Public perceptions of naloxone use in the outpatient setting

Smith, Jordan O.; Malinowski, Scott S.; Ballou, Jordan M.

doi:10.9740/mhc.2019.07.275

Cited by 15 publications

(22 citation statements)

References 10 publications

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“…Addiction stigmas extended to the overdose antidote naloxone (Narcan®), the ready availability of which was viewed by commenters within the misdirected attention and individual blame category as enabling persons with addiction by providing a “safety net” against the negative consequences of drug use. These comments echo findings from other studies highlighting beliefs among community members and health care workers that naloxone availability serves to enable or encourage opioid use (Gatewood et al, 2016; Smith et al, 2019).…”

Section: Discussionsupporting

confidence: 71%

Where the Fault Lies: Representations of Addiction in Audience Reactions to Media Coverage of the Opioid Epidemic

Russell

Thames

Spence

et al. 2020

Contemporary Drug Problems

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The unprecedented number of deaths in the U.S. attributed to opioids has been referred to as an “epidemic of addiction.” Media coverage of the epidemic has stoked public discussion of addiction on social media platforms. This article describes how addiction is represented in comments on media coverage of the “opioid epidemic” and examines the relationship between media framing and audience representations of addiction. Content analysis methods were applied to data obtained from news posts ( n = 397) and comments ( n = 2,836) on the Facebook pages of 42 newspapers in Ohio, where overdose deaths are among the highest in the U.S. Eleven percent of comments were identified as referencing addiction ( n = 319). These comments were classified into two overarching categories: (1) support, disease, and contributing factors expressed support for persons affected by the epidemic, represented addiction as a disease requiring treatment, and highlighted social and structural factors seen as contributing to the epidemic (61.1% of comments referencing addiction); and (2) misdirected attention and individual blame questioned the media focus on addiction and overdose deaths, highlighted individual choices to misuse opioids, and suggested that media coverage of the epidemic diverts attention away from other social problems viewed as being more worthy of public attention (38.9% of comments). Representations of addiction in comments were found to be independent of (not associated with) frames in media coverage ( p = .945). Together, these results suggest that while a majority of commenters represent addiction as a legitimate social problem that warrants intervention and support, a substantial minority are dismissive of the epidemic, express anger and disdain for persons who use opioids, and seek to counter popular narratives of social and structural factors contributing to addiction.

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Section: Discussionsupporting

confidence: 71%

Where the Fault Lies: Representations of Addiction in Audience Reactions to Media Coverage of the Opioid Epidemic

Russell

Thames

Spence

et al. 2020

Contemporary Drug Problems

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“…However, barriers to widespread access remain, and some people who use opioids still do not carry the medication, even if they were trained and given naloxone at no cost. In a recent national survey of attitudes toward naloxone among the general population, half of the respondents endorsed that "naloxone is only necessary for people who abuse opioids," and 51% of respondents endorsed that "having naloxone available enables more drug use among people who abuse opioids" [28]. These contested beliefs about the place and role of naloxone-who should have it and the behavioral impacts of possession and use-permeate across social networks of both people who use opioids and people who do not use drugs (or do not identify as people who use drugs) [22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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“…In general, expert opinion suggests that naloxone is only prescribed for those dependent on or addicted to opioids, which may deter patients from picking up naloxone prescriptions [ 28 ]. Other individuals may be concerned with judgement in inquiring about naloxone products in community pharmacies, or such that they would be labeled as addicts by law enforcement if found carrying it.…”

Section: Discussionmentioning

confidence: 99%

“…A 2019 study on public perceptions of naloxone use found that 61% of survey respondents had never heard of naloxone or were unaware that a medication existed to treat opioid overdose. Of respondents that self-reported current or past opioid use, over half felt they were not at risk of overdose [ 28 ]. Contrary to these misconceptions, the range of patients that may benefit from a naloxone prescription includes any individual using opioids, especially at higher doses, those who use opioids in combination with other sedating medications such as benzodiazepines, and those taking opioids who suffer from a chronic medical condition such as the human immunodeficiency virus, liver or lung disease, in addition to those who are opioid-dependent or people who inject opioids [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Pharmacy Students’ Perceptions and Stigma Surrounding Naloxone Use in Patients with Opioid Use Disorder: A Mixed Methods Evaluation

et al. 2020

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Pharmacists represent a key group of healthcare professionals that can increase awareness and destigmatize naloxone use. The objective of this study was to investigate pharmacy student perceptions of the use, dispensing, and stigma surrounding naloxone. An electronic survey was administered to pharmacy students that included questions about demographics, work history, naloxone use, and naloxone stigma. Separate qualitative interviews were performed to identify themes surrounding naloxone use. Two-hundred sixty-two participants completed the survey. The majority of participants were “highly willing” (74%) to fill a naloxone prescription for a patient and “somewhat comfortable” (38%) in counseling on naloxone; most were “somewhat comfortable” (38%) administering naloxone. Naloxone is “very rarely” (87%) recommended in community workplace settings, and the majority (64%) reported that patients never request information about naloxone availability. Seventy-six percent of respondents reported that naloxone-associated interactions have an influence on the way they communicate with patients in community pharmacy settings. Thematic analyses found that pharmacy students identify the importance of naloxone as a life-saving medication and the need for naloxone training, but patient-perceived stigma and limited access to naloxone remain prevalent. Pharmacy students are generally well-versed and inclined toward distributing, counseling on, and administering naloxone. Naloxone is rarely dispensed and patient conversations involving naloxone are infrequent in community settings. Future efforts focused on approaches toward difficult patient conversations and normalization of naloxone are needed to destigmatize and facilitate use.

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Public perceptions of naloxone use in the outpatient setting

Cited by 15 publications

References 10 publications

Where the Fault Lies: Representations of Addiction in Audience Reactions to Media Coverage of the Opioid Epidemic

Where the Fault Lies: Representations of Addiction in Audience Reactions to Media Coverage of the Opioid Epidemic

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

Pharmacy Students’ Perceptions and Stigma Surrounding Naloxone Use in Patients with Opioid Use Disorder: A Mixed Methods Evaluation

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