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Recommendations for Implementation of Harm Reduction Programming in Emergency Care Settings

Houston, Katherine (2022) Recommendations for Implementation of Harm Reduction Programming in Emergency Care Settings. Master Essay, University of Pittsburgh.

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Pennsylvania has some of the highest rates of overdose deaths in the United States and spends billions of dollars yearly on costs related to overdose deaths, lost productivity, preventable infections, treatment-related costs, and incarceration. Decades of research show the effectiveness of syringe service programs in improving health outcomes and cost reduction at all levels of the social-ecological model. Pennsylvania law prohibits syringe service programming from legally operating and has only two county-sanctioned programs within the commonwealth. Proposed legislation to legalize syringe service programs has been introduced in both the Pennsylvania House and Senate, but the proposed changes do not address questions about funding, access, and implementation, leaving concerns about the accessibility of programs for rural Pennsylvanians who inject drugs. This essay examines current laws, concerns of implementation, and proposes how emergency medical facilities can begin syringe distribution to increase syringe access for people who inject drugs (PWID) in rural communities.

PWID often use emergency medicine as a last resort for medical care. PWID experience stigma throughout their daily lives, and research shows that stigmatization by the medical community happens frequently. The medical community, particularly in emergency medical settings, should undergo comprehensive training on harm reduction education to destigmatize views on drug use, improve interactions with patients who use drugs, and how to effectively discuss substance use and risk reduction measures prior to syringe distribution to ensure program success. These topics will allow for better provider-patient relationships, work to prevent compassion fatigue, lessen the frequency that PWID utilize emergency medicine, and build trust with PWID.

The public health significance of this paper is that little research has been conducted on implementing syringe distribution in emergency medical settings and no studies were found that emphasize educating emergency medical staff on harm reduction theories and practices. Research has shown the effectiveness of harm reduction programming and of compassion fatigue within the emergency medical communities, but no programs or research have examined how emergency medical settings could be utilized as the first point of introduction to harm reduction programming and education to improve health outcomes, reduce viral infections and fatal overdoses.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Houston, Katherinekatherinejoannehouston@gmail.comkjh1040000-0003-2675-1534
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairHawk, Marymary.hawk@pitt.edumary.hawkUNSPECIFIED
Committee MemberFriedman, Mackeymrf9@pitt.edumrf9UNSPECIFIED
Date: 18 May 2022
Date Type: Completion
Submission Date: 17 May 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 57
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: syringe exchange, needle exchange, syringe service program, syringe distribution
Date Deposited: 18 May 2022 20:34
Last Modified: 18 May 2022 20:34


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