Catalysts for Change: Youth-Driven Insights in Opioid Harm Reduction

The objective of this paper is to present the key themes that emerged from the discussion held by a cohort consisting of young people who are using opioids, harm reduction practitioners, or, in some cases, both, based in various regions worldwide. The discussion was divided into a series of conversations centered on understanding the needs and challenges faced by young people who use opioids (YPWUO) and harm reduction practitioners. This study involved eight representatives from Canada, Indonesia, Kenya, Mexico, Portugal, Uganda, The United States, and Zimbabwe, who, during the research period gathered data from their own countries. Using a qualitative approach, each collaborator responded to research questions, focused on the needs and challenges of YPWUO, the challenges harm reduction practitioners face while implementing harm reduction strategies, and recommendations on how to ensure harm reduction services that are accessible and take into consideration the well-being of YPWUO. The questions were answered based on their personal experiences. Additionally, they offered insight by examining existing data and policies within their respective contexts. Moreover, the representatives engaged in dialogue regarding the most effective strategies to meet the specific needs of the YPWUO and facilitate positive transformation within this community. The meetings were conducted remotely during the months of October, November and December 2023, and a written record of the discussions was obtained. The duration of the discussions ranged from thirty minutes to one hour. During the research, discussions highlighted challenges commonly faced by YPWUO such as access to safe supply, stigma, discrimination, lack of healthcare, housing issues, and policy-related challenges. The study emphasizes the importance of youth-tailored healthcare and harm reduction services, policy changes, community engagement, and comprehensive drug education. Harm reduction practitioners face challenges related to policy issues, harm reduction services, access to naloxone, trauma, and mental health. Recommendations include supportive-centered services, comprehensive drug education, community engagement, improved data collection, youth-tailored services, policy changes, sustainable funding for harm reduction organizations, and cover the basic needs of YPWUO.The intersection of housing, healthcare, stigma, and policy challenges underscores the need for a holistic and collaborative approach to address the complex issues faced by YPWUO including their vulnerability to exposure to HIV and other blood transmitted infections. Putting into practice harm reduction’s concept of “nothing about us without us”, we must ensure that these interventions are led, designed, implemented and evaluated by key populations.