TY - JOUR PY - 2019// TI - "You can see those concentric rings going out": Emergency personnel's experiences treating overdose and perspectives on policy-level responses to the opioid crisis in New Hampshire JO - Drug and alcohol dependence A1 - Saunders, Elizabeth A1 - Metcalf, Stephen A. A1 - Walsh, Olivia A1 - Moore, Sarah K. A1 - Meier, Andrea A1 - McLeman, Bethany A1 - Auty, Samantha A1 - Bessen, Sarah A1 - Marsch, Lisa A. SP - e107555 EP - e107555 VL - 204 IS - N2 - BACKGROUND: In parallel to a substantial increase in opioid overdose deaths in New Hampshire (NH), emergency personnel experienced an increase in opioid-related encounters. To inform public health responses to this crisis, insights into the experiences and perspectives of those emergency personnel who treat opioid-related overdoses are warranted. AIMS: Systematically examine emergency personnel's experiences treating opioid overdoses and obtain their perspectives on policy-level responses to the opioid crisis in NH.

METHODS: Semi-structured qualitative interviews were conducted with 18 first responders [firefighters (n = 6), police officers (n = 6), emergency medical service providers (n = 6)] and 18 emergency department personnel employed in six NH counties. Interviews focused on emergency personnel's perspectives on fentanyl/heroin formulations, experiences treating overdoses, harm reduction strategies, and experiences with treatment referral. Interviews were audio recorded, transcribed verbatim, and analyzed using content analysis.

RESULTS: Emergency personnel cited the potency and inconsistency of fentanyl-laced heroin as primary drivers of opioid overdose. Increases in overdose-related encounters took a substantial emotional toll on emergency personnel, who described a range of responses including feelings of burnout, exhaustion, and helplessness. While some emergency personnel felt conflicted about the implementation of harm reduction strategies like syringe services programs, others emphasized the necessity of these services. Emergency personnel expressed frustration with barriers to treatment referral in the state and recommended immediate treatment access after overdose events.

CONCLUSIONS: Findings suggest that interventions addressing trauma and burnout are necessary to support emergency personnel, while expanded harm reduction and treatment access are critical to support those who experience opioid overdose in NH.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

LA - en SN - 0376-8716 UR - http://dx.doi.org/10.1016/j.drugalcdep.2019.107555 ID - ref1 ER -