“I felt like a superhero”: The experience of responding to drug overdose among individuals trained in overdose prevention

Abstract

Background Overdose prevention programs (OPPs) train people who inject drugs and other community members to prevent, recognise and respond to opioid overdose. However, little is known about the experience of taking up the role of an “overdose responder” for the participants. Methods We present findings from qualitative interviews with 30 participants from two OPPs in Los Angeles, CA, USA from 2010–2011 who had responded to at least one overdose since being trained in overdose prevention and response. Results Being trained by an OPP and responding to overdoses had both positive and negative effects for trained “responders”. Positive effects include an increased sense of control and confidence, feelings of heroism and pride, and a recognition and appreciation of one’s expertise. Negative effects include a sense of burden, regret, fear, and anger, which sometimes led to cutting social ties, but might also be mitigated by the increased empowerment associated with the positive effects. Conclusion Findings suggest that becoming an overdose responder can involve taking up a new social role that has positive effects, but also confers some stress that may require additional support. OPPs should provide flexible opportunities for social support to individuals making the transition to this new and critical social role. Equipping individuals with the skills, technology, and support they need to respond to drug overdose has the potential to confer both individual and community-wide benefits.

“Feeling confident and equipped”: Evaluating the acceptability and efficacy of an overdose response and naloxone administration intervention to service industry employees in New York City

“…Many SIEs stated that this intervention made them feel “empowered” as similarly reported in previous studies (Marshall et al, 2017; Wagner et al, 2014). Participants also stated that being supplied with naloxone made them feel “equipped” so that they could act in the event of an overdose:

“ Feeling confident and equipped to be an agent in saving someone’s life and that to a person is just invaluable…to be at work and – or somewhere else and know that you can do something .”

[Sevn, male]

“ I learned a lot.

…”

“…Two authors (BWS and LE) with qualitative expertise separately coded one transcript, using a preliminary list of a priori codes based on topical domains addressed in the interview protocol (e.g., willingness to intervene, empowerment, etc.) adapted from similar studies (Marshall et al, 2017; Wagner et al, 2014). The coders met regularly during this process to discuss emergent themes and the addition of new code categories (e.g., importance of staying calm, requesting emergency medical services (EMS) and not police, etc.).…”

How competent are people who use opioids at responding to overdoses? Qualitative analyses of actions and decisions taken during overdose emergencies

“…Additionally, participants demonstrated how they had acquired new skills and knowledge from their training, were willing to prioritize this new formal knowledge above non-evidence-based strategies they had used in the past (contrary to [21]) and felt empowered by their ability to respond [36,44,61,62]. This includes their ability to rapidly assess a scene for signs and symptoms of overdose, anticipate and empathize with a victim's withdrawal symptoms, withhold or titrate a naloxone dose depending on the drugs probably taken, communicate effectively with a confused victim and persuade a reluctant patient to accept professional medical care.…”

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

“…Multiple ecological and other observational studies of community naloxone distribution programs demonstrated that PWID can learn overdose prevention and administer naloxone successfully (Doe-Simkins, Walley, Epstein, & Moyer, 2009; Green, Heimer, & Grau, 2008; Seal et al, 2003; Seal et al, 2005; Tobin, Sherman, Beilenson, Welsh, & Latkin, 2009), and suggested potential ancillary benefits such as decreased substance use, social connection, and empowerment (Wagner et al, 2014; Wagner et al, 2010). San Francisco documented a dramatic reduction in heroin overdose mortality in the early 2000s, from approximately 180 heroin overdose deaths per year in the late 1990s to 10-11 per year from 2010-2012, although some of that decrease was a result of transitions to prescription opioids (Visconti, Santos, Lemos, Burke, & Coffin, 2015).…”