Medical students’ attitudes and knowledge about harm reduction and access to health care for people who misuse substances

Abstract

Background Individuals who misuse substances are at increased risk of poor health outcomes and face barriers when accessing the health care system. Harm reduction strategies are one tool to help improve health outcomes and access to health care for this population. As front line service providers for individuals who misuse substances, physicians should be knowledgeable about harm reduction strategies in order to provide the best possible care. Medical school curriculum plays an integral part in gaining this knowledge and forming attitudes on harm reduction and access to health care for people who misuse substances. Objectives This study aimed to investigate the knowledge and attitudes of pre-clerkship medical school students on the use of harm reduction strategies and access to health care for people who misuse substances. Methods A cross-sectional survey of pre-clerkship medical students (n=129) was conducted at Memorial University. Students completed a 23-item online questionnaire about their attitudes on access to health care for people who misuse substances, knowledge about locally available harm reduction services, and attitudes about the use of harm reduction strategies. Results There were a total of 83 respondents for a response rate of 64%. Most students knew about locally available harm reduction services and think harm reduction strategies are beneficial. Almost all (95%) agreed that people who misuse substances experience discrimination in the health care system but were divided (43% agreeing) when asked if this population had equitable access to health care. Overall, few students (26%) had previous experience with harm reduction services, and the majority (82%) would like to see more pre-clerkship teaching about harm reduction in the curriculum. Conclusion Pre-clerkship medical students at Memorial University have a good level of general knowledge about local harm reduction services; they have a positive attitude towards harm reduction strategies but they are not certain about their attitudes on barriers to health for people who misuse substances. This study suggests that students want more classroom teaching and exposure to harm reduction strategies. This may help promote positive attitudes toward harm reduction services and help students understand the barriers to accessing health care for individuals who misuse substances.