Title : Scaling compassion: A multi-tiered approach to harm reduction training for future clinicians and community stakeholders
Abstract:
Background: Opioid use disorder (OUD) is a complex obstacle currently affecting the healthcare system in our country. While there have been many efforts to help those impacted by OUD, Arizona is one of the few states where overdose deaths have increased in the past year. The unhoused population is uniquely vulnerable to its worst outcomes through poor healthcare access and lack of treatment resources. Despite the escalating overdose crisis in Phoenix, Arizona, formal harm reduction training remains inconsistent in medical education. Led by the College of Public Health, the Naloxone and Overdose Prevention Alliance (NOPAL) Initiative partnered with local medical institutions to provide training to their student body interested in community-centered initiatives.
Methods: Utilizing a three-prong strategy that includes (1) clinical experiential learning, (2) community capacity building, and (3) intersectoral partnerships, NOPAL aims to teach harm reduction principles to future health professionals while forming a multidimensional care network for the unhoused community of Phoenix. NOPAL delivered training to medical students that integrated harm reduction philosophies and covered topics such as overdose prevention and recognition, and naloxone education and administration. A pre- and post-survey was administered to gauge knowledge and comfort in recognizing an overdose and administering naloxone.
Results: Within the medical student population, the self-stated mean rating (on a scale of 1-5) for knowledge on how to respond to an opioid overdose was 2.3, and comfort in administering naloxone in an opioid overdose scenario was 2.3 prior to receiving harm reduction and overdose response training. After receiving the aforementioned training, the mean rating for knowledge on how to respond to an opioid overdose was 4.1 and comfort in administering naloxone in an opioid overdose scenario was 4.0. The difference in self-stated rating was statistically significant at a p-value < 0.001.
Conclusions: NOPAL+SMP demonstrates that street medicine programs can serve as more than medical providers; they are powerful engines for multifactorial community collaboration, systemic reform, and healthcare culture change. By training future clinicians alongside community stakeholders, we establish and broaden a sustainable, public-health-aligned ecosystem prepared to address the needs of the unhoused with dignity and evidence-based care.
