Naloxone perspectives from people who use opioids: Findings from an ethnographic study in three states

Abstract

Background: Naloxone is an opioid antagonist that can reverse an opioid overdose. Increased opioid-related mortality rates led to greater distribution of naloxone without a prescription and administration of naloxone by laypersons. This study fills a gap in knowledge of naloxone experiences among active users of opioids living in suburban communities. Purpose: The purpose of this article is to provide nurse practitioners with an in-depth understanding of current naloxone use practices among people who experience overdose events. The specific aims are to compare access to naloxone in diverse suburban towns, to examine administration differences across settings, and to understand perspectives on naloxone experiences from people who are actively using opioids. Methodological orientation: The data for this analysis were drawn from an ethnographic study in the suburban towns around Atlanta, Georgia; Boston, Massachusetts; and New Haven, Connecticut. Short surveys and in-depth interviews were collected. Inductive methods were used to compare data across settings. Sample: The sample of 106 included 48% female, 62% White, 24% African American/Black, 13% more than one race, and 21% Hispanic/Latinx. The mean age was 41.35 years. Conclusions: Differences between study settings in access to naloxone, administration frequency, and delivery systems were found. Findings suggest more education and training is needed in overdose prevention and harm reduction intervention. Studies on delivery systems need to address the increase in fentanyl-related overdoses. Implications for practice: Nurse practitioners can help to target distribution of naloxone in local communities, facilitate collaboration with harm reduction services, and provide evidence-based education and training to laypersons.

Evaluation of a pharmacist‐led intervention on naloxone co‐prescribing in patients receiving chronic opioid therapy

“…The top reason our seven interviewed patients listed for not picking up naloxone was cost, confirming the findings of previous studies. 23,24 Indeed, the average wholesale price of one box of naloxone nasal spray (Narcan Nasal Spray, Adapt Pharma, Inc., Plymouth Meeting, PA) as of September 2021 in our health system's pharmaceutical supplier website was $150. In addition, patients mentioned a perceived lack of necessity for naloxone.…”

Perspectives of Stakeholders of Equitable Access to Community Naloxone Programs: A Literature Review

“…Our review revealed the lack of literature that focused on inequity associated with opioid-related health outcomes or strategies to minimize barriers and promote access by the vulnerable groups who are disproportionately experiencing opiate-related harms, including individuals with disabilities and without accessible means of transportation [67], as well as low-income individuals, particularly those without stable housing [36,74]. These vulnerable groups reported barriers related to the varying number of nearby community pharmacies with naloxone distribution programs in different areas [34,65] or the loss of naloxone kits during transient housing [74]. A study conducted by Mitchell et al (2017) underscored the need for the placement of naloxone kits in common spaces of low-income housing in order to facilitate better access to naloxone by the marginalized populations [16].…”

Barriers and Motivators to Opioid Treatment Among Suburban Women Who Are Pregnant and Mothers in Caregiver Roles

“…In the past, suburban communities were not viewed as high-risk areas for drug research or drug treatment funding. Reports on increased opioid use and opioid-related overdose mortality rates in the suburbs ( Cicero et al, 2014 ; Kuehn, 2014 ) only recently drew greater awareness of the suburbs as a risk environment for opioid use ( Zoorob and Salemi, 2017 ; Boeri and Lamonica, 2020 ). Suburban towns have fewer treatment programs for women and other needed health and social services compared to cities, and residential treatment in the suburbs for women with children in their care is virtually non-existent ( Allard and Roth, 2010 ; Lamonica et al, 2021 ).…”

“…Suburban towns have fewer treatment programs for women and other needed health and social services compared to cities, and residential treatment in the suburbs for women with children in their care is virtually non-existent ( Allard and Roth, 2010 ; Lamonica et al, 2021 ). Reports of increased opioid dependence among women with children and pregnant women reveal an urgent need for treatment that addresses the social and familial situation of suburban mothers ( Marsh et al, 2000 ; Maeda et al, 2014 ; Patrick et al, 2015 ; Angelotta et al, 2016 ; Klaman et al, 2017 ; Reddy et al, 2017 ; Boeri and Lamonica, 2020 ; Lamonica et al, 2021 ).…”