Kruis Nathan E, McLean Katherine, Perry Payton, Nackley Marielle K
Department of Criminal Justice, Penn State Altoona, Altoona, PA, USA.
Department of Criminal Justice, Penn State Greater Allegheny, McKeesport, PA, USA.
Subst Use Misuse. 2022;57(10):1534-1544. doi: 10.1080/10826084.2022.2092150. Epub 2022 Jul 6.
Prior work has suggested that first responders have mixed feelings about harm reduction strategies used to fight the opioid epidemic, such as the use of naloxone to reverse opioid overdose. Researchers have also noted that provider-based stigma of people who use opioids (PWUO) may influence perceptions of appropriate interventions for opioid use disorder (OUD). This study examined first responders' perceptions of naloxone and the relationship between stigma of OUD and perceptions of naloxone.
A web-based survey assessing perceptions of PWUO and naloxone was administered to 282 police officers and students enrolled in EMT and paramedic training courses located in the Northeastern United States. Bivariate and multivariable analyses assessed the relationship between variants of stigma (e.g., perceived dangerousness, blame, social distance, and fatalism) and self-reported perceptions of naloxone.
Participants, in the aggregate, held slightly negative attitudes toward the use of naloxone. Findings from multivariable modeling suggest that stigma of OUD, living in a rural area, and prior experience administering naloxone, were significantly and inversely related to support for the use of naloxone. Support for the disease model of addiction and associating drug use with low socioeconomic status were positively related to support for the use of naloxone.
Efforts to alleviate perceptions of PWUO as dangerous, blameworthy, or incapable of recovery may increase first responders' support for naloxone. To this end, first responder training programs should include instruction on the disease model of addiction, and more broadly, attempt to foster familiarity between PWUO and the professionals who serve them.
先前的研究表明，急救人员对用于抗击阿片类药物流行的减少伤害策略（如使用纳洛酮逆转阿片类药物过量）看法不一。研究人员还指出，医疗服务提供者对阿片类药物使用者（PWUO）的污名化可能会影响对阿片类药物使用障碍（OUD）适当干预措施的看法。本研究调查了急救人员对纳洛酮的看法以及OUD污名化与纳洛酮看法之间的关系。
对美国东北部282名警察以及参加急救医疗技术员（EMT）和护理人员培训课程的学生进行了一项基于网络的调查，以评估他们对PWUO和纳洛酮的看法。双变量和多变量分析评估了污名化变体（如感知危险性、责备、社会距离和宿命论）与自我报告的纳洛酮看法之间的关系。
总体而言，参与者对纳洛酮的使用持略微消极的态度。多变量建模结果表明，OUD污名化、生活在农村地区以及先前有使用纳洛酮的经验，与对使用纳洛酮的支持呈显著负相关。对成瘾疾病模型的支持以及将药物使用与低社会经济地位联系起来，与对使用纳洛酮的支持呈正相关。
减轻对PWUO危险、应受责备或无法康复的看法的努力，可能会增加急救人员对纳洛酮的支持。为此，急救人员培训计划应包括成瘾疾病模型的教学，更广泛地说，应努力促进PWUO与为他们服务的专业人员之间的熟悉度。
