Vol. 2, Issue 2, Part A (2025)

Background: Opioid use disorder (OUD) remains a pressing global public health challenge, with rising overdose rates and limited access to evidence-based interventions. Nurse-led harm reduction approaches offer a pragmatic and person-centered model for engaging individuals at risk, delivering essential services, and bridging care gaps. Objectives: This study aimed to evaluate the effectiveness of nurse-led harm reduction interventions on reducing high-risk opioid use behaviors, improving overdose preparedness, enhancing linkage to opioid agonist therapy (OAT), and increasing program retention among individuals with OUD. Methods: A prospective, quasi-experimental study was conducted with 240 adults diagnosed with OUD across community and outpatient settings. Participants received a structured 12-week nurse-led harm reduction program including naloxone education and distribution, safer injection counseling, motivational interviewing, and facilitated linkage to OAT. Quantitative data were analyzed using descriptive statistics, paired t-tests, chi-square tests, and multivariable logistic regression to identify predictors of outcomes. Results: High-risk injecting behaviors decreased significantly from 67.9% at baseline to 40.8% at 12 weeks (p<0.001). Naloxone possession increased from 31.7% to 68.3% (p<0.001), and competency rose from 28.8% to 63.3% (p<0.001). Linkage to OAT improved from 35.0% to 56.7% (p<0.001), while emergency department visits declined significantly (p=0.002). Retention at week 12 was 75.8%. Frequent nurse check-ins were independently associated with reduced high-risk injecting (aOR 2.11; 95% CI 1.35-3.31) and increased retention (aOR 2.59; 95% CI 1.52-4.42). Conclusion: Nurse-led harm reduction interventions demonstrated measurable benefits in risk reduction, treatment linkage, and program retention among people with OUD. These findings highlight the potential of integrating nursing leadership into harm reduction frameworks to deliver accessible, evidence-based, and compassionate care. Expanding nurse-led harm reduction services through structured training, supportive policies, and cross-sectoral collaboration can enhance public health responses to the opioid crisis and reduce preventable harms.