无人愿意接受纳洛酮注射：吸毒者对纳洛酮看法的初步定性分析
Nobody Wants to Be Narcan'd: A Pilot Qualitative Analysis of Drug Users' Perspectives on Naloxone.
机构信息
University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts.
Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts.
出版信息
West J Emerg Med. 2021 Feb 8;22(2):339-345. doi: 10.5811/westjem.2020.10.48768.
INTRODUCTION
Bystander naloxone distribution is an important component of public health initiatives to decrease opioid-related deaths. While there is evidence supporting naloxone distribution programs, the effects of increasing naloxone availability on the behavior of people who use drugs have not been adequately delineated. In this study we sought to 1) evaluate whether individuals' drug use patterns have changed due to naloxone availability; and 2) explore individuals' knowledge of, access to, experiences with, and perceptions of naloxone.
METHODS
We conducted a pilot study of adults presenting to the emergency department whose medical history included non-medical opioid use. Semi-structured interviews were conducted with participants and thematic analysis was used to code and analyze interview transcripts.
RESULTS
Ten participants completed the study. All were aware of naloxone by brand name (Narcan) and had been trained in its use, and all but one had either currently or previously possessed a kit. Barriers to naloxone administration included fear of legal repercussions, not having it available, and a desire to avoid interrupting another user's "high." Of the eight participants who reported being revived with naloxone at least once during their lifetime, all described experiencing a noxious physical response and expressed a desire to avoid receiving it again. Furthermore, participants did not report increasing their use of opioids when naloxone was available.
CONCLUSIONS
Participants were accepting of and knowledgeable about naloxone, and were willing to administer naloxone to save a life. Participants tended to use opioids more cautiously when naloxone was present due to fears of experiencing precipitated withdrawal. This study provides preliminary evidence countering the unsubstantiated narrative that increased naloxone availability begets more high-risk opioid use and further supports increasing naloxone access.
简介
旁观者纳洛酮的分发是减少阿片类药物相关死亡的公共卫生举措的重要组成部分。虽然有证据支持纳洛酮分发计划，但增加纳洛酮的可获得性对吸毒者行为的影响尚未得到充分阐述。在这项研究中，我们试图 1）评估个体的药物使用模式是否因纳洛酮的可获得性而发生变化；2）探讨个体对纳洛酮的了解、获取、使用经验和看法。
方法
我们对因非医疗用途的阿片类药物使用而就诊于急诊部的成年人进行了一项试点研究。对参与者进行了半结构化访谈，并使用主题分析对访谈记录进行了编码和分析。
结果
10 名参与者完成了研究。所有人都知道纳洛酮（纳洛酮）的商品名，并接受过使用培训，除一人外，所有人都曾拥有或目前拥有一个套件。纳洛酮给药的障碍包括害怕法律后果、无法获得纳洛酮，以及避免中断另一个使用者的“快感”。在报告至少一次在其一生中因纳洛酮而复苏的八名参与者中，所有人都描述了经历了一种有害的身体反应，并表示希望避免再次接受纳洛酮。此外，参与者报告说，当纳洛酮可用时，他们并没有增加阿片类药物的使用。
结论
参与者接受并了解纳洛酮，并且愿意给予纳洛酮以拯救生命。由于担心经历撤药反应，参与者在纳洛酮存在时往往更谨慎地使用阿片类药物。这项研究提供了初步证据，反驳了增加纳洛酮的可获得性会导致更高风险的阿片类药物使用的毫无根据的说法，并进一步支持增加纳洛酮的可获得性。
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