Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative study

Abstract Background Substance use treatment (SUT) and harm reduction are often perceived as having distinct goals despite people who use drugs routinely having needs that encompass both services. The co-occurring SUT and harm reduction needs of people who use drugs warrant collaboration between serv...

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Main Authors: Molly C. Reid, Samantha J. Harris, Suzanne M. Grieb, Sabrina Gattine, Zekiye Lukco, Brandon Hool, Mary Aguirre, Fernanda Alonso Aranda, Catherine Tomko, Sara Whaley, Brendan Saloner, Sean T. Allen
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Harm Reduction Journal
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Online Access:https://doi.org/10.1186/s12954-025-01172-5
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author Molly C. Reid
Samantha J. Harris
Suzanne M. Grieb
Sabrina Gattine
Zekiye Lukco
Brandon Hool
Mary Aguirre
Fernanda Alonso Aranda
Catherine Tomko
Sara Whaley
Brendan Saloner
Sean T. Allen
author_facet Molly C. Reid
Samantha J. Harris
Suzanne M. Grieb
Sabrina Gattine
Zekiye Lukco
Brandon Hool
Mary Aguirre
Fernanda Alonso Aranda
Catherine Tomko
Sara Whaley
Brendan Saloner
Sean T. Allen
author_sort Molly C. Reid
collection DOAJ
description Abstract Background Substance use treatment (SUT) and harm reduction are often perceived as having distinct goals despite people who use drugs routinely having needs that encompass both services. The co-occurring SUT and harm reduction needs of people who use drugs warrant collaboration between service providers. However, little work has explored such collaborations, or lack thereof. This research explores how SUT providers responded to expanded harm reduction programming from the perspectives of syringe services program (SSP) operators in Michigan. Methods We conducted in-depth, semi-structured interviews with a geographically diverse sample of SSP operators (n = 19) in Michigan during October and November 2021. The interview guide broadly explored the contributing factors to SSP implementation, including SSP relationships with SUT providers. Analyses of transcribed interviews were conducted using an iterative, thematic constant comparison process informed by grounded theory. Results Participants described a range of responses to SSP implementation from SUT providers. Many SSP operators identified significant barriers to effective collaboration with SUT providers due to lack of awareness about harm reduction approaches and stigmatization of drug use. For example, SUT providers were often reluctant to accept free harm reduction supplies (e.g., sterile syringes, naloxone) to offer their clients. Participants also reported difficulties connecting their clients to evidence-based SUT providers. Incremental relationship building and education about the role of harm reduction in recovery were required for effective collaboration between SUT providers and SSPs. Conclusions Tensions between SUT and harm reduction providers may create challenges that impede recovery among people who use drugs. Ensuring SUT and harm reduction providers understand the unique and complementary roles of each approach is necessary to advance the health of people who use drugs.
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spelling doaj-art-b04be1fd37074a22b9388cdcd0ab7e7f2025-08-20T03:45:23ZengBMCHarm Reduction Journal1477-75172025-03-012211810.1186/s12954-025-01172-5Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative studyMolly C. Reid0Samantha J. Harris1Suzanne M. Grieb2Sabrina Gattine3Zekiye Lukco4Brandon Hool5Mary Aguirre6Fernanda Alonso Aranda7Catherine Tomko8Sara Whaley9Brendan Saloner10Sean T. Allen11Department of Mental Health, Johns Hopkins University Bloomberg School of Public HealthDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public HealthCenter for Child and Community Health Research, Johns Hopkins University School of MedicineDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public HealthMichigan Department of Health and Human ServicesMichigan Department of Health and Human ServicesMichigan Department of Health and Human ServicesDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public HealthDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public HealthDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public HealthDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public HealthDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public HealthAbstract Background Substance use treatment (SUT) and harm reduction are often perceived as having distinct goals despite people who use drugs routinely having needs that encompass both services. The co-occurring SUT and harm reduction needs of people who use drugs warrant collaboration between service providers. However, little work has explored such collaborations, or lack thereof. This research explores how SUT providers responded to expanded harm reduction programming from the perspectives of syringe services program (SSP) operators in Michigan. Methods We conducted in-depth, semi-structured interviews with a geographically diverse sample of SSP operators (n = 19) in Michigan during October and November 2021. The interview guide broadly explored the contributing factors to SSP implementation, including SSP relationships with SUT providers. Analyses of transcribed interviews were conducted using an iterative, thematic constant comparison process informed by grounded theory. Results Participants described a range of responses to SSP implementation from SUT providers. Many SSP operators identified significant barriers to effective collaboration with SUT providers due to lack of awareness about harm reduction approaches and stigmatization of drug use. For example, SUT providers were often reluctant to accept free harm reduction supplies (e.g., sterile syringes, naloxone) to offer their clients. Participants also reported difficulties connecting their clients to evidence-based SUT providers. Incremental relationship building and education about the role of harm reduction in recovery were required for effective collaboration between SUT providers and SSPs. Conclusions Tensions between SUT and harm reduction providers may create challenges that impede recovery among people who use drugs. Ensuring SUT and harm reduction providers understand the unique and complementary roles of each approach is necessary to advance the health of people who use drugs.https://doi.org/10.1186/s12954-025-01172-5Harm reductionSubstance use treatmentIntegrated services
spellingShingle Molly C. Reid
Samantha J. Harris
Suzanne M. Grieb
Sabrina Gattine
Zekiye Lukco
Brandon Hool
Mary Aguirre
Fernanda Alonso Aranda
Catherine Tomko
Sara Whaley
Brendan Saloner
Sean T. Allen
Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative study
Harm Reduction Journal
Harm reduction
Substance use treatment
Integrated services
title Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative study
title_full Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative study
title_fullStr Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative study
title_full_unstemmed Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative study
title_short Perspectives of syringe services program operators in Michigan on their relationship with substance use treatment: a qualitative study
title_sort perspectives of syringe services program operators in michigan on their relationship with substance use treatment a qualitative study
topic Harm reduction
Substance use treatment
Integrated services
url https://doi.org/10.1186/s12954-025-01172-5
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