@article{ref1,
title="Reasons people who use opioids do not accept or carry no-cost naloxone: qualitative  interview study",
journal="JMIR formative research",
year="2020",
author="Bennett, Alex S. and Freeman, Robert and Des Jarlais, Don C. and Aronson, Ian David",
volume="4",
number="12",
pages="e22411-e22411",
abstract="BACKGROUND: Many people use opioids and are at risk of overdose. Naloxone is an  opioid antagonist used to counter the effects of opioid overdose. There is an  increased availability of naloxone in New York City; however, many who use opioids  decline no-cost naloxone even when offered. Others may have the medication but opt  not to carry it and report that they would be reluctant to administer it if they  were to witness an overdose. <br><br>OBJECTIVE: We aim to better understand why people who  use opioids may be reluctant to accept, carry, and administer naloxone, and to  inform the development of messaging content that addresses barriers to its  acceptance and use. <br><br>METHODS: We conducted formative qualitative interviews with 20  people who use opioids who are 18 years and older in New York City. Participants  were recruited via key informants and chain referral. <br><br>RESULTS: Participants cited 4  main barriers that may impede rates of naloxone acceptance, possession, and use: (1)  stigma related to substance use, (2) indifference toward overdose, (3) fear of  negative consequences of carrying naloxone, and (4) fear of misrecognizing the need  for naloxone. Participants also offered suggestions about messaging content to  tackle the identified barriers, including messages designed to normalize naloxone  possession and use, encourage shared responsibility for community health, and elicit  empathy for people who use drugs. Taken together, participants' narratives hold  implications for the following potential messaging content: (1) naloxone is  short-acting, and withdrawal sickness does not have to be long-lasting; (2) it is  critical to accurately identify an opioid-involved overdose; (3) anyone can  overdose; (4) naloxone cannot do harm; and (5) the prompt administration of the  medication can help ensure that someone can enjoy another day. Finally, participants  suggested that messaging should also debunk myths and stereotypes about people who  use drugs more generally; people who use opioids who reverse overdoses should be  framed as lay public health advocates and not just &quot;others&quot; to be managed with  stigmatizing practices and language. <br><br>CONCLUSIONS: It must be made a public health  priority to get naloxone to people who use opioids who are best positioned to  reverse an overdose, and to increase the likelihood that they will carry naloxone  and use it when needed. Developing, tailoring, and deploying messages to address  stigma, indifference toward overdose, fear and trepidation about reversing an  overdose, and fear of police involvement may help alleviate fears among some people  who are reluctant to obtain naloxone and use the medication on someone in an  overdose situation.<p /> <p>Language: en</p>",
language="en",
issn="2561-326X",
doi="10.2196/22411",
url="http://dx.doi.org/10.2196/22411"
}