Developing harm reduction in the context of youth substance use: insights from a multi-site qualitative analysis of young people’s harm minimization strategies

Abstract

BackgroundYouth substance use programming and educational strategies are frequently informed by prevention approaches that emphasize abstinence goals, which often do not resonate with youth in their lack of acknowledgment of young people’s social context and how young people perceive positive effects of substance use. Further, approaches to drug prevention have been critiqued as adopting a one-size-fits-all approach and therefore inadequate in addressing substance use in the context of population variation and inequities. In response to the limitations of current approaches to prevention, programming informed by harm reduction principles that aims to minimize harms without requiring abstinence is emergent in school settings. However, youth perspectives informing harm reduction are limited in both research and program development.MethodsThis paper draws on data from the Researching Adolescent Distress and Resilience (RADAR) study, which utilized an ethnographic approach to bring youth voice to the literature on mental health and substance use. Qualitative data collection included individual interviews (n = 86) with young people aged 13–18 across three communities—representing urban, suburban, and rural geographies—in British Columbia, Canada. A multi-site qualitative analysis of interview data was conducted to identify themes across and within each research site.ResultsAcross all three sites, young people’s individual experiences of substance use were shaped by geographic, socio-cultural, and political contexts, with youth describing their use in relation to the nature of substance use in peer groups and in the broader community. To manage their own substance use and reduce related harms, youth employed a variety of ad hoc harm minimization strategies that were reflective of their respective contexts.ConclusionsThe findings from this study suggest the importance of harm reduction approaches that are contextually relevant and responsive to the lived experiences of youth. Youth perspectives in the development of harm reduction programming are needed to ensure that approaches are relatable and meaningful to young people, and effective for promoting the minimization of substance-related harms.

Mental Health Needs of Adolescents and the Nursing Cares: Integrative Review

“…28 The strategy was approached as a positive method of care by allowing adolescents to manage their own substance use, shaping care in relation to their socio-cultural and political contexts, employing a variety of harm minimization strategies that are reflected in their contexts. 28 Cognitive behavioral therapy Garmy P, et al 2015. 29 The effect of a school-based universal intervention and prevention of depressive symptoms in adolescents, with an emphasis on females, has been reported, and a positive result has been found to apply such an intervention.…”

“…psychoactive substances such as alcohol and cannabis. 28 It is noted that it is relevant to know how the adolescent sees the consumption of alcohol and other drugs, and what he considers common within his family and his group of friends, so then, to draw care that is consistent with their health needs.…”

Young people who inject drugs in Mozambique: should we emphasize them in the National Harm Reduction Plan?

“…Harm reduction strategies can benefit both HIV negative and positive young PWID to prevent HIV acquisition and ongoing transmission among those not yet infected and to maintain health, promote adherence to HIV treatment, and reduce the risk of onward transmission [25]. The school context is an excellent environment to advocate and introduce youth harm reduction approaches to prevent substance abuse [26,27].…”

"Drugs Are a Taboo”: A Qualitative Study on Young People's Perspective on The Role of Education and Harm Reduction Strategies Associated With The Use of Psychoactive Substances Before Adulthood

“…Having this in mind, schools may be one of the most adequate contexts to promote health literacy (23) in various domains such as drug use One of the promising strategies to address it is thought to be harm reduction philosophy (12,(28)(29)(30) since it allows a more pragmatic and exible response to the use of drugs in adolescents (12,(28)(29)(30) and it can become a link between them and other health and social services (31)(32)(33).…”

“…Having this in mind, in order to encompass the complexity of the problems that adolescents face and to design interventions that are relevant and congruent with their sociocultural characteristics (17,27,28) it is necessary to give the protagonists of this phenomena a primary role in the research. This was the goal in this paper where the youngsters took up the expert role in identifying their own needs, the obstacles in accessing and using general health services, harm reduction services and in the development of possible changes in the eld of drug use in adolescence to build a more effective, congruent and empowering response.…”