ArticleHarm reduction journal2026
Integrating harm reduction interventions for older adults in opioid treatment programs: a qualitative study of patient and provider perspectives.
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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7 authors.
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Abstract
backgroundThe prevalence of opioid use disorder (OUD) among older adults has increased rapidly, yet this population faces unique challenges in accessing harm reduction services within opioid treatment programs (OTPs). The objective of this study was to explore patient and provider perspectives on the acceptability and feasibility of delivering harm reduction interventions to older adults within OTPs.
methodsFrom June 2023 to February 2024, we conducted a qualitative study with two OTPs in San Diego County, California. Participants included 25 patients aged 55 and older receiving medications for OUD, and 15 OTP providers. Semi-structured interviews and thematic analysis focused exploring participants' beliefs, attitudes, and experiences with harm reduction interventions.
resultsBoth patients and providers expressed broad acceptability and perceived need for harm reduction services within OTPs. Key barriers identified included intersectional stigma related to age and substance use, lack of age-appropriate interventions, transportation challenges, and technological barriers. Strong patient-provider relationships were viewed as critical for successful implementation; patients emphasized the value of providers with lived experience. Providers highlighted implementation challenges, including resource constraints, sustainability concerns, and the need for integrated care models addressing complex medical and social needs. While providers viewed the frequent contact inherent in OTP settings as an opportunity for relationship building and service delivery, cognitive changes among some patients and multiple chronic conditions could complicate care provision.
conclusionPatients and providers report high acceptability for integrating harm reduction services within OTPs tailored to older adults, but significant barriers exist. Addressing these barriers through tailored interventions, improved accessibility, and efforts to reduce stigma may improve care for this vulnerable population. Implementation strategies should focus on establishing sustainable funding mechanisms, strong community partnerships, and ongoing provider training. Finally, harm reduction services may require regular review to ensure they accommodate the unique needs of older adults with OUD.
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