Harm reduction research is improving care for patients who use substances

Research from Lawson Health Research Institute is helping to advance harm reduction strategies in hospitals for people who use substances. In an announcement today, Arielle Kayabaga, Member of Parliament for London West, on behalf of the Honourable Ya’ara Saks, Canada’s Minister of Mental Health and Addictions, announced how $72,768 in funding from Health Canada’s Substance Use and Addictions Program is supporting this ongoing work at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London (St. Joseph’s).

“Here in London, just like many other cities across Canada, we’re seeing substance use harms continue to take a tragic toll on our families and friends,” says MP Kayabaga. “We are committed to supporting organizations who are on the ground in communities, helping to keep people who use substances safe.”

Research from Lawson has found patients who use methamphetamine reported stigma and a lack of understanding about addiction among health-care providers and hospital staff. This can sometimes result in patients not seeking care, experiencing withdrawal while receiving care or leaving a hospital against medical advice.

Building on those findings, a team led by Lawson researchers, Drs. Cheryl Forchuk and Michael Silverman, has been working to implement and study harm reduction strategies at LHSC and St. Joseph’s, including those aimed at facilitating changes in attitude, knowledge, organizational support and safety approaches.

“There’s a lot of stigma and misunderstanding about substance use,” says Dr. Forchuk, Scientist and Assistant Scientific Director at Lawson. “This project aims to embed education on substance use and harm reduction as a foundational way to improve care and outcomes.”

As part of the research project, Darren Scott, a Peer Harm Reduction Worker with Regional HIV/AIDS Connection who has lived experience with substance use, and Tammy Fischer, a Clinical Nursing Educator in LHSC’s Mental Health and Addictions Program, have been working to educate health-care workers about harm reduction practices.

“I am able to share with patient caregivers how I was treated while I was in active addiction,” shares Scott. “I can let them know what people are going through from the other side and provide advice on how to care for them. The health-care teams have been fantastic and very open-minded throughout this project. I have received feedback that it is vital to include people with lived experience in this education.”

One area of focus from this study has been education around sharps boxes in inpatient hospital rooms. Sharps boxes allow for the safe disposal of sharps like needles to protect the health and safety of patients and health-care teams. Through this study, the research team identified that when sharps boxes are removed from the rooms of patients suspected of using substances to discourage substance use it leads to harm. 

“About half of patients who use substances are still using in-hospital, since suddenly stopping use is often not feasible nor safe. Access to sharps boxes decreases the risk of injury to health-care teams and patients,” Fischer explains. “People who use any injection must have safe means to dispose of used equipment.” 

The team launched a campaign to educate health-care teams on the importance of keeping sharps boxes in patient rooms. Preliminary data from interviews with patients who use substances found they noticed a difference after this education. Patients felt more comfortable speaking to health-care teams and noted they could be more open about discussing their addiction.

Government of Canada funding is critically important to this work and builds on just over $1 million in previously announced funding. The project is one of several harm reduction research initiatives being explored collaboratively through LHSC and St. Joseph’s to ensure people who use substances receive the highest quality of equitable care.

“This investment is part of our comprehensive and compassionate approach to reducing harms as a result of substance use. We will continue to use every tool at our disposal to build a safer, healthier and more caring future for all Canadians,” says Minister Saks. “Supporting local organizations who have deep roots in their communities and have the trust of their patients is making a real difference in people’s lives in the community of London, Ontario.”