BACKGROUND:
Substance Use Disorders (SUDs) pose a significant public health challenge in Nigeria, contributing substantially to the burden of morbidity, mortality, and social instability.¹˒² Traditional abstinence-only approaches often fail to address the complex needs of diverse populations, particularly in resource-constrained settings.³ Harm reduction strategies offer a pragmatic alternative, aiming to minimise the negative health, social, and economic consequences of drug use.⁴˒⁵ This abstract presents an innovative subnational model that integrated harm reduction services directly into the Primary Health Care (PHC) system.⁶

METHODS:
We employed a mixed-methods, prospective cohort design implemented across selected PHC facilities. The target population comprised People Who Inject Drugs (PWID) and individuals engaged in high-risk substance use behaviours. The intervention involved a comprehensive outpatient drug treatment programme delivered through the PHC network, incorporating four core components: Needle and Syringe Programmes (NSP), robust HIV and sexually transmitted infection (STI) screening, holistic psychosocial support, and medication-assisted treatment (MAT) with naltrexone.⁷˒⁸ Data collection included routine service delivery records, client surveys and service engagement, and qualitative interviews with beneficiaries and service providers. Data were analysed for service uptake and behavioural outcomes, with comparative analyses conducted where feasible.⁹

RESULTS:
Preliminary data from the first year of implementation indicated a 25% reduction in reported risky injecting practices among PWID, consistent with outcomes from comparable harm reduction programmes.⁴˒¹⁰ A 30% increase in HIV/STI screening uptake was observed in participating PHCs, while client retention in psychosocial support programmes showed 60% adherence at three months, reflecting improved engagement in care.⁶˒⁹

CONCLUSIONS:
This initiative demonstrates the translation of global harm reduction best practices into a localised PHC-based framework, addressing ethical imperatives to provide dignity-affirming, non-discriminatory care to highly stigmatised populations.⁵˒¹¹ It offers a compelling blueprint for other regions confronting SUD epidemics, underscoring the role of integrated, community-based harm reduction as a cornerstone of effective public health strategy.¹²