Harm Reduction: A Concept Analysis

Abstract

Background Over the last 25 years, harm reduction has shifted to focus on public health and addressing the opioid crisis. Nurses working in addictions treatment utilize the principles of harm reduction to improve the health of clients. Aims Concept clarity assists healthcare providers to understand the applications and attributes of a concept. Method A concept analysis of harm reduction using the Rodgers (1989) method of evolutionary analysis was undertaken. A comprehensive review of the literature was conducted using CINAHL Plus and Social Work Abstracts. Findings The key attributes of harm reduction include safety, supplies, education, partnerships, and policy. Applications of harm reduction include needle exchange programs, supervised consumption sites, medication-assisted treatment, and increased access to take-home naloxone kits. The main antecedent to harm reduction is the presence of harm. Consequences explored include safer injection practices, decreased transmission of blood-borne illnesses, improved client relationships, and decreased overdose-related deaths. Stigma, health promotion, and pragmatism are the related concepts discussed. A model case is provided. Conclusion The principles of harm reduction are becoming increasingly popular as an inclusive and evidence-based nursing approach to addictions treatment and management. As using substances continues to shift and increase, harm reduction strategies must remain malleable and available in both the community and hospital settings to address the issue and decrease the associated healthcare costs. Future implications for nursing practice and research are provided.