Social support and harm reduction activities in a peer led pilot study with respondent driven sampling and community based participatory action research

Background: People who smoke drugs (PWSD) are at high risk of both infectious disease and overdose. Harm reduction activities organised by their peers in the community can reduce risk by providing education; safer smoking supplies, and facilitate access to other services. Peers also provide a network of people who provide social support to PWSD which may reinforce harm reducing behaviours. We evaluated the numbers of supportive network members and the relationships between received support and participants’ harm reducing activities.Methods: Initial participant-researchers with past or current lived drug use experience were employed from communities in Abbotsford and Vancouver to interview ten friends from their social networks who use illegal drugs mainly through smoking. Contacts completed a questionnaire about people in their own harm reduction networks, and their relationships with each other. We categorised social support into informational, emotional and tangible aspects, and harm reduction into being trained in the use of, or carrying naloxone; assisting peers with overdoses, using brass screens to smoke, obtaining pipes from service organisations and being trained in CPR.Results: Fifteen initial participant-researchers interviewed 149 participants who provided information on up to 10 people who were friends or contacts and the relationships between them. People who smoked drugs in public were 1.46 (95% CI;1.13-1.78) more likely to assist peers with possible overdoses if they received tangible support; women who received tangible support were 1.24(95% CI;1.02-1.45) more likely to carry, and be trained in the use of naloxone. There was no relationship between number of supportive network members and harm reduction behaviours.Conclusions: In this pilot study, PWSD who received tangible support were more likely to assist peers in possible overdoses and be trained in the use of and/or carry naloxone, than those who did not receive tangible support. Future work on the social relationships of PWSD may prove valuable in the search for credible and effective interventions.