Harm reduction interventions for AYA who use opioids: A scoping review

Adolescents and young adults (AYA) are highly vulnerable to substance use and substance use-related harms. Existing harm reduction programs do not optimally serve AYA, and there is minimal data regarding harm reduction interventions specific to AYA.

We conducted a preliminary search in MEDLINE (Ovid) to identify names used to describe harm reduction interventions to include in the final search. We performed a scoping review of electronic bibliographic databases MEDLINE (Ovid), Embase (Elsevier), PsycINFO (EBSCO), and Web of Science (Clarivate). We included studies that discussed any harm reduction interventions specific to adolescents and young adults. We performed thematic analysis of included studies and used a narrative synthesis approach to consolidate and present findings.

We included 58 studies in our review. AYA demonstrated different patterns of substance use and engagement with harm reduction compared to adults. AYA are open to harm reduction practices and engage in forms of harm reduction informally. A variety of harm reduction interventions were effective among AYA, including naloxone training, fentanyl test strips, and safe injection facilities. AYA respond well to programs that are convenient, private, and emphasize longitudinal relationship building with community and providers. They may uniquely benefit from virtual programming, telehealth, and delivery services.

We must better serve AYA with youth-centered programs that prioritize privacy, safety, and convenience; offer a wide variety of services relevant to AYA substance use patterns; offer mobile and virtual options; and focus on building and leveraging community and networks.