“I wanted to close the chapter completely … and I feel like that [carrying naloxone] would keep it open a little bit”: Refusal to carry naloxone among newly-abstinent opioid users and 12-step identity

Transformation of identity in substance use as a pathway to recovery and the potential of treatment for hepatitis C: a systematic review

“…Bowles et al [68] found that AA/NA philosophy has a negative impact on the uptake and carriage of naloxone, an important intervention to address opiate related overdoses. The acceptance of a harm reduction intervention for potential future lapses by the individual or their social circle is not compatible with a 'recovering' identity and so the individual declines this intervention for fear of loss of acceptance by the group [68]. NA and AA have neoliberal views about the recovery journey that places responsibility with the individual to make the required changes; this approach does not therefore, take account of the important social changes required by members of the individuals' social network, such as family members and the recovery process that they must also make [62].…”

Take-Home Naloxone and the Prevention of Deaths from Heroin Overdose: Pursuing Strong Science, Fuller Understanding, Greater Impact

“…Institutional inertia abounds, and the novelty of the concept of take-home naloxone adds to the inertia. There are also important parts of the treatment and rehabilitation sector which do not recognize the importance of overdose awareness, training in emergency intervention, and naloxone administration, e.g., many residential rehabilitation and detoxification facilities as well as 12step and other mutual aid support groups [79][80][81]. In the UK, it is 25 years since we first called for the provision of take-home naloxone, to be provided by drug-treatment services and other agencies including prison, residential and needle and syringe exchange schemes.…”

The lived experiences of women currently in addiction recovery in Mississauga, Ontario

“…Arguably, it does not need to be one or the other -both harm reduction and abstinence-only programs can be included in addiction service options for clients. Bowles et al (2021) argue that there is room to add a harm reduction approach to abstinence-only programs (including 12-step programs) and although abstinence can be the end goal, implementing harm reduction methods such as providing naloxone to those in treatment can help save lives in the case of relapse. Bowle et al's (2021) work suggests that the two methods of recovery can be used together and mirrors Kruk and Sandberg's (2013) earlier research.…”

“…Consistent with these findings, Russell et al (2021) found that perceived negative stigma and judgement carried by organizations would prevent individuals from seeking treatment or continuing with the treatment process. In addition, Bowles et al (2021) found that those in abstinence-only programs were less likely to carry naloxone than those in harm reduction programs because once they got sober, they did not want to experience stigma associated with drug use. They felt that carrying naloxone would open them to stigma and they wanted to completely move away from that identity of drug user and the stigma associated with it.…”

“…Those with substance user problems also feared that they might have to remove certain friends and family members from their lives because those people will hinder recovery (Hill & Leeming, 2014). Bowles et al (2021) found that many participants reduced their friend group because remaining friends with those they used substances with was not helpful for recovery or abstinence. Gueta and Addad's (2014) study on Israeli women found that, for those who were mothers, being available for their children and family as well as having their support was an important motivator to stay sober.…”