School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z8, Canada.
British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada.
Subst Abuse Treat Prev Policy. 2022 Jul 26;17(1):56. doi: 10.1186/s13011-022-00484-0.
Canada and the United States continue to experience increasing overdose deaths attributed to highly toxic illicit substances, driven by fentanyl and its analogues. Many bystanders report being hesitant to call 9-1-1 at an overdose due to fears around police presence and arrests. In Canada, a federal law was enacted in 2017, the Good Samaritan Drug Overdose Act (GSDOA), to provide protection from simple drug possession and related charges when 9-1-1 is called to an overdose. There is limited evidence, however, that the GSDOA has improved rates of intention to call 9-1-1 at overdose events. We therefore sought to examine intent to call 9-1-1 among persons who received GSDOA education and were at risk of witnessing an overdose.
A cross-sectional survey was conducted with people at risk of witnessing an overdose recruited at 19 Take Home Naloxone (THN) program sites across British Columbia as well as online through Foundry from October 2020 to April 2021. Descriptive statistics were used to examine intention to call 9-1-1 at future overdoses. Multivariable logistic regression models were built in hierarchical fashion to examine factors associated with intention to call 9-1-1.
Overall, 89.6% (n = 404) of the eligible sample reported intention to call 9-1-1. In the multivariable model, factors positively associated with intention to call 9-1-1 included identifying as a cisgender woman (adjusted odds ratio [AOR]: 3.37; 95% CI: 1.19-9.50) and having previous GSDOA awareness ([AOR]: 4.16; 95% CI: 1.62-10.70). Having experienced a stimulant overdose in the past 6 months was negatively associated with intention to call 9-1-1 ([AOR]: 0.24; 95% CI: 0.09-0.65).
A small proportion of the respondents reported that, despite the enactment of GSDOA, they did not intend to call 9-1-1 and those who were aware of the act were more likely to report an intention to call at future overdose events. Increasing GSDOA awareness and/or additional interventions to support the aims of the GSDOA could address ongoing reluctance to seek emergency medical care by people who use drugs.
加拿大和美国继续经历与芬太尼及其类似物有关的高毒性非法药物导致的过量死亡人数增加。许多旁观者报告说，由于担心警察的存在和逮捕，他们在发生过量用药时不愿拨打 9-1-1。2017 年，加拿大颁布了一项联邦法律，即《好撒玛利亚人药物过量法》（Good Samaritan Drug Overdose Act，GSDOA），规定在拨打 9-1-1 救治过量用药者时，对简单持有毒品和相关指控提供保护。然而，几乎没有证据表明 GSDOA 提高了人们在过量用药事件中拨打 9-1-1 的意愿。因此，我们试图调查接受 GSDOA 教育且有目击过量用药风险的人拨打 9-1-1 的意愿。
2020 年 10 月至 2021 年 4 月，在不列颠哥伦比亚省的 19 个带回家纳洛酮（Take Home Naloxone，THN）项目点以及通过 Foundry 在线招募有目击过量用药风险的人进行横断面调查。使用描述性统计数据来检查未来过量用药时拨打 9-1-1 的意愿。采用分层方式建立多变量逻辑回归模型，以检查与拨打 9-1-1 意愿相关的因素。
总体而言，在合格样本中，89.6%（n=404）报告了拨打 9-1-1 的意愿。在多变量模型中，与拨打 9-1-1 意愿呈正相关的因素包括被认定为顺性别女性（调整后的优势比 [adjusted odds ratio，AOR]：3.37；95%置信区间 [95% confidence interval，CI]：1.19-9.50）和之前有 GSDOA 意识（AOR：4.16；95% CI：1.62-10.70）。过去 6 个月经历过兴奋剂过量的人拨打 9-1-1 的意愿呈负相关（AOR：0.24；95% CI：0.09-0.65）。
尽管颁布了 GSDOA，但仍有一小部分受访者表示他们不打算拨打 9-1-1，而那些了解该法案的人更有可能报告在未来的过量用药事件中拨打 9-1-1 的意愿。增加对 GSDOA 的认识和/或采取额外的干预措施来支持该法案的目标，可能有助于解决吸毒者不愿寻求紧急医疗护理的问题。
