Harm reduction social work with people who use drugs: a qualitative interview study with social workers in harm reduction services in Sweden.
Drug addiction
Harm reduction
Harm reduction social work
People who use drugs
Recovery
Rehabilitation
Social work
Journal
Harm reduction journal
ISSN: 1477-7517
Titre abrégé: Harm Reduct J
Pays: England
ID NLM: 101153624
Informations de publication
Date de publication:
14 10 2023
14 10 2023
Historique:
received:
10
08
2023
accepted:
05
10
2023
medline:
23
10
2023
pubmed:
14
10
2023
entrez:
14
10
2023
Statut:
epublish
Résumé
Social work with people who use drugs (PWUD) has traditionally focused on abstinence and rehabilitation. In recent years, harm reduction has gained an increasingly more important role in social work with PWUD, and social workers are key professionals in many harm reduction services. This study investigates how social workers in harm reduction services for PWUD in Sweden understand the concept of harm reduction and how it relates to goals of rehabilitation, and how they assess and deal with dilemmas and challenges in everyday work. The study is based on interviews with 22 social workers in harm reduction services for PWUD in the Scania region of Sweden. A thematic analysis in three steps was used in coding and processing the data. The social workers pointed to similar values between social work and harm reduction and argued for combining the two fields to improve services for PWUD. Three overarching principles for Harm Reduction Social Work (HRSW) were developed based on the social workers accounts: (1) Harm reduction is a prerequisite for rather than a counterpoint to rehabilitation and recovery, (2) motivational work must be non-mandatory and based on the client's goals, (3) a holistic perspective is crucial for Harm Reduction Social Work. Challenges in doing HRSW concerned restrictive laws, policies, and guidelines, resistance from managers, difficulties in setting boundaries between client autonomy and life-saving interventions, and the risk of normalizing high-risk behaviors. We use the concept of Harm Reduction Social Work to show how social work with PWUD can have a primary focus on reducing harm and risks, while at the same time it involves a holistic perspective that facilitates motivation and change. The suggested principles of HRSW can provide guidance in practical social work with vulnerable PWUD. Social workers can have important roles in most harm reduction settings and may act to enable recovery.
Sections du résumé
BACKGROUND
Social work with people who use drugs (PWUD) has traditionally focused on abstinence and rehabilitation. In recent years, harm reduction has gained an increasingly more important role in social work with PWUD, and social workers are key professionals in many harm reduction services. This study investigates how social workers in harm reduction services for PWUD in Sweden understand the concept of harm reduction and how it relates to goals of rehabilitation, and how they assess and deal with dilemmas and challenges in everyday work.
METHODS
The study is based on interviews with 22 social workers in harm reduction services for PWUD in the Scania region of Sweden. A thematic analysis in three steps was used in coding and processing the data.
RESULTS
The social workers pointed to similar values between social work and harm reduction and argued for combining the two fields to improve services for PWUD. Three overarching principles for Harm Reduction Social Work (HRSW) were developed based on the social workers accounts: (1) Harm reduction is a prerequisite for rather than a counterpoint to rehabilitation and recovery, (2) motivational work must be non-mandatory and based on the client's goals, (3) a holistic perspective is crucial for Harm Reduction Social Work. Challenges in doing HRSW concerned restrictive laws, policies, and guidelines, resistance from managers, difficulties in setting boundaries between client autonomy and life-saving interventions, and the risk of normalizing high-risk behaviors.
CONCLUSIONS
We use the concept of Harm Reduction Social Work to show how social work with PWUD can have a primary focus on reducing harm and risks, while at the same time it involves a holistic perspective that facilitates motivation and change. The suggested principles of HRSW can provide guidance in practical social work with vulnerable PWUD. Social workers can have important roles in most harm reduction settings and may act to enable recovery.
Identifiants
pubmed: 37833801
doi: 10.1186/s12954-023-00884-w
pii: 10.1186/s12954-023-00884-w
pmc: PMC10576387
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
146Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Psychol Addict Behav. 2013 Dec;27(4):1102-9
pubmed: 23088408
Soc Work. 2004 Jul;49(3):356-63
pubmed: 15281690
Harm Reduct J. 2015 Feb 18;12:1
pubmed: 25889208
Health Soc Work. 2003 May;28(2):117-25
pubmed: 12774533
Int J Drug Policy. 2022 Jun;104:103672
pubmed: 35405454
Int J Drug Policy. 2015 Jul;26(7):617-25
pubmed: 25962733
BMC Psychiatry. 2020 Feb 7;20(1):49
pubmed: 32028921
Int J Addict. 1991 Dec;26(12):1293-302
pubmed: 1787022
Soc Sci Med. 2006 Jun;62(12):3035-47
pubmed: 16413645
Subst Use Misuse. 2008;43(12-13):1971-86
pubmed: 19016174
Harm Reduct J. 2022 Mar 4;19(1):23
pubmed: 35246162
Drug Alcohol Depend. 2022 Jan 1;230:109179
pubmed: 34847503
Drug Alcohol Depend. 1983 Feb;11(1):99-103
pubmed: 6851866
Subst Abus. 2017 Oct-Dec;38(4):369-375
pubmed: 28605275