Research > Harm Reduction within Mainstream Services

INVESTIGATORS

Lois Jackson, Dalhousie University (Principal Investigator)

Lois.Jackson@dal.ca

Sam Campbell, Queen Elizabeth Health Science Centre, Halifax

Margaret Dykeman, University of New Brunswick, Fredericton

John Fraser, North End Community Health Clinic, Halifax

Jacqueline Gahagan, Dalhousie University

Claudia Jahn, Community Action on Homelessness, Halifax

Jeff Karabanow, Dalhousie University

Fiona Martin, Dalhousie University

COMMUNITY COLLABORATORS

• AIDS Coalition of Cape Breton, Sydney, NS
• AIDS Committee of Newfoundland and Labrador, St. John’s, NL
• AIDS New Brunswick, Fredericton, NB
• AIDS PEI, Charlottetown, PE
• AIDS Saint John, NB
• Direction 180, Halifax, NS
• Emergency Health Service, Halifax, NS
• Halifax Housing Help, NS
• Mainline Needle Exchange, Halifax, NS
• AIDS Moncton, NB

RESEARCH COORDINATOR

Andrea D’Sylva

School of Health and Human Performance

Dalhousie University

902.494.7061

adsylva@dal.ca

SUMMARY OF RESEARCH PROJECT

This research has been developed with our community-based, multi-sectoral research network. Our network is composed of 10 community collaborators [listed above] as well as an advisory group of four policy-makers from Atlantic Canada.  This network developed in 2006, as part of a nationally-funded research study that sought to understand how  injection drug users’ social relationships with peers, family, friends, physicians, community services etc. influence safer/unsafe practices.   We interviewed over 100 injection drug users from across Atlantic Canada, in rural and urban areas.  A key finding was that mainstream services (such as emergency rooms and emergency shelters) often do not meet the needs of injection drug users in terms of harm reduction supports (eg. do not provide clean needles).  We are, therefore, conducting a second study to explore the opportunities and challenges to potentially integrating harm reduction services and supports into such mainstream services as emergency departments and emergency shelters.  Our previous research with injection drug users allowed us to hear the voices of people who use drugs. We believe that there is also a need to hear from staff, who may encounter users, in emergency shelters and emergency departments.

The current research has two key objectives: 1) To understand the policies and practices (formal and informal) that guide the provision of services to drug users within emergency departments and emergency shelters across Atlantic Canada; and, 2) To conduct a series of workshops to discuss with a broad range of key stakeholders (eg. physicians, nurses, police, community groups) the challenges and opportunities to integrating harm reduction services into emergency departments and emergency shelters.

In addition to persons using drugs, it is clear that there are clients/patients within emergency shelters and emergency departments who are not using drugs, and their social and health needs must be met, including their need for a safe environment. Likewise, there is a need to ensure the safety of staff who work in these settings. Providing access to services for all, while recognizing the needs of both using and non-using clients/patients and staff is without doubt crucial. Our research is aimed at understanding and discussing this timely and important issue, and working with key stakeholders to provide strategies to ensure access to services for all.

METHODS

One-on-one qualitative interviews will be conducted with individuals (frontline staff / managers / administrators) working in emergency shelters, and individuals (triage staff/ nurses, paramedics, physicians and managers) working in emergency departments. The interviews will take place in rural and urban emergency departments and emergency shelters across Atlantic Canada.  Approximately forty-eight (48) interviews will be conducted: twenty-four (24) in emergency shelters and twenty-four (24) in emergency departments.

FUNDING

This research is funded by the Canadian Institutes for Health Research (CIHR).

 TIMELINE