Post-overdose interventions triggered by calling 911: Centering the perspectives of people who use drugs (PWUDs)


Autoři: Karla D. Wagner aff001;  Robert W. Harding aff001;  Richard Kelley aff002;  Brian Labus aff003;  Silvia R. Verdugo aff004;  Elizabeth Copulsky aff005;  Jeanette M. Bowles aff005;  Maria Luisa Mittal aff005;  Peter J. Davidson aff005
Působiště autorů: School of Community Health Sciences, University of Nevada, Reno, Nevada, United States of America aff001;  Nevada Center for Applied Research, University of Nevada, Reno, Nevada, United States of America aff002;  School of Public Health, University of Nevada, Las Vegas, Nevada, United States of America aff003;  FirstWatch, Inc., Carlsbad, California, United States of America aff004;  Division of Infectious Disease and Global Public Health, Department of Medicine, University of California, San Diego, California, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223823

Souhrn

Background

Opioid overdose deaths have increased exponentially in the United States. Bystander response to opioid overdose ideally involves administering naloxone, providing rescue breathing, and calling 911 to summon emergency medical assistance. Recently in the US, public health and public safety agencies have begun seeking to use 911 calls as a method to identify and deliver post-overdose interventions to opioid overdose patients. Little is known about the opinions of PWUDs about the barriers, benefits, or potential harms of post-overdose interventions linked to the 911 system. We sought to understand the perspectives of PWUDs about a method for using 911 data to identify opioid overdose cases and trigger a post-overdose intervention.

Methods and findings

We conducted three focus groups with 11 PWUDs in 2018. Results are organized into 4 categories: willingness to call 911 (benefits and risks of calling), thoughts about a technique to identify opioid overdoses in 911 data (benefits and concerns), thoughts about the proposed post-overdose intervention (benefits and concerns), and recommendations for developing an ideal post-overdose intervention. For most participants, calling 911 was synonymous with “calling the police” and law enforcement-related fears were pervasive, limiting willingness to engage with the 911 system. The technique to identify opioid overdoses and the proposed post-overdose intervention were identified as potentially lifesaving, but the benefits were balanced by concerns related to law enforcement involvement, intervention timing, and risks to privacy/reputation. Nearly universally, participants wished for a way to summon emergency medical assistance without triggering a law enforcement response.

Conclusions

The fact that the 911 system in the US inextricably links emergency medical assistance with law enforcement response inherently problematizes calling 911 for PWUDs, and has implications for surveillance and intervention. It is imperative to center the perspectives of PWUDs when designing and implementing interventions that rely on the 911 system for activation.

Klíčová slova:

Critical care and emergency medicine – Drug research and development – Law enforcement – Opioids – Police – Public and occupational health – Safety – Nevada


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Článek vyšel v časopise

PLOS One


2019 Číslo 10