People who use drugs engagement in substance use disorder services and harm reduction: evaluation, challenges and future direction of a community-based intervention

Background:

Since 1996, an urban community-based organization has been providing screening, testing, overdose prevention, referrals, and access to treatment for substance use disorders (SUD) and communicable diseases such as HIV through its Life Points harm reduction program.

Methods:

In 2021, the organization recruited a convenience sample of people who use drugs for a survey focused on substance use, healthcare, and barriers to SUD services. Community health workers conducted outreach and collected data using an encrypted identifier. Paper surveys were entered into Qualtrics for analysis.

Results:

Fifty-five people who use drugs participated, with most being active participants in the Life Points harm reduction service. The average age was 42.9 years, with diverse demographics. Heroin was the most commonly used substance. Many reported having healthcare insurance and previous involvement with the Department of Health & Human Services. Females were more likely to engage in community mental health services and report the need to participate in sex to meet basic social needs. Social determinants of health such as access to food, legal justice, and transportation were identified as barriers to services. About 44% expressed willingness to enroll in a drug treatment program in the next 30 days.

Conclusion:

The sample reflects increased participation by White participants in recent years. Most participants reported having healthcare insurance, possibly due to engagement with community health workers. Community organizations and healthcare professionals should address social determinants of health to improve access to services for people who use drugs, including investing in mobile unit outreach.