Although an increasing number of emergency departments (ED) offer opioid agonist treatment, naloxone, and other harm reduction measures, little is known about patient perspectives on harm reduction practices delivered in the ED. The objective of this study was to identify patient-focused barriers and facilitators to harm reduction strategies in the ED. We conducted semistructured interviews with a convenience sample of individuals in Massachusetts diagnosed with opioid use disorder. We developed an interview guide, and interviews were recorded, transcribed, and analyzed in an iterative process using reflexive thematic analysis. After initial interviews and coding, we triangulated the results among a focus group of 4 individuals with lived experience. We interviewed 25 participants with opioid use disorder, 6 recruited from 1 ED and 19 recruited from opioid agonist treatment clinics. Key themes included accessibility of harm reduction supplies, lack of self-care resulting from withdrawal and hopelessness, the impact of stigma on the likelihood of using harm reduction practices, habit and knowledge, as well as the need for user-centered harm reduction interventions. In this study, people with lived experience discussed the characteristics and need for user-centered harm reduction strategies in the ED that centered on reducing stigma, treatment of withdrawal, and availability of harm reduction materials.

中文翻译：

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减少阿片类药物使用障碍危害的障碍和促进因素：对有生活经验的人的定性研究

尽管越来越多的急诊科 (ED) 提供阿片类激动剂治疗、纳洛酮和其他减少伤害措施，但患者对急诊科提供的减少伤害做法的看法却知之甚少。本研究的目的是确定急诊室中以患者为中心的减少伤害策略的障碍和促进因素。我们对马萨诸塞州被诊断患有阿片类药物使用障碍的个人进行了半结构化访谈。我们制定了采访指南，并使用反思性主题分析在迭代过程中记录、转录和分析采访。经过初步访谈和编码后，我们在由 4 名具有生活经验的人组成的焦点小组中对结果进行了三角测量。我们采访了 25 名患有阿片类药物使用障碍的参与者，其中 6 名是从 1 急诊室招募的，19 名是从阿片类药物激动剂治疗诊所招募的。关键主题包括减少伤害用品的可及性、因戒断和绝望而缺乏自我保健、耻辱对使用减少伤害做法、习惯和知识的可能性的影响，以及以用户为中心的减少伤害干预措施的必要性。在这项研究中，有生活经验的人讨论了急诊室中以用户为中心的减少伤害策略的特征和需求，该策略的重点是减少耻辱、戒断治疗和减少伤害材料的可用性。