A hospital successfully integrated a harm reduction services intervention for patients whose substance use goals did not include abstinence.

Background

Evidence-based addiction care is becoming more widely available in hospital settings, but hospital-based harm reduction interventions are often limited to prescribing naloxone. Many health care settings have not implemented other strategies, such as syringe service programs. This article describes the implementation of a hospital intervention that provides both harm reduction education and equipment (e.g., syringes, pipes, fentanyl test strips, and other safe use supplies) in an urban safety-net hospital in San Francisco.

Findings

An interprofessional addiction care team composed of patient navigators, nurses, and clinicians implemented the harm reduction intervention. The team educated hospital staff, clinicians, and patients on harm reduction, including the infection risks associated with drug use. For patients whose substance use goals did not include abstinence, harm reduction kits were distributed at discharge. Harm reduction kits were assembled based on individual patient needs and included information about mental health services. Over a one-year period, 196 harm reduction kits were distributed. A key element to the program’s success was obtaining leadership buy-in, which was secured by conducting a needs assessment on the patient population prior to piloting the intervention and through partnering with a community-based organization that supplied the harm reduction equipment.

Program/Policy Takeaways

This article demonstrated how a hospital can integrate harm reduction services into patient education and discharge planning. Providers and health systems can use the insights of this study to implement or strengthen harm reduction strategies implemented in their care settings.