(WITHDRAWN) Perceptions of Naloxone Administration Among Chronic Pain Patients and First Responders: Direction for Social Work Practice and Research

Background and Purpose: Opioid overdoses remain a persistent health crisis which necessitates a multifaceted treatment approach including the administration of naloxone as a first line of defense. However, perceptions of the importance of naloxone in addressing the opioid epidemic from both patients at risk for overdose and first responders who administer naloxone is limited.

Methods: This cross-sectional survey investigates the attitudes of first responders and chronic pain patients in Southwestern Pennsylvania to better understand their perceptions of naloxone administration and its efficacy in curtailing the opioid epidemic. Eligibility for chronic pain patients included: ages ≥18, chronic pain (3 months or longer), and currently taking opioid medications. First responders from the southwest part of the state were identified through the statewide EMS association in Pennsylvania. Data collected included demographics, substance use, mental health, health characteristics, and perceptions and attitudes on naloxone administration and opioid overdose. Descriptive and univariate statistics were calculated to characterize both cohorts and assess their perceptions and attitudes on the efficacy of naloxone administration.

Results: A total of 237 participants completed the survey (120 chronic pain patients and 117 first responders). The majority of participants, 39.7% (n=94) were between the age range of 36-54, nearly half (43.5%; n=103) were female, 81.9% of the participants were White (n=194), and 18.1% were African American (n=43). For chronic pain patients, 38% (n=46) of the participants screened positive for opioid medication misuse. Chronic pain patients were significantly more likely (96%, P=<.001) than first responders (56%) to agree that providing naloxone to first responders would save lives. Over 80% (N=103) of patients agreed that providing naloxone to friends and family members would save lives, yet only 59% (N=69) of first responders agreed with this statement (P=<.001). While 30% percent of patients (N=37) agreed that distributing naloxone would encourage people to use even more opioid analgesics, there were nearly twice as many (N=69; 60%) first responders who agreed with this statement (P=<.001). Less than a quarter (N=28) of patients thought that preventing overdoses is not effective in combatting the opioid epidemic because people will overdose again, while twice as many (N=64; 55%) first responders agreed (P=0.91) with this statement.

Conclusion and Implications: Social workers play a critical role in the substance abuse treatment system through their interaction with patients and healthcare providers. These data help to characterize and highlight the differences of the perceptions and attitudes of chronic pain patients and first responders towards naloxone administration, illuminating critical areas of health education. Further, these data can help inform social workers in identifying and implementing areas of training for both chronic pain patients and first responders. In order to better establish these findings, future social work research should employ longitudinal designs to examine the role that education and training can achieve in impacting attitudes and behaviors around naloxone administration.