Association Between Access to Harm Reduction Services and Socioeconomic Improvement Among People Who Use Drugs in Nigeria

Background People who use drugs (PWUD) in Nigeria face intersecting social, economic, and health challenges, yet evidence on the broader socioeconomic benefits of harm reduction remains limited. This study examined the association between access to harm reduction services and improvements in substance use and socioeconomic outcomes among PWUD in three Nigerian states. Methods A cross-sectional analysis was conducted using data from 210 PWUD enrolled in harm reduction programmes across Abia, Gombe, and the Federal Capital Territory. Outcomes included self-reported improvements in substance use, housing, employment, relationships with family and friends, crime reduction, and community participation. Access to harm reduction services was dichotomised into high versus low/no access. Descriptive statistics, chi-square tests, and multivariable logistic regression models were used to assess associations, adjusting for age, sex, education, employment status, state, and stigma. Results High access to harm reduction services was significantly associated with reductions in substance use (aOR = 3.77, 95% CI: 1.61–8.84) and improvements in housing (aOR = 3.04, 95% CI: 1.49–6.22). Employment improvement was strongly associated with being employed (aOR = 4.85, 95% CI: 2.18–10.75). Improved relationships were more likely among older participants, females, those with secondary or higher education, while stigma significantly reduced the odds. Crime reduction and community participation also improved. Conclusion Harm reduction services in Nigeria appear to yield important benefits, particularly in reducing substance use and improving housing stability. Strengthening access, reducing stigma, and scaling evidence-based interventions may enhance the broader social reintegration of PWUD.