Document Type
Article
Abstract
Background
Harm Reduction (HR) approaches applied to substance use aim to decrease the toxic consequences of overdose. The addition of xylazine and benzodiazepines to fentanyl, the primary opioid in the US drug supply, increases the likelihood of overdose. Likewise, adding fentanyl to other popular substances, such as cocaine and methamphetamine, has further driven the exponential increase in opioid and stimulant overdoses. Engaging lay community members in HR efforts may help to combat the overdose crisis. Substance use is common in live music settings, and working musicians may be uniquely positioned within “the scene” – individuals who populate specific cultural niches within live entertainment – making them attractive candidates to assist with and/or lead lay HR promotion. Therefore, this study aimed to gather perspectives to inform a tailored needs assessment among working musicians in South Carolina using Community-Based Participatory Research (CBPR) methods to ascertain local patterns and impacts of substance use.
Methods
Using a CBPR framework, a three-person community leadership team and the academic research team collaboratively developed a semi-structured interview to guide focus groups with working musicians. A total of 19 working musicians participated in focus groups, followed by HR and naloxone administration training. The focus groups were audio-recorded, transcribed, verified for accuracy, and coded by a team of researchers using rapid qualitative analysis to identify themes and exemplar quotes.
Results
Participants reported observing a variety of legal and illegal substances used within the South Carolina music “scene” and broader community. Concerns reported by musicians included venue practices of over-selling to promote over-consumption of alcohol, using substances to “self-medicate”, and recreational drug use misidentified as dependence. Although musicians suggested HR efforts are necessary, many lacked knowledge and awareness of HR tools and were unfamiliar with local HR initiatives. Barriers and facilitators include a lack of overdose knowledge and a close-knit community, respectively.
Conclusions
Using CBPR methods, we found that HR efforts are necessary in “the scene” of central South Carolina to leverage strengths to combat the national opioid crisis at the community level.
Digital Object Identifier (DOI)
Publication Info
Published in Harm Reduction Journal, Volume 23, Issue 62, 2026.
Rights
© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
APA Citation
Frary, S. G., Pomerantz, J., Bellanger, T., Jennings, C., Blevins, H., Howard, C., Linger, M., Fuller, M., Houston-Dial, R., Joshi, A., Ouzts, N., Eidson, B., Harrod, S. B., & Harrison, S. (2026). Assessing working musicians’ perspectives of need and barriers regarding lay harm reduction efforts for substance-related harm in South Carolina. Harm Reduction Journal, 23(62).https://doi.org/10.1186/s12954-025-01367-w