Attitudes toward syringe exchange programs in a rural Appalachian community

Abstract

Objectives

To evaluate community attitudes concerning syringe exchange programs (SEPs) in a rural community as part of an effort to implement evidence-based harm reduction strategies and improve health outcomes related to opioid use disorder.

Methods

Dissemination of a 24-item survey to individuals living in a rural community followed by comparative analysis of survey results based on support for SEPs.

Results

Three hundred and sixty-one individuals responded. Overall, 49.3% of respondents indicated support for syringe exchange. Individuals who support syringe exchange as a harm reduction service are more likely to: agree that opioid use disorder is a real illness (p < 0.0001); agree that anyone can become addicted to pain medications (p = 0.01); agree that medication assisted treatment is effective (p < 0.0001); agree that individuals with OUD have the same right to a job (p < 0.0001); be willing to administer naloxone to a stranger (p < 0.0001); support HIV and HCV screening (p < 0.0001), condom distribution (p < 0.0001), and medication for opioid use disorder (p < 0.0001). They are less likely to believe that harm reduction services encourage drug use (p < 0.0001).

Conclusions

Positive correlations exist between support for SEPs, awareness of OUD as a chronic illness, less stigmatizing attitudes toward individuals with OUD, and support for other harm reduction strategies. Efforts to increase awareness of OUD as a chronic illness may lead to greater acceptance of harm reduction strategies in rural areas, easing evolution of evidence-based healthy policy.

Keywords:

• Stigma
• substance abuse
• harm reduction
• syringe exchange programs
• opioid use disorder
• infectious disease

Acknowledgements

Prisma Health Addiction Research Center provided support for the activities of the survey, statistical analysis, and manuscript completion.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

This project was funded as part of a Health Resources and Services Administration Rural Communities Opioid Response Program‐Planning grant [grant no. GRANT12686474].