloxone. Hospitals can better serve individuals with substance use disorders by incorporating harm reduction education and equipment provision as essential addiction care. We describe the implementation of a hospital intervention that provides harm reduction education and equipment (e.g., syringes, pipes, and fentanyl test strips) to patients via an addiction consult team in an urban, safety-net hospital.MethodsWe performed a needs assessment to determine patient harm reduction needs. We partnered with a community-based organization who provided us harm reduction equipment and training. We engaged executive, regulatory, and nursing leadership to obtain support. After ensuring regulatory compliance, training our team, and developing a workflow, we implemented this harm reduction program that provides education and equipment to individuals whose substance use goals do not include abstinence.ResultsDuring a 12-month period we provided 195 individuals harm reduction kits.ConclusionsThis intervention allowed us to advance hospital-based addiction care, better educate and engage patients, staff, and clinicians, and reduce stigma. By establishing a community harm reduction partner, obtaining support from hospital leadership, and incorporating feedback from staff, clinicians, and patients, we successfully implemented harm reduction education and equipment provision in a hospital setting as part of evidence-based addiction care.Trial registration: Commentary, none.

【 授权许可】

CC BY