Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
The W. Maurice Young Centre for Applied Ethics, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
Harm Reduct J. 2024 Oct 23;21(1):189. doi: 10.1186/s12954-024-01063-1.
Progressive harm reduction policies have been implemented in British Columbia, Canada. However, youth who use drugs face barriers to receiving harm reduction care, resulting in increasing opioid-related hospitalizations and drug toxicity deaths. This scoping review collates peer-reviewed evidence to understand the barriers and facilitators faced by youth who use drugs when accessing harm reduction programming in British Columbia, Canada.
This scoping review entailed conducting a systematic search of relevant databases to identify relevant articles. Articles were included if they: (i) contained youth falling between the ages of 12 and 26 years old; (ii) explored accessibility, barriers, and/or facilitators to harm reduction care or related topics; (iii) were empirical research articles using primary data (i.e., reviews, grey literature, theoretical or conceptual papers, books, etc. were excluded); and (iv) were available in the English language, given the geographic focus on British Columbia.
A total of 398 sources were identified and ultimately, data from 13 sources were charted and extracted. When investigating barriers to harm reduction care among youth, four themes emerged: self-stigma, service navigation, service delivery, and negative provider interactions. Furthermore, in exploring factors that facilitate harm reduction care for youth, four themes surfaced: ability to meet basic needs, positive provider interactions, social networks, and risk mitigation guidance.
The expansion of harm reduction services in 2016 did not fully address accessibility challenges faced by youth who use drugs. Barriers continue to hinder harm reduction engagement, while supportive networks, positive provider interactions, and the ability to meet basic needs facilitated sustained access. Tailored policy interventions rooted in equity are crucial to improving access to harm reduction services for youth who use drugs.
加拿大不列颠哥伦比亚省实施了渐进式减少伤害政策。然而,吸毒的年轻人在获得减少伤害护理方面面临障碍,导致阿片类药物相关住院和药物毒性死亡人数不断增加。本范围综述汇总了同行评议的证据,以了解加拿大不列颠哥伦比亚省吸毒青年在获得减少伤害方案时面临的障碍和促进因素。
本范围综述包括对相关数据库进行系统搜索,以确定相关文章。如果文章符合以下标准,则将其纳入:(i)包含年龄在 12 至 26 岁之间的青年;(ii)探讨减少伤害护理或相关主题的可及性、障碍和/或促进因素;(iii)使用主要数据(即综述、灰色文献、理论或概念论文、书籍等)进行实证研究文章;(iv)以英文提供,鉴于该研究的地理重点是不列颠哥伦比亚省。
共确定了 398 个来源,最终对 13 个来源的数据进行了图表绘制和提取。在调查青年获得减少伤害护理的障碍时,出现了四个主题:自我污名化、服务导航、服务提供和负面提供者互动。此外,在探讨促进青年减少伤害护理的因素时,出现了四个主题:满足基本需求的能力、积极的提供者互动、社交网络和风险缓解指导。
2016 年减少伤害服务的扩大并没有完全解决吸毒青年面临的可及性挑战。障碍继续阻碍减少伤害的参与,而支持性网络、积极的提供者互动和满足基本需求的能力促进了持续的获得。基于公平的定制政策干预对于改善吸毒青年获得减少伤害服务至关重要。