School of Media, Culture and Society, University of the West of Scotland, Paisley, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Meridian Court, Cadogan St, Glasgow, UK.
Scottish Improvement Science Collaborating Centre, University of Dundee, Dundee, UK.
Int J Drug Policy. 2018 Aug;58:46-54. doi: 10.1016/j.drugpo.2018.05.002. Epub 2018 May 24.
The supply of naloxone, the opioid antagonist, for peer administration ('take-home naloxone' (THN)) has been promoted as a means of preventing opioid-related deaths for over 20 years. Despite this, little is known about PWID experiences of take-home naloxone administration. The aim of this study was to advance the evidence base on THN by producing one of the first examinations of the lived-experience of THN use among PWID.
Qualitative, face to face, semi-structured interviews were undertaken at a harm reduction service with individuals known to have used take-home naloxone in an overdose situation in a large urban area in Scotland. Interpretative Phenomenological Analysis (IPA) was then applied to the data from these in-depth accounts.
The primary analysis involved a total of 8 PWID (seven male, one female) known to have used take-home naloxone. This paper focuses on the two main themes concerning naloxone administration: psychological impacts of peer administration and role perceptions. In the former, the feelings participants encounter at different stages of their naloxone experience, including before, during and after use, are explored. In the latter, the concepts of role legitimacy, role adequacy, role responsibility and role support are considered.
This study demonstrates that responding to an overdose using take-home naloxone is complex, both practically and emotionally, for those involved. Although protocols exist, a multitude of individual, social and environmental factors shape responses in the short and longer terms. Despite these challenges, participants generally conveyed a strong sense of therapeutic commitment to using take-home naloxone in their communities.
纳洛酮作为阿片类拮抗剂的供应，用于同伴给药（“携带回家的纳洛酮”（THN）），作为预防阿片类相关死亡的一种手段已经推广了 20 多年。尽管如此，很少有人了解 PWID 对携带回家的纳洛酮给药的体验。本研究的目的是通过对 PWID 使用 THN 的生活体验进行首次检查之一，来推进 THN 的证据基础。
在苏格兰一个大城市的一个减少伤害服务机构，与已知在过量情况下使用过携带回家的纳洛酮的个人进行了定性、面对面、半结构化访谈。然后对这些深入叙述的数据应用解释现象学分析（IPA）。
主要分析共涉及 8 名已知在过量情况下使用过携带回家的纳洛酮的 PWID（7 名男性，1 名女性）。本文重点介绍了与纳洛酮给药有关的两个主要主题：同伴给药的心理影响和角色认知。在前一个主题中，探讨了参与者在纳洛酮体验的不同阶段（包括使用前、使用中和使用后）所经历的感受。在后一个主题中，考虑了角色合法性、角色充分性、角色责任和角色支持的概念。
本研究表明，对于涉及的人员来说，使用携带回家的纳洛酮来应对过量是复杂的，无论是在实践上还是在情感上。尽管存在方案，但许多个人、社会和环境因素会在短期和长期内影响反应。尽管存在这些挑战，但参与者普遍对在社区中使用携带回家的纳洛酮表达了强烈的治疗承诺。
