Sheltering risks: Implementation of harm reduction in homeless shelters during an overdose emergency

dc.contributor.authorWallace, Bruce
dc.contributor.authorBarber, Katrina
dc.contributor.authorPauly, Bernie
dc.date.accessioned2020-12-02T20:18:25Z
dc.date.available2020-12-02T20:18:25Z
dc.date.copyright2018en_US
dc.date.issued2018
dc.description.abstractBackground The current opioid overdose crisis in North America is heightening awareness of the need for and the challenges of implementing harm reduction, notably within complex and diverse settings such as homeless shelters. In this paper, we explore the implementation of harm reduction in homeless shelters during an emerging overdose emergency. Methods The objective of this qualitative study was to identify and understand micro-environment level factors within emergency shelters responding to homelessness and substance use, and the macro-level influences that produce and sustain structural vulnerabilities. We conducted eight focus groups with a total of 49 participants during an emerging overdose emergency. These included shelter residents (n = 23), shelter staff (n = 13), and harm reduction workers (n = 13). Results The findings illustrate the challenges of implementing an overdose response when substance use is prohibited onsite, without an expectation of abstinence, and where harm reduction services are limited to the distribution of supplies. In this context, harm reduction is partially implemented and incomplete. Shelters can be a site of risks and trauma for residents and staff due to experiencing, witnessing, and responding to overdoses. Conclusion The current overdose crisis heightens the challenges of implementing harm reduction, particularly within complex and diverse settings such as homeless shelters. When harm reduction is limited to the distribution of supplies such as clean equipment and naloxone, important principles of engagement and the development of trust necessary to the provision of services are overlooked with negative implications for service users.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipThis work was supported by the Vancouver Foundation. The funding body had no role in the study design or preparation of the manuscript.en_US
dc.identifier.citationWallace, B., Barber, K., Pauly, B. (2018). Sheltering risks: Implementation of harm reduction in homeless shelters during an overdose emergency. International Journal of Drug Policy, 53, 83-89. https://doi.org/10.1016/j.drugpo.2017.12.011.en_US
dc.identifier.urihttps://doi.org/10.1016/j.drugpo.2017.12.011
dc.identifier.urihttp://hdl.handle.net/1828/12430
dc.language.isoenen_US
dc.publisherInternational Journal of Drug Policyen_US
dc.subjectSubstance useen_US
dc.subjectHarm reductionen_US
dc.subjectHomelessnessen_US
dc.subjectSheltersen_US
dc.subjectOverdoseen_US
dc.titleSheltering risks: Implementation of harm reduction in homeless shelters during an overdose emergencyen_US
dc.typePostprinten_US

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