title: Challenges and opportunities to integrating family members of injection drug users into harm reduction efforts within the Atlantic Canadian context.
abstract: BACKGROUND
  This paper explores injection drug users' (IDUs) relationships with non-drug using family members in order to understand the potential opportunities for, and challenges to, having these family members provide harm reduction services (e.g., clean syringes).
  
  
  METHODS
  The qualitative data for this paper were drawn from a larger study of IDUs' relationships with key individuals in their lives (e.g., friends, family members). Interviews were conducted with 115 IDUs from across Atlantic Canada living in both urban and rural areas.
  
  
  RESULTS
  IDUs report that their relationships with family members are variable and dynamic, often changing over time. IDUs and family members engage in a variety of strategies to protect themselves from the multiple harms associated with drug use. Several strategies of self-protection (e.g., discontinuing all contact) are antithetical to the provision of harm reduction supports by family members. However, other strategies are based on continued contact, providing a potential opportunity for the integration of harm reduction approaches. Some family members not only have contact but provide supports (e.g., emotional support, housing) thus potentially facilitating the integration of harm reduction. In a few instances, family members already provide harm reduction supports (e.g., safe space to use).
  
  
  CONCLUSIONS
  Conceptualizing addictions as a health and social justice issue, and providing appropriate interventions, may reduce some of the harms experienced by users and family members thus encouraging sustained relationships and greater integration of harm reduction approaches into the relationship. Targeted education to family members about harm reduction may also further encourage their involvement in such efforts. Likewise, supporting family members who are already providing harm reduction supports will likely assist in the scaling-up of harm reduction efforts.
authors: School of Health and Human Performance, Faculty of Health Professions, Dalhousie University, 1459 Oxford Street, Halifax, Nova Scotia, Canada B3H 4R2. lois.jackson@dal.ca
authors: Lois A
authors: LA
authors: Jackson
authors: Margaret
authors: M
authors: Dykeman
authors: Jacqueline
authors: J
authors: Gahagan
authors: Jeff
authors: J
authors: Karabanow
authors: Joanne
authors: J
authors: Parker
mesh_terms: D000328:Adult; D002170:Canada / Q000208:ethnology; D055030:Drug Users / Q000523:psychology*; D057172:Economic Recession; D005190:Family / Q000523:psychology*; D005260:Female; D005378:Financial Support; D040261:Harm Reduction; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012944:Social Support; D015819:Substance Abuse, Intravenous / Q000191:economics / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D014505:Urban Population; D055815:Young Adult