Toward Harm Reduction in Hospitals: A Qualitative Case Study of a Large Academic Health Sciences Centre

Harm reduction is a philosophy and set of strategies that aims to minimize the harms associated with substance use in people who are unwilling or unable to stop. There is a strong evidence base for harm reduction interventions in community settings, but there has been minimal uptake of these strategies in acute care facilities. This is concerning because people who use drugs (PWUD) have high rates of hospitalizations. Research suggests that PWUD report that their care needs and preferences are typically not met or respected while in hospital, and factors including restrictive hospital policies, stigma from healthcare professionals, and denial of pain medication contribute to a variety of health and social harms in this population. Despite calls for more integration of harm reduction into acute care, there has been minimal research that explores the perspectives of hospital-based healthcare providers on the potential role of harm reduction in hospital settings.