Harm Reduction, Stigma and the Problem of Low Compassion Satisfaction

Background & Objective: Canada is in the midst of an opioid crisis. Given the sheer magnitude of the crisis and escalating death toll, the mobilization of harm reduction interventions is an important priority. Currently, little is known about the role played by stigmatization, particularly in terms of how this may impact the endorsement and uptake of harm reduction strategies and initiatives among front-line providers. Materials & Methods: Opening Minds, the anti-stigma initiative of the Mental Health Commission of Canada, undertook a one-and-a-half-year research project to understand the qualities, characteristics, sources, consequences, and solutions to the problem of stigmatization on the front-lines of the opioid crisis. A qualitative key informant design was selected. Participants included various first responder and health provider groups, people with lived experience of opioid or other drug use, and people in key policy or programming roles. Eight focus groups were held across Canada, and 15 one-on-one key informant interviews were completed. Results: Analysis of focus group and key informant interviews revealed three main ways in which stigma shows up on the front lines of the opioid crisis among providers. These themes coalesced around a central main problem, that of low compassion satisfaction. Suggestions for how these concerns can be addressed were also identified. Conclusion: The findings from this research revealed several key ways that stigma ‘shows up’ in the experiences and perceptions of front-line providers and provide several promising avenues for combatting stigmatization related to opioid use and harm reduction. An important avenue for future research is to develop and elaborate on the theoretical connections between the concepts of stigmatization and compassion satisfaction as a way to better understanding the problem of stigmatization in helping environments.