Use of harm reduction practices by state-licensed specialty substance use treatment programs

Area of Science:

• Public Health
• Substance Use Disorder Treatment
• Harm Reduction

Background:

• Specialty substance use treatment programs can implement harm reduction practices to improve patient health.
• Key strategies include distributing naloxone and avoiding client discharge based on positive urine drug screens for individuals with Opioid Use Disorder (OUD).

Purpose of the Study:

• To determine the prevalence of naloxone distribution and urine drug screen policies in New Jersey substance use treatment programs.
• To identify characteristics of clients in programs utilizing both harm reduction practices.

Main Methods:

• A cross-sectional survey of 108 New Jersey substance use treatment programs.
• Linking survey data with administrative records for 14,838 OUD treatment admissions (July 2021-June 2022).
• Regression analysis to examine program and client factors associated with harm reduction practice adoption.

Main Results:

• 55.6% of programs dispensed naloxone; 50.9% did not use toxicology screens for discharge decisions.
• Opioid Treatment Programs (OTPs) were more likely to adopt both practices compared to non-OTPs.
• Clients referred from correctional programs were less likely to attend programs using these harm reduction strategies.

Conclusions:

• Increased adoption of harm reduction practices is needed in non-OTP settings.
• Targeted efforts are required for programs serving clients referred by the criminal justice system.