The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA.
Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire, USA.
Drug Alcohol Depend. 2019 Nov 1;204:107555. doi: 10.1016/j.drugalcdep.2019.107555. Epub 2019 Sep 13.
In parallel to a substantial increase in opioid overdose deaths in New Hampshire (NH), emergency personnel experienced an increase in opioid-related encounters. To inform public health responses to this crisis, insights into the experiences and perspectives of those emergency personnel who treat opioid-related overdoses are warranted.
Systematically examine emergency personnel's experiences treating opioid overdoses and obtain their perspectives on policy-level responses to the opioid crisis in NH.
Semi-structured qualitative interviews were conducted with 18 first responders [firefighters (n = 6), police officers (n = 6), emergency medical service providers (n = 6)] and 18 emergency department personnel employed in six NH counties. Interviews focused on emergency personnel's perspectives on fentanyl/heroin formulations, experiences treating overdoses, harm reduction strategies, and experiences with treatment referral. Interviews were audio recorded, transcribed verbatim, and analyzed using content analysis.
Emergency personnel cited the potency and inconsistency of fentanyl-laced heroin as primary drivers of opioid overdose. Increases in overdose-related encounters took a substantial emotional toll on emergency personnel, who described a range of responses including feelings of burnout, exhaustion, and helplessness. While some emergency personnel felt conflicted about the implementation of harm reduction strategies like syringe services programs, others emphasized the necessity of these services. Emergency personnel expressed frustration with barriers to treatment referral in the state and recommended immediate treatment access after overdose events.
Findings suggest that interventions addressing trauma and burnout are necessary to support emergency personnel, while expanded harm reduction and treatment access are critical to support those who experience opioid overdose in NH.
在新罕布什尔州（NH）阿片类药物过量死亡人数大幅增加的同时，急救人员也遇到了与阿片类药物相关的事件增加。为了为应对这一危机提供公共卫生对策，有必要了解治疗阿片类药物相关过量的急救人员的经验和观点。
系统地检查急救人员治疗阿片类药物过量的经验，并了解他们对 NH 阿片类药物危机的政策应对的看法。
对来自 NH 六个县的 18 名一线急救人员[消防员（n=6）、警察（n=6）、紧急医疗服务提供者（n=6）]和 18 名急诊部门人员进行了半结构式定性访谈。访谈重点是急救人员对芬太尼/海洛因制剂的看法、治疗过量的经验、减少伤害策略以及治疗转介的经验。采访进行了录音、逐字转录，并使用内容分析法进行了分析。
急救人员指出，芬太尼掺假海洛因的效力和不一致性是阿片类药物过量的主要驱动因素。与过量相关的事件增加给急救人员带来了巨大的情感压力，他们描述了一系列反应，包括倦怠、疲惫和无助感。虽然一些急救人员对实施诸如注射器服务项目等减少伤害策略感到矛盾，但其他人则强调了这些服务的必要性。急救人员对该州治疗转介的障碍表示不满，并建议在发生过量事件后立即获得治疗。
研究结果表明，有必要采取干预措施来解决创伤和倦怠问题，以支持急救人员，同时扩大减少伤害和获得治疗的机会对于支持 NH 中经历阿片类药物过量的人至关重要。
