为什么一些接受了过量用药教育和纳洛酮治疗的人在发生过量用药时不愿意拨打急救医疗服务？
Why are some people who have received overdose education and naloxone reticent to call Emergency Medical Services in the event of overdose?
机构信息
Department of Anthropology, University of Colorado Denver, Denver, CO, USA; Department of Health & Behavioral Sciences, University of Colorado Denver, Denver, CO, USA.
Department of Health & Behavioral Sciences, University of Colorado Denver, Denver, CO, USA; Division of General Internal Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave. B-180 Aurora, CO 80045, USA(1); Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA(2).
出版信息
Int J Drug Policy. 2017 Oct;48:115-124. doi: 10.1016/j.drugpo.2017.06.008. Epub 2017 Jul 19.
BACKGROUND
Overdose Education and Naloxone Distribution (OEND) training for persons who inject drugs (PWID) underlines the importance of summoning emergency medical services (EMS). To encourage PWID to do so, Colorado enacted a Good Samaritan law providing limited immunity from prosecution for possession of a controlled substance and/or drug paraphernalia to the overdose victim and the witnesses who in good faith provide emergency assistance. This paper examines the law's influence by describing OEND trained PWIDs' experience reversing overdoses and their decision about calling for EMS support.
METHODS
Findings from two complementary studies, a qualitative study based on semi-structured interviews with OEND trained PWID who had reversed one or more overdoses, and an on-going fieldwork-based project examining PWIDs' self-identified health concerns were triangulated to describe and explain participants' decision to call for EMS.
RESULTS
In most overdose reversals described, no EMS call was made. Participants reported several reasons for not doing so. Most frequent was the fear that despite the Good Samaritan law, a police response would result in arrest of the victim and/or witness for outstanding warrants, or sentence violations. Fears were based on individual and collective experience, and reinforced by the city of Denver's aggressive approach to managing homelessness through increased enforcement of misdemeanors and the imposition of more recent ordinances, including a camping ban, to control space. The city's homeless crisis was reflected as well in the concern expressed by housed PWID that an EMS intervention would jeopardize their public housing.
CONCLUSION
Results suggest that the immunity provided by the Good Samaritan law does not address PWIDs' fear that their current legal status as well as the victim's will result in arrest and incarceration. As currently conceived, the Good Samaritan law does not provide immunity for PWIDs' already enmeshed in the criminal justice system, or PWID fearful of losing their housing.
背景
对注射毒品者（PWID）进行过量急救教育和纳洛酮分发（OEND）培训强调了召唤紧急医疗服务（EMS）的重要性。为了鼓励 PWID 这样做，科罗拉多州颁布了一项“好撒玛利亚人法”，为因持有受控物质和/或吸毒用具而受到的刑事起诉提供有限豁免，以及为善意提供急救的过量受害者和证人提供有限豁免。本文通过描述接受过 OEND 培训的 PWID 逆转过量用药的经验以及他们关于寻求 EMS 支持的决定，来探讨该法律的影响。
方法
本研究结合了两项互补研究的结果，一项是基于对曾逆转过一次或多次过量用药的接受过 OEND 培训的 PWID 进行半结构化访谈的定性研究，另一项是正在进行的基于实地考察的项目，旨在调查 PWID 自我识别的健康问题。这两项研究的结果相互验证，以描述和解释参与者拨打 EMS 电话的决定。
结果
在大多数描述的过量用药逆转案例中，并未拨打 EMS 电话。参与者报告了不这样做的几个原因。最常见的原因是担心，尽管有“好撒玛利亚人法”，警察的反应仍会导致受害者和/或证人因未决逮捕令或判刑违规而被捕。这种恐惧基于个人和集体经验，并因丹佛市通过加强对轻罪的执法以及实施包括禁止露营在内的最新条例来管理无家可归者的积极态度而得到强化，这些条例旨在控制空间。城市无家可归者危机也反映在有住房的 PWID 所表达的担忧中，即 EMS 的干预会危及他们的公共住房。
结论
结果表明，“好撒玛利亚人法”所提供的豁免权并不能解决 PWID 对自己当前法律地位以及受害者将被捕入狱的担忧。就目前的情况来看，“好撒玛利亚人法”并不为已经卷入刑事司法系统的 PWID 或担心失去住房的 PWID 提供豁免权。
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