Differing Attitudes Towards Harm Reduction Amongst Social Work Professionals in Three Geographical Areas in Sweden

Author: Julie Holeksa Torkel Richert

Theme: Social Science & Policy Research Year: 2022

Social work professionals (SWPs) are primary institutional contacts for people who use drugs. Their
attitudes towards interventions and treatment goals impact their treatment recommendations.
Access to harm reduction (HR) interventions such as needle exchange, overdose prevention, and
opioid substitution therapy has developed disparately within Sweden. We aimed to compare
attitudes towards HR amongst SWPs in three areas, defining access in Malmö as “high”, Gothenburg
as “medium”, and Gävleborg as “low”.
We conducted a survey of SWPs working with people who use drugs, utilizing the Harm Reduction
Acceptability Scale to assess attitudes towards HR philosophy and treatment goals. Lower scores
(scale of 1-5) indicate more positive attitudes. A one-way ANOVA with Tukey’s HSD Test for multiple
comparisons was performed to assess the effect of location on mean score. ANCOVA was used to
control for other variables, such as gender, age, education, managerial role, and meeting with
There were 206 valid survey responses, (Malmö: 78, Gothenburg: 81, Gävleborg: 47). Mean scores
were Malmö: 2.04, Gothenburg 2.16, Gävleborg 2.57. The overall mean score (2.2) indicated positive
attitudes towards HR. ANOVA revealed a significant difference (F(2, 205) = 10.9, p = < .001) between
groups. Post-hoc testing found that the mean was significantly higher in Gävleborg (p = <.001) than
the other two areas. Differences remained significant when controlling for other variables.
Despite overall positive attitudes, opinions were geographically stratified. Results indicated that
attitudes reflected the local differences in HR development and access, suggesting that SWPs who
were more exposed to HR had more positive attitudes. This impacts the types of advice and services
clients have access to, ultimately influencing health outcomes such as risk of overdose or infection
with HCV and/or HIV. Professional development interventions should be implemented to address
negative attitudes. This will increase equality of care throughout the country.
Disclosure of Interest Statement:
The authors report no conflicts of interest.

Download abstract