Sarah Bessen1, Stephen A Metcalf2, Elizabeth C Saunders3, Sarah K Moore4, Andrea Meier5, Bethany McLeman6, Olivia Walsh7, Lisa A Marsch8. 1. Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA. Electronic address: Sarah.Y.Bessen.MED@dartmouth.edu. 2. Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA. Electronic address: stephen.a.metcalf@dartmouth.edu. 3. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA. Electronic address: elizabeth.c.saunders.GR@dartmouth.edu. 4. Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA. Electronic address: sarah.k.moore@dartmouth.edu. 5. Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA. Electronic address: andrea.l.meier@dartmouth.edu. 6. Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA. Electronic address: bethany.m.mcleman@dartmouth.edu. 7. Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA. Electronic address: olivia.e.walsh@dartmouth.edu. 8. Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA. Electronic address: lisa.a.marsch@dartmouth.edu.
Abstract
BACKGROUND: The United States is in the midst of a devastating opioid crisis, and the state of New Hampshire (NH) has been disproportionately impacted. Naloxone is an opioid overdose reversal medication that is critical for saving lives. This study was conducted to understand emergency responders' and opioid users' experiences with, and opinions about, naloxone use and distribution in NH. METHODS: Semi-structured interviews were conducted with 76 opioid users and 36 emergency responders in six NH counties in 2016-2017. Interviews focused on respondents' experiences with opioid use and overdose. Interviews were transcribed, coded, and reviewed for consensus among coders. Directed content analysis was used to review high-level domains and identify subthemes. RESULTS: Users and responders largely agreed that naloxone had become increasingly available in NH at the time of the study. Reported responder barriers to naloxone acceptance included perceptions that increased naloxone availability may enable riskier opioid use and fails to address the underlying causes of addiction. Reported opioid-user barriers included cost, legality, and lack of knowledge regarding distribution locations and indications for use. CONCLUSION: Opioid users' and emergency responders' perceptions about naloxone may limit the optimal use of naloxone within the community. This study identifies opportunities to address misconceptions about naloxone and challenges in accessing naloxone, which may improve opioid overdose prevention strategies.
BACKGROUND: The United States is in the midst of a devastating opioid crisis, and the state of New Hampshire (NH) has been disproportionately impacted. Naloxone is an opioid overdose reversal medication that is critical for saving lives. This study was conducted to understand emergency responders' and opioid users' experiences with, and opinions about, naloxone use and distribution in NH. METHODS: Semi-structured interviews were conducted with 76 opioid users and 36 emergency responders in six NH counties in 2016-2017. Interviews focused on respondents' experiences with opioid use and overdose. Interviews were transcribed, coded, and reviewed for consensus among coders. Directed content analysis was used to review high-level domains and identify subthemes. RESULTS: Users and responders largely agreed that naloxone had become increasingly available in NH at the time of the study. Reported responder barriers to naloxone acceptance included perceptions that increased naloxone availability may enable riskier opioid use and fails to address the underlying causes of addiction. Reported opioid-user barriers included cost, legality, and lack of knowledge regarding distribution locations and indications for use. CONCLUSION: Opioid users' and emergency responders' perceptions about naloxone may limit the optimal use of naloxone within the community. This study identifies opportunities to address misconceptions about naloxone and challenges in accessing naloxone, which may improve opioid overdose prevention strategies.
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