A scoping review on barriers and facilitators to harm reduction care among youth in British Columbia, Canada.

Background: Progressive harm reduction policies have been implemented in British Columbia, Canada. However, youth who use drugs face barriers to receiving harm reduction care, resulting in increasing opioid-related hospitalizations and drug toxicity deaths. This scoping review collates peer-reviewed evidence to understand the barriers and facilitators faced by youth who use drugs when accessing harm reduction programming in British Columbia, Canada.

Methods: This scoping review entailed conducting a systematic search of relevant databases to identify relevant articles. Articles were included if they: (i) contained youth falling between the ages of 12 and 26 years old; (ii) explored accessibility, barriers, and/or facilitators to harm reduction care or related topics; (iii) were empirical research articles using primary data (i.e., reviews, grey literature, theoretical or conceptual papers, books, etc. were excluded); and (iv) were available in the English language, given the geographic focus on British Columbia.

Results: A total of 398 sources were identified and ultimately, data from 13 sources were charted and extracted. When investigating barriers to harm reduction care among youth, four themes emerged: self-stigma, service navigation, service delivery, and negative provider interactions. Furthermore, in exploring factors that facilitate harm reduction care for youth, four themes surfaced: ability to meet basic needs, positive provider interactions, social networks, and risk mitigation guidance.

Conclusions: The expansion of harm reduction services in 2016 did not fully address accessibility challenges faced by youth who use drugs. Barriers continue to hinder harm reduction engagement, while supportive networks, positive provider interactions, and the ability to meet basic needs facilitated sustained access. Tailored policy interventions rooted in equity are crucial to improving access to harm reduction services for youth who use drugs.