Exploring Harm Reduction Among Canadian Veterans Experiencing Homelessness

BACKGROUND: The use of substances is substantially higher among people experiencing homelessness than the general population (Podymow, Turnbull, Coyle, Yetisir, & Wells, 2006). In Canada, veteran homelessness is an increasing concern and it is estimated that there are 2,950 veterans experiencing homelessness (Gaetz et al., 2016). Furthermore, veterans often use substances, particularly alcohol, to cope with the transition from the military to civilian life (Ray & Forchuk, 2011). A strategy that has been shown to reduce the negative harms of substance use and facilitate housing stability is harm reduction (MacNeil & Pauly, 2010). Exploring how veterans who have experienced homelessness perceive harm reduction may provide further information to properly address this group’s unique housing and health needs. METHODS: This study was a secondary analysis on data collected from The Canadian Model for Housing and Support of Veterans Experiencing Homelessness study, which evaluated a veteran-specific housing model in four Canadian cities including Calgary, London, Toronto, and Victoria. In total, 78 veterans participated in the primary study and qualitative data was collected via focus groups with veterans, staff, and stakeholders in three cycles at each of the four sites from 2012 to 2014 (Forchuk & Richardson, 2015). For the secondary analysis, a thematic analysis was conducted on the veteran focus group data, whereby transcripts were analyzed for themes related to harm reduction. Quotes were extracted and organized into themes that captured the veterans’ understanding of harm reduction. FINDINGS: Various themes emerged from the focus group data with veterans including (a) Regimented Structure, (b) Understanding Both Worlds, (c) Congruent Recovery Journeys, (d) Location: Close Enough to Services, Far Enough from Harm, and (e) Harm Reduction is Housing Stability and Housing Stability is Harm Reduction. These themes represent the interface between the military culture and homeless serving culture. Overall, veterans considered harm reduction as an essential component of housing, as it helped to create stability in their lives. CONCLUSION: The themes demonstrated that harm reduction may be a part of the solution to veteran homelessness. The findings of this study may inform the way in which nurses, Housing First programs, institutions, and the government address this groups’ housing and substance use needs. Additional research is needed to further explore harm reduction among Canadian veterans experiencing homelessness