Harm Reduction: A Concept Analysis

BackgroundOver the last 25 years, harm reduction has shifted to focus on public health and addressing the opioid crisis. Nurses working in addictions treatment utilize the principles of harm reduction to improve the health of clients. AimsConcept clarity assists healthcare providers to understand the applications and attributes of a concept. MethodA concept analysis of harm reduction using the Rodgers (1989) method of evolutionary analysis was un-dertaken. A comprehensive review of the literature was conducted using CINAHL Plus and Social Work Abstracts. FindingsThe key attributes of harm reduction include safety, supplies, education, partnerships, and policy. Applications of harm reduction include needle exchange programs, supervised consumption sites, medication-assisted treatment, and increased access to take-home naloxone kits. The main antecedent to harm reduction is the presence of harm. Consequences explored include safer injection practices, decreased transmission of blood-borne illnesses, improved client relationships, and decreased overdose-related deaths. Stigma, health promotion, and pragmatism are the related concepts discussed. A model case is provided. ConclusionThe principles of harm reduction are becoming increasingly popular as an inclusive and evidence-based nursing approach to addictions treatment and management. As using substances continues to shift and in-crease, harm reduction strategies must remain malleable and available in both the community and hospital settings to address the issue and decrease the associated healthcare costs. Future implications for nursing practice and research are provided.

Prevalence and perceived importance of racial matching in the psychotherapeutic dyad: A national survey of addictions treatment clinical practices

Background: Despite conflicting results in the literature concerning its efficacy in practice, racial matching has been identified as a component of culturally sensitive treatment. Methods: This study examined the perceived importance and prevalence of racial matching by surveying a national sample of substance abuse treatment centers from the Substance Abuse and Mental Health Services Administration (SAMHSA). Results: Using univariate statistical analysis, results for the prevalence of racial matching revealed that in 58% of the clinics, there was the potential to match a counselor with a racially similar client, while in 39% of the clinics, there was no potential to provide such a match. Among the agencies that displayed a potential for racial matching, 26% of the respondents indicated that they never racially matched clients and therapists, 71% reported that they sometimes practice racial matching, 15% indicated that they usually racially match, and only 7% purported to always racially match clients and therapists. Results for the perceived importance of racial matching revealed that in both situations where treatment centers had the potential for racial matching and did not have the potential for racial matching, supervisors reported that it was relatively important to provide culturally sensitive treatment but that it was not as important to match clients in substance abuse centers with racially/ethnically similar counselors. Conclusion: The topic of racial matching can be very complex and has shown variation amongst substance abuse centers; however, this study emphasizes the importance of providing culturally sensitive treatment and an appreciation of differences among members within each racial group. Keywords: culturally responsive counseling; cross-racial counseling; addictions treatment