Deonarine Andrew, Amlani Ashraf, Ambrose Graham, Buxton Jane A
School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.
Harm Reduct J. 2016 May 21;13(1):17. doi: 10.1186/s12954-016-0106-1.
The British Columbia take-home naloxone (BCTHN) program has been in operation since 2012 and has resulted in the successful reversal of over 581 opioid overdoses. The study aims to explore BCTHN program participant perspectives about the program, barriers to participants contacting emergency services (calling "911") during an overdose, and perspectives of law enforcement officials on naloxone administration by police officers.
Two focus groups and four individual interviews were conducted with BCTHN program participants; interviews with two law enforcement officials were also conducted. Qualitative analysis of all transcripts was performed.
Positive themes about the BCTHN program from participants included easy to understand training, correcting misperceptions in the community, and positive interactions with emergency services. Potential barriers to contacting emergency services during an overdose include concerns about being arrested for outstanding warrants or for other illegal activities (such as drug possession) and confiscation of kits. Law enforcement officials noted that warrants were complex situational issues, kits would normally not be confiscated, and admitted arrests for drug possession or other activities may not serve the public good in an overdose situation. Law enforcement officials were concerned about legal liability and jurisdictional/authorization issues if naloxone administration privileges were expanded to police.
Program participants and law enforcement officials expressed differing perspectives about warrants, kit confiscation, and arrests. Facilitating communication between BCTHN program participants and other stakeholders may address some of the confusion and remove potential barriers to further improving program outcomes. Naloxone administration by law enforcement would require policies to address jurisdiction/authorization and liability issues.
不列颠哥伦比亚省带回家的纳洛酮（BCTHN）项目自2012年开始实施，已成功逆转了超过581例阿片类药物过量使用情况。本研究旨在探讨BCTHN项目参与者对该项目的看法、过量用药时参与者联系紧急服务（拨打“911”）的障碍以及执法官员对警察使用纳洛酮的看法。
对BCTHN项目参与者进行了两个焦点小组讨论和四次个人访谈；还对两名执法官员进行了访谈。对所有访谈记录进行了定性分析。
参与者对BCTHN项目的积极主题包括易于理解的培训、纠正社区中的误解以及与紧急服务的积极互动。过量用药时联系紧急服务的潜在障碍包括担心因未执行的逮捕令或其他非法活动（如持有毒品）而被捕以及试剂盒被没收。执法官员指出，逮捕令是复杂的情况问题，试剂盒通常不会被没收，因持有毒品或其他活动而被逮捕在过量用药情况下可能不符合公共利益。执法官员担心如果将纳洛酮使用特权扩大到警察，会涉及法律责任和管辖权/授权问题。
项目参与者和执法官员对逮捕令、试剂盒没收和逮捕表达了不同的看法。促进BCTHN项目参与者与其他利益相关者之间的沟通可能会解决一些困惑，并消除进一步改善项目成果的潜在障碍。执法人员使用纳洛酮需要制定政策来解决管辖权/授权和责任问题。
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