“Generally, you get 86′ed because you're a liability”: An application of Integrated Threat Theory to frequently witnessed overdoses and social distancing responses

Bowles, Jeanette M.; Smith, Laramie R.; Verdugo, Silvia R.; Wagner, Karla D.; Davidson, Peter

doi:10.1016/j.socscimed.2020.113190

Cited by 25 publications

(19 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with findings from other studies, the participants in the present study mentioned stigma as a perceived barrier to naloxone use (Bennett et al, 2020; Bowles et al, 2020; Kahn et al, 2020; Latkin et al, 2019; Rochester & Graboyes, 2020). There is also available literature regarding the need to better train pharmacists on opioid use disorder and the efficacy of naloxone to address stigma (Green et al, 2017).…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, public health officials should aim their future work at decreasing the stigma associated with opioid use disorder and naloxone among individuals within the social network of PWUO and within the community at large. In addition, as has been reported in the literature, many of the participants in the present study identified cost as a perceived barrier to naloxone use among PWUO, in particular (Bowles et al, 2020; Davis et al, 2013; Kahn et al, 2020; Khatiwoda et al, 2018; Lankenau et al, 2013; Richert, 2015; Rochester & Graboyes, 2020; Wagner et al, 2014; Walley et al, 2013). To mitigate this issue, policymakers and medical professionals have proposed the re-classification of naloxone as an over-the-counter (OTC) medication (Evoy et al, 2021).…”

Section: Discussionsupporting

confidence: 74%

“…Very few participants in this study described using opioids with someone else or having naloxone present as a precautionary measure to overdose. More commonly, the participants described protective factors such as their awareness of opioid purity (i.e., the presence of fentanyl), as has been reported by other researchers (Bowles et al, 2020;Harris et al, 2021;Kahn et al, 2020). Therefore, public health officials should disseminate the harm reduction message among PWUO to never use alone in addition to being aware of the purity of opioids as protective measures against fatal overdose.…”

Section: Discussionmentioning

confidence: 63%

“…A convenience sample of N = 25 participants was selected with recruitment assistance from peer support individuals employed at five behavioral health treatment centers in Michigan and Ohio accessed in this study. Several researchers have used convenience sampling of small sample size (i.e., 18-52 participants) in other phenomenological studies among PWUO (Bennett et al, 2020;Bowles et al, 2020;Kahn et al, 2020;Rochester & Graboyes, 2020). Participants were excluded based on their self-reported opioid use history, where only those who reported not having used any opioid other than medication-assisted treatments such as methadone and buprenorphine by any route of administration within the past 6 months were eligible.…”

Section: Participant Recruitmentmentioning

confidence: 99%

See 3 more Smart Citations

The Role of the Social Network in Fatal Opioid Overdose Prevention: The Former Opioid User’s Perspective

Wygonik

Glassman

Tucker-Gail

2021

Journal of Drug Issues

View full text Add to dashboard Cite

Naloxone hydrochloride (naloxone) is an effective fatal opioid overdose prevention strategy. The study findings describe former opioid users’ phenomenological perspectives regarding their social network, settings of use, and the benefits and barriers to naloxone. Participants ( N = 25) with at least 6 months of recovery time ( M = 30, SD = 14.40) were interviewed individually for an average of 21 ( SD = 5.13) min. The sample was predominately male, Caucasian, and non-Hispanic with an average age of 37 ( SD = 7.22) years. Interview transcripts were analyzed using systematic thematic analysis. During their period of opioid use, most participants differentiated the members of their social network as other people who use opioids (PWUO) and nonusers. The participants described several opportunities for members of their social network to use naloxone. They discussed barriers to naloxone use specific to PWUO within their social network such as apathy toward overdose. Future interventions should be tailored to address naloxone use barriers specific to PWUO and nonusers.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 63%

Section: Participant Recruitmentmentioning

confidence: 99%

See 2 more Smart Citations

The Role of the Social Network in Fatal Opioid Overdose Prevention: The Former Opioid User’s Perspective

Wygonik

Glassman

Tucker-Gail

2021

Journal of Drug Issues

View full text Add to dashboard Cite

show abstract

“…In part, this may be associated with a perception on the part of people who use drugs of “acceptable” or “unacceptable” drug-use behaviors. For example, Bowles et al [ 38 ] found that people who frequently overdosed were often shunned by their drug-using social networks; they were considered a liability that placed others who used drugs at risk. Here, ongoing criminalization has created an atmosphere so toxic for people who use drugs that the only means of group safety and preservation is to distance from riskier drug users.…”

Section: Discussionmentioning

confidence: 99%

Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study

et al. 2020

View full text Add to dashboard Cite

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. 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. 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. 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 "others" to be managed with stigmatizing practices and language. 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.

show abstract

Individual and social network correlates of responding to multiple overdoses among a cohort of people who use drugs

Wagner¹,

Marks²,

Felsher³

et al. 2022

Drug and Alcohol Dependence Reports

View full text Add to dashboard Cite

“Generally, you get 86′ed because you're a liability”: An application of Integrated Threat Theory to frequently witnessed overdoses and social distancing responses

Cited by 25 publications

References 24 publications

The Role of the Social Network in Fatal Opioid Overdose Prevention: The Former Opioid User’s Perspective

The Role of the Social Network in Fatal Opioid Overdose Prevention: The Former Opioid User’s Perspective

Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study

Individual and social network correlates of responding to multiple overdoses among a cohort of people who use drugs

Contact Info

Product

Resources

About