# Enhancing the Care Continuum for Veterans Who Inject Drugs Using Harm Reduction Approaches

> **NIH VA I01** · EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL · 2022 · —

## Abstract

Project Goals: The long-term goal of this Innovation Project is to implement comprehensive harm reduction
services in VA that will reduce high and unacceptable rates of fatal overdoses and prevent viral (HCV, HIV)
and invasive bacterial (sepsis, endocarditis) infections associated with the rise in opioid and other drug
injection among Veterans. The Phase I goal is to work collaboratively with multiple VA Medical Centers
(VAMCs), VA operational partners, community agencies and Veterans to develop comprehensive harm
reduction “bundles” that are adaptable for use in different service lines (i.e., inpatient, outpatient) and
geographic areas (i.e., urban, suburban, rural). These “bundles” will include options for accessing and
providing sterile syringes, Narcan and overdose prevention education, skin cleaning education, and
recommendations for infectious disease screening and other prevention resources. We will develop a Harm
Reduction Community of Practice to collaboratively explore and address social, logistical and policy barriers to
implementing harm reduction approaches in VA, develop harm reduction delivery models that include
recommendations for who, when and how “bundles” are provided, and develop supporting resources (e.g.,
provider training, model community contracts) for implementation of harm reduction approaches). Our second
goal is develop an implementation study for Phase II, including identification of participating VAMCs,
implementation strategies, and outcomes. The Long-term Aim of the Phase II Project is to conduct a multi-
site implementation study assessing the impact of providing harm reduction services, including access to
sterile syringes, on Veterans’ health outcomes, VAMCs financial burden of care, and the culture of healthcare
for Veterans who inject drugs. Innovation: Despite the strong and overwhelming evidence-base for harm
reduction approaches, healthcare systems in the U.S. have been slow to adopt them into practice. Recent
changes in federal policies and a 2018 National Ethics in Healthcare opinion allow healthcare agencies to
develop comprehensive harm reduction services in the interest of public health. Continued restrictions on the
use of federal funding to purchase sterile syringes require partnering with state or community agencies to
support access. This creates opportunities to bridge care for vulnerable and hard-to-reach Veterans and assist
them in accessing needed resources to protect their health and engage in self-care. If successful, VA will be
among the first healthcare systems in the U.S. to offer these critical services to IVDUs. Impact: Increasing
access to sterile syringes, Narcan and other harm reduction resources will prevent fatal overdoses and costly
viral and bacterial infections. If implemented in accordance with principles of patient-centered care, it will also
help reduce stigma associated with IVDU and engage this vulnerable population of Veterans in VA care.
Phase I Accomplishments include th...

## Key facts

- **NIH application ID:** 10237183
- **Project number:** 5I01HX003191-02
- **Recipient organization:** EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL
- **Principal Investigator:** Westyn Branch-Elliman
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-10-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10237183

## Citation

> US National Institutes of Health, RePORTER application 10237183, Enhancing the Care Continuum for Veterans Who Inject Drugs Using Harm Reduction Approaches (5I01HX003191-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10237183. Licensed CC0.

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