Perspectives of Businesses on Physical and Virtual Harm Reduction Services in Canada: A Qualitative Study.

The opioid epidemic has claimed many lives and harm reduction strategies have been implemented to reduce overdose mortality and improve health outcomes. Supervised consumption sites (SCS) and their virtual counterparts, overdose response hotlines and apps (ORHAs), are interventions to reduce overdose harms. In this study, we explore the business community's perspectives with commercial space near SCS on these harm reduction strategies and virtual services. Twenty-three business owners and staff within 1 km of an SCS were recruited across Canada. Inductive thematic analysis using grounded theory was employed to identify themes. Five themes were identified: (1) access to bathrooms has been a common source of conflict; (2) substance use and associated disruptions have been on the rise since the COVID-19 pandemic with litter around the businesses; (3) many businesses feel compassion fatigue when interacting with people who use substances; (4) harm reduction services were positively viewed by most participants, with some expressing concerns; (5) virtual harm reduction services were seen as necessary and an additional tool in the toolkit with disadvantages being lack of access to a phone and no immediate help available in case of an overdose. This study provides important business insights on harm reduction strategies to understand their viewpoint on SCS and ORHAs. We identified areas for potential improvement in both overdose prevention interventions and identified improvements. Virtual services have the potential to expand within communities and improve health outcomes.