Literature examining disparities related to SUD highlight the factors that influence treatment utilization and outcomes across various demographic groups, including race, age, and gender. Drug toxicity mortality rates in the United States (US) among racial and ethnic groups (except for non-Hispanic Asian), different biological sexes, and age groups of 25 years and older have all increased in recent years [1]. Research found that individuals experiencing substance use disorders (SUD) are often associated with a lower quality of life compared to the general population or those with other chronic health conditions [2].

Perceived treatment needs are lower for minority racial and ethnic groups, such as African-Americans and Latinos, who tend to underestimate their personal treatment needs compared to White/Caucasian individuals [3]. This difference is correlated to disparities in SUD treatments and overall health. Limited access to SUD treatment is influenced by environmental factors. Studies have found that the effective integration of SUD treatment into primary care and hospital settings is limited due to a lack of SUD-related training for healthcare providers [4]. Rural and urban areas also present significant disadvantages to underserved communities, including a lack of essential services and underutilization of available resources. These challenges are emphasized by limited facilities and public transportation options, impacting the clients’ access to care [5–7].

Among people with drug use, stigma is also a challenge for accessing health-related services, including non-prescription syringes. Stigma operates at both individual and systemic levels. For example, enacted stigma from experiences of discrimination and dismissive attitude and behavior from health care providers, including pharmacists, may leave left a negative perception affecting engagement and utilization of these services [8, 9]. However, people with drug use reported a more comfortable experience during their interaction with safe syringe programs when those experiences are provided by community health workers who may have a more non-judgmental approach and positive attitude [10]. Harm reduction strategies aimed at mitigating the adverse consequences of drug use have gained increasing attention from public health stakeholders. A potential benefit of this attention is that harm reduction strategies can overcome other known barriers to combating drug overdose, such as individuals’ fears of engaging with healthcare and emergency systems to systemic issues in healthcare and emergency medical response systems [11].

Incorporating harm reduction initiatives within inpatient facilities offers a unique opportunity to connect inpatient and outpatient care, thereby expanding harm reduction services [12]. However, challenges related to stigma, power dynamics, and role coordination among care team members were identified as barriers to successful implementation with mental health disorders and untreated SUD often experience an increased risk of chronic physical conditions due to mental illness, untreated SUD, and physical health outcomes [13]. Access to basic needs such as stable housing, nutritious food, and employment opportunities becomes difficult, exacerbating the health disparities they already encounter. Additionally, navigating the criminal justice system poses a significant challenge for many in these communities, which can lead to a cycle of incarceration rather than addressing the underlying issues of mental health and substance use.

These disparities highlight the need for increased support for harm reductionists to reach those communities. Advocating for systemic changes, such as increased funding for treatment of SUD as a part of holistic healthcare can contribute to systems that promote the long-term health of people struggling with substance use [10]. In addition to in-patient facilities, the use of mobile healthcare is a potential resource to expand SUD treatment. Mobile health clinics have been designed to provide pension screening and triage [14], increase patient accessibility [15] and provide follow-up services [6]. They have proven to be effective for health screening and education [6, 7]. Making services available through outreach including mobile health units may enhance substance use disorder services to persons who use drugs.

The community-based organization has previously collaborated with other community organizations and health departments to identify communities disproportionately affected by HIV and populations at high risk, who may not have access to traditional testing services [16, 17]. Utilizing mobile testing units and vehicles equipped with private counseling spaces was an effective way to bring HIV counseling and rapid testing directly to at-risk populations, such as street corners, homeless shelters, and community special events, where the most participants were tested. This method ensured that HIV testing reached individuals who may otherwise go untested, which ultimately contributed to HIV prevention efforts. Logs were collected to record clients’ demographics and harm reduction services received, including condoms for males and females, syringes, wound and hygiene kits, and referrals. Analyzing data from community-based harm reduction and service referrals was conducted to determine social determinants of health [18–22].