Public Support for Harm Reduction Strategies to Address the Opioid Pandemic in the United States: A Latent Class Analysis.

BACKGROUND AND AIMS: Harm reduction represents an approach that aims to reduce risk, promote safety, and prevent disease or disability, and has proven to be effective in preventing overdose death. However, public perceptions are mixed. Past studies have not examined public perceptions across a range of different types of harm reduction strategies. We examine public support for five different types of common harm reduction strategies, including the legalization of safe consumption sites, FDA approval of over-the-counter/nonprescription naloxone, increased number of methadone clinic locations, decriminalizing Fentanyl testing strips, and implementation of syringe service programs, in a national representative sample.

METHODS: Latent class analysis was applied to JCOIN Survey 10 data (N∼6500) to investigate whether there are distinct profiles of perceptions supporting these different types of harm reduction strategies. We also explore how demographics and past direct and indirect experiences with opioid use, overdose, and criminal legal involvement relate to these profiles.

RESULTS: We found four distinct profiles: a group of 22.9% expressing strong support for harm reduction policies, a group with mixed support (35.4%), that is, they support some but not other harm reduction policies, a profile of individuals holding neutral opinions (22.4%), and a group holding strong opposition for harm reduction policies (19.3%). Demographics and past experiences with opioids and criminal legal involvement are differentially associated with these profiles.

CONCLUSIONS: Information and educational programs should be designed to target different groups of individuals to increase understanding and support for harm reduction policies and programs.