ArticleJournal of addictive diseases
The integration of harm reduction services in the Veterans Health Administration (VHA): a qualitative analysis of barriers and facilitators.
Article in Journal of addictive diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Application status of the CFIR-ERIC matching tool in healthcare context: a scoping review.Implementation science : IS · 2026Article
- Mental Health Prescribers' Perceptions of Patients With Substance Use Disorders and Harm Reduction Services.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2026Article
- Long-term, bidirectional associations between depressive symptom severity and opioid use among people with HIV: A prospective cohort study.Addictive behaviors reports · 2025Article
- Development of a pragmatic measure for the Practical, Robust Implementation and Sustainability Model.Psychological services · 2025Article
- Harm reduction stories: leveraging graphic medicine to engage veterans in substance use services within the VA.Harm reduction journal · 2023Article
- "I wouldn't need Narcan for myself, but I can have it for somebody else:" perceptions of harm reduction among hospitalized patients with OUD.Addiction science & clinical practice · 2023Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSubstance use is common among U.S. military veterans and veterans are at high risk for negative consequences associated with substance use, such as injection-related infections and overdose. Although harm reduction services (HRS) are highly evidence-based, implementation in traditional healthcare settings has been limited. This formative, qualitative study sought to identify barriers and facilitators to the integration of HRS and identify appropriate implementation strategies to support the optimized integration of a comprehensive bundle of HRS in the Veterans Health Administration (VHA).
methodsSemi-structured interviews explored how harm reduction is currently understood by VHA providers and elicited input on perceived facilitators and barriers to implementation. Data were analyzed using a directed content analysis and the Practical, Robust Implementation and Sustainability Model (PRISM) implementation framework was used to organize findings. Results were then mapped to relevant implementation strategies using the Consolidated Framework for Implementation Research - Expert Recommendations for Implementing Change (CFIR - ERIC) tool.
results15 interviews with VHA providers were conducted across 5 sites. Respondents reported that current HRS are fragmented and dependent on the knowledge, time, and comfort level of individual providers. Stigma around substance use at the patient, provider, and institutional levels was noted to be a key barrier to HRS adoption. Based on identified barriers and facilitators, strategies that may be effective for increasing adoption of HRS include engagement of champions, communication and educational strategies, and adaptation of existing infrastructure.
conclusionsMany of the barriers identified in this formative study may be addressed using evidence-based implementation strategies. Additional research is needed to identify implementation strategies that are effective for addressing stigma, which is perceived to be a persistent challenge to the provision of integrated harm reduction services.
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