Abstract: Just Get It out There: Overdose Education and Naloxone Distribution Program Design Informed By People Who Use Drugs and Naloxone Distributors (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Saturday, January 13, 2024

Independence BR A, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

Michael Enich, PhD Candidate, Rutgers University, New Brunswick, NJ

Nora Sullivan, MDiv, PhD Student, Rutgers University, New Brunswick, NJ

Rachel Flumo, Graduate Student, Rutgers University, NJ

Stephanie Campos, PhD, Adjunct Professor, John Jay College of Criminal Justice, NY

Netanya Flores, Graduate Student, Temple University, PA

Jenna Mellor, MPA, Executive Director, New Jersey Harm Reduction Coalition, New Brunswick, NJ

Caitlin O'Neill, Director, New Jersey Harm Reduction Coalition, NJ

Amesika Nyaku, MD, MS, Assistant Professor, Division of Infectious Diseases, Department of Medicine, Rutgers University, NJ

Background & Purpose

People who use drugs are disproportionately affected by the overdose epidemic. Overdose education and naloxone distribution programs are meant to inform participants of overdose risks and distribute the opioid overdose reversal agent naloxone to affected communities. However, overdose education and naloxone distribution program design varies widely and people who use drugs are often not prioritized for direct naloxone distribution or consulted for their unique perspectives from the frontlines of overdose response. The purpose of this project was to understand the perspectives of people who use drugs and community naloxone distributors on overdose education and naloxone distribution program design.

Methods

We used a community-based participatory research model to elucidate participant perceptions of what overdose education and naloxone distribution programs should look like in the context of each individual’s specific overdose risk environment. In collaboration with a local harm reduction organization and with advising from community members who used drugs, we conducted semi-structured in-depth interviews with people who use drugs and naloxone distributors (n = 30) in New Brunswick and Newark, New Jersey between February and November of 2022. Interviews were analyzed using thematic analysis. Participants were appropriately compensated for their time, drove network-based sampling, and were asked to review study results. Results were distributed via community meetings with local stakeholders and informed future overdose education and naloxone distribution program design at partner organizations.

Results

Interviews identified the following themes: increasing naloxone knowledge throughout the community, people who use drug-driven peer-based naloxone access, increasing people who use drugs-informed overdose education and naloxone distribution program design, and a desire for broader overdose education and naloxone distribution program scope. Most participants knew what naloxone was, learned about it from informal, non-overdose education program settings and emphasized that naloxone needed to be ubiquitous in the community. Participants most often received naloxone from peers and believed that peer-based distribution should be prioritized. They suggested this could be done by integrating distribution into community organizations, placing naloxone at accessible locations, and equipping people who use drugs to distribute naloxone. Participants also suggested overdose education and naloxone distribution programs should address psychosocial issues related to naloxone administration and drug use, including naloxone stigma, issues related to substance use and recovery, and the need for holistic programming.

Conclusions & Implications

In summary, people who use drugs and community naloxone distributors emphasized peer-led community naloxone distribution that prioritized novel ways for people who use drugs to access naloxone. Participants emphasized that naloxone should be ubiquitous in their communities. Overdose education and naloxone distribution program design should prioritize people who use drugs’ perspectives and direct community naloxone distribution.