Developing a comprehensive inventory to define harm reduction housing.

Area of Science:

• Public Health
• Urban Planning
• Social Work

Background:

• Boston faces substance use challenges, homelessness, and changes in illicit drug supply.
• Six low-threshold harm reduction housing (HRH) sites were established for people who use drugs (PWUD).
• HRH provides transitional supportive housing with a "housing first" approach, integrating harm reduction services without requiring abstinence.

Purpose of the Study:

• To understand the characteristics and operations of Boston's HRH sites.
• To develop a comprehensive inventory tool for evaluating harm reduction strategies in transitional housing.
• To catalog common features of HRH sites for broader application.

Main Methods:

• Collected data from June-September 2023, including 19 staff interviews and ethnographic observations at six HRH sites.
• Developed an inventory through data triangulation, expert review, and pilot testing with residents.
• Administered a survey to 106 residents to assess awareness, use, and helpfulness of inventory items.

Main Results:

• HRH staff identified best practices, resources, and policies, including overdose prevention, behavioral policies, security, and harm reduction supply distribution.
• A 32-item inventory was finalized, assessing services, policies, and best practices.
• Residents valued harm reduction services; medical supports were highly valued but underutilized.

Conclusions:

• The HRH inventory effectively assesses harm reduction provision and residents' awareness of safety components.
• This tool aids in standardizing HRH concepts and practices for PWUD.
• The inventory can assist other cities in planning and implementing harm reduction housing.