Barriers to the dissemination of four harm reduction strategies: a survey of addiction treatment providers in Ontario

Abstract

A sample of service providers at addictions agencies' in Ontario were interviewed by telephone to assess attitudes toward, anticipated internal and external barriers to implementing, and expected benefits of four harm reduction strategies: needle exchange, moderate drinking goals, methadone treatment, and provision of free condoms to clients. Respondents were also asked to define harm reduction, list its most important elements, and describe what they find most troubling and most appealing about harm reduction. Attitudes toward harm reduction in general and the services provided at each agency were also assessed. Results indicated that the service providers surveyed had positive attitudes toward each of the four harm reduction strategies and harm reduction in general, and the majority of respondents were aware of the benefits associated with each strategy. Almost all of the agencies surveyed allowed for moderate drinking outcomes in the treatment of alcohol problems, and most agencies provided free condoms to clients. In terms of barriers, anticipated negative community reaction to needle exchange, methadone treatment, and free condoms was a major concern for the majority of respondents. Lack of staff, of funding, or anticipated staff resistance were also cited as potential barriers to introducing these strategies. In the case of methadone maintenance, the unavailability of a qualified physician was listed as the primary constraint. Implications for future efforts directed at encouraging the adoption of these strategies and suggestions for future research are discussed.

Harm Reduction for Women in Treatment for Alcohol Use Problems: Exploring the Impact of Dominant Addiction Discourse

“…Our findings are both supported and contradicted by an Ontario exploration of barriers to the dissemination of harm reduction (Hobden & Cunningham, 2006). Like the Ontario study, we found that there was little consensus in defining harm reduction or its core elements.…”

“…Only 28% of inpatient, correctional and detoxificationbased programs supported nonabstinence goals (Rosenberg et al, 1996). Furthermore, although Hobden and Cunningham's (2006) findings showed that Ontario service providers strongly supported moderate drinking goals, there was no consensus about what constitutes harm reduction or any elaboration on the provision of moderate drinking services which continues to be significant gaps in service delivery. 1 A growing focus on managed drinking in Canada has begun to emerge, specifically addressing the needs of those with a coexisting housing instability and severe drinking problem, resulting in the creation and study of more concretely developed programming around managed or controlled drinking programs than we have seen to date (Pauly et al, 2018;Stockwell et al, 2018;Vallance et al, 2016).…”

“…https://orcid.org/0000-0001-9186-571X Note 1. Our study focused on women and alcohol use and conducted in-depth interviews with both service users and providers which probed for detailed perceptions, while Hobden and Cunningham (2006) employed a survey.…”

A cross-sectional study of public attitudes towards safer drug use practices in British Columbia, Canada

“…Addressing community concerns is particularly important as one Canadian study found that the anticipated community resistance to harm reduction was the biggest barrier for service providers to implementing harm reduction programming [40]. This anticipated concern has been quantified in our study as overall support for community needle distribution was lower than general needle distribution.…”

Challenges and Successes of Harm Reduction Services in Drop-in Centers: Perspectives of Service Providers

“…A study in Russia reported major challenges in service provision for drug users, including lack of resources, rehabilitation programs, and social support (10). Another study of service providers in Canada identified potential barriers to implementing harm reduction strategies, including lack of staff and funding, as well as anticipated staff resistance (11).…”