Peer-delivered harm reduction and recovery support services: initial evaluation from a hybrid recovery community drop-in center and syringe exchange program

Robert D Ashford,Brenda Curtis,Austin M Brown

doi:10.1186/s12954-018-0258-2

Robert D Ashford, Brenda Curtis + Show 1 more

Open Access

https://doi.org/10.1186/s12954-018-0258-2

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Abstract

BackgroundRecovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effective in improving SUD outcomes, as well as improving the engagement and effectiveness of harm reduction programs.MethodsThis study provides an initial evaluation of a hybrid recovery community organization providing PRSS as well as peer-based harm reduction services via a syringe exchange program. Administrative data collected during normal operations of the Missouri Network for Opiate Reform and Recovery were analyzed using Pearson chi-square tests and Monte Carlo chi-square tests.ResultsIntravenous substance-using participants (N = 417) had an average of 2.14 engagements (SD = 2.59) with the program. Over the evaluation period, a range of 5345–8995 sterile syringes were provided, with a range of 600–1530 used syringes collected. Participant housing status, criminal justice status, and previous health diagnosis were all significantly related to whether they had multiple engagements.ConclusionsResults suggest that recovery community organizations are well situated and staffed to also provide harm reduction services, such as syringe exchange programs. Given the relationship between engagement and participant housing, criminal justice status, and previous health diagnosis, recommendations for service delivery include additional education and outreach for homeless, justice-involved, LatinX, and LGBTQ+ identifying individuals.

Highlights

Recovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies
The number of recovery community organizations (RCO) in the USA has expanded in large part due to federal investment through the Recovery Community Services Program (RCSP) and Access to Recovery (ATR) Substance Abuse and Mental Health Services Administration
Outside of the USA, peer-based harm reduction programs have shown that peer-delivered services are a viable option in reducing death and transmission of disease and having a positive impact on the quality of life of people who use drugs (PWUD) and those seeking recovery [2,3,4]

Summary

Introduction

Recovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. Peer recovery support services (PRSS) are effective in improving SUD outcomes, as well as improving the engagement and effectiveness of harm reduction programs. Peer-based recovery community organizations (RCO) and programs have presented unique opportunities for the study of community responses to the opioid crisis in the USA. Outside of the USA, peer-based harm reduction programs have shown that peer-delivered services are a viable option in reducing death and transmission of disease and having a positive impact on the quality of life of people who use drugs (PWUD) and those seeking recovery [2,3,4]. The organizations provide recovery support services, advocacy, and community education around substance use disorder (SUD). In addition to providing recovery-specific brick and mortar space for pro-social activities and delivery of PRSS, RCOs provide community outreach and operate as an information and referral clearinghouse for other SUD and non-SUD support organizations such as local housing, local treatment providers, and other social support services [6]

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