ArticleHarm reduction journal2026
Assessing working musicians' perspectives of need and barriers regarding lay harm reduction efforts for substance-related harm in South Carolina.
Article in Harm reduction journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHarm Reduction (HR) approaches applied to substance use aim to decrease the toxic consequences of overdose. The addition of xylazine and benzodiazepines to fentanyl, the primary opioid in the US drug supply, increases the likelihood of overdose. Likewise, adding fentanyl to other popular substances, such as cocaine and methamphetamine, has further driven the exponential increase in opioid and stimulant overdoses. Engaging lay community members in HR efforts may help to combat the overdose crisis. Substance use is common in live music settings, and working musicians may be uniquely positioned within "the scene" - individuals who populate specific cultural niches within live entertainment - making them attractive candidates to assist with and/or lead lay HR promotion. Therefore, this study aimed to gather perspectives to inform a tailored needs assessment among working musicians in South Carolina using Community-Based Participatory Research (CBPR) methods to ascertain local patterns and impacts of substance use.
methodsUsing a CBPR framework, a three-person community leadership team and the academic research team collaboratively developed a semi-structured interview to guide focus groups with working musicians. A total of 19 working musicians participated in focus groups, followed by HR and naloxone administration training. The focus groups were audio-recorded, transcribed, verified for accuracy, and coded by a team of researchers using rapid qualitative analysis to identify themes and exemplar quotes.
resultsParticipants reported observing a variety of legal and illegal substances used within the South Carolina music "scene" and broader community. Concerns reported by musicians included venue practices of over-selling to promote over-consumption of alcohol, using substances to "self-medicate", and recreational drug use misidentified as dependence. Although musicians suggested HR efforts are necessary, many lacked knowledge and awareness of HR tools and were unfamiliar with local HR initiatives. Barriers and facilitators include a lack of overdose knowledge and a close-knit community, respectively.
conclusionsUsing CBPR methods, we found that HR efforts are necessary in "the scene" of central South Carolina to leverage strengths to combat the national opioid crisis at the community level.
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