Improving Access to Harm Reduction Services for Black and Latinx people in Boston: Perspectives from Professional and Clinical Key Informants

Type: Poster Presentation
Date: March 2024


E Ragutshteyn, R Paradise, J Desmarais, A Hoyos-Céspedes, S O’Malley, D Dooley, A Bazzi, S Kimmel, “Improving Access to Harm Reduction Services for Black and Latinx people in Boston: Perspectives from Professional and Clinical Key Informants”, Grayken Center for Addiction Together for Hope: Boston Addiction Conference 2024 (poster presentation)


Background: In Massachusetts, the rate of overdose-related deaths per 100,000 increased from 36.4 to 51.7 among Black non-Latinx residents and from 39.1 to 45.5 among Latinx residents from 2021 to 2022.(1)  Black and Latinx individuals are experiencing rising opioid overdose rates but are less likely than White residents to receive substance use treatment.(2) Black and Latinx individuals are also less likely to receive naloxone.(3)  To address opioid overdose disparities, it is essential that Black and Latinx individuals have access to harm reduction services. To guide equitable program development, we interviewed key informants who work in opioid overdose response,  prevention, and treatment to explore their perspectives and recommendation on improving harm reduction access and reducing disparities.

Objective : To summarize perspectives on racial and ethnic disparities in harm reduction services from  key informants working in opioid use disorder policy and clinical services.

Methods : In 2021, the Boston Overdose Linkage to Treatment Study (BOLTS) team conducted qualitative interviews with key informants (N=28) who work with overdose survivors – including clinicians, nonclinical program staff, first responders, policymakers, harm reductionists, community leaders, and program managers – to examine racial/ethnic inequities in access to treatment for people who recently experienced an opioid overdose in Boston. We conducted a targeted analysis of key informant perspectives and recommendations for harm reduction interventions.

Results: Three themes emerged from this analysis: 

Key informants described: 1) how the history of racialized drug policies impact harm reduction today by engendering lack of trust and concentrating services in disinvested and segregated communities; 2) current strategies harm reduction programs use aiming to reach Black and Latinx individuals such having diverse and multi-lingual staff, engaging in outreach, and providing smoking supplies as is often requested by program participants; 3) how decentralizing harm reduction services across the city rather than concentrating them in one area could improve access to harm reduction services among Black and Latinx people at risk of opioid overdose.

Conclusions: Despite increasing efforts to make harm reduction programs welcoming to Black and Latinx people at risk of opioid overdose, key informants felt that the legacy of drug policies that primarily target people of color engender a lack of trust in harm reduction services. Decentralizing services, providing culturally responsive services such as safer smoking supplies, and hiring staff members with lived experience of substance use could make harm reduction programs more accessible for Black and Latinx communities.

View Presentation