Release Date
Geography
Language of Resource
Full Text Available
Open Access / OK to Reproduce
Peer Reviewed
Objective
This paper examines how the Emergency Department (ED) is organized to provide harm reduction and identifies facilitators and barriers to implementation in light of interactions between system elements.
Findings/Key points
An array of system agents, including substance use specialist providers and non-specialist providers, interacted in ways that enable the provision of harm reduction interventions in the ED, including opioid agonist treatment, supervised consumption, and withdrawal management. However, limited access to specialist providers, when coupled with specialist control, non-specialist reliance, and concerns related to safety, created tensions in the system that hinder harm reduction provision with resulting implications for the delivery of care.
Design/methods
Interviews with Emergency Physicians (n = 5), Emergency Nurses (n = 10), and clinical leaders (n = 5)
