Parsons Janet A, Markowitz Benjamin, Thomas Rekha, Norris Kris, Charles Mercy, King Chantelle, Sellen Kate, Campbell Douglas M, Leece Pamela, Klaiman Michelle, Chapman Leigh, Hopkins Shaun, Shahin Rita, Handford Curtis, Stergiopoulos Vicky, Morrison Laurie J, Strike Carol, Orkin Aaron M
Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
PLoS One. 2025 Jun 25;20(6):e0326495. doi: 10.1371/journal.pone.0326495. eCollection 2025.
Canada's opioid crisis continues to escalate. Naloxone can effectively reverse the effects of opioid overdose. We planned a randomized trial on the effectiveness of a point-of-care overdose education and naloxone distribution (OEND) intervention on participants' performance in a simulated opioid overdose scenario. In preparation for the trial, we conducted a feasibility study which included a qualitative process evaluation aimed at eliciting participants' perspectives of the study's OEND tool and procedures, and how their lived experiences of the opioid crisis intersected with their experiences of the study. Twenty-three participants were interviewed, including people with lived experiences of opioid use or overdose, and people living in neighbourhoods or working in services where they were likely to encounter overdose. Thematic analysis of interview transcripts was informed by stigma theory. Participants' accounts depicted challenges faced by people who take opioids in their everyday lives, deep losses experienced, negative attitudes encountered, and systemic barriers to care. Participation in the study itself was portrayed as meaningful. We explored participants' experiences through three key themes: (1) who were the participants - describing their experiences related to opioid overdose, opioid use and attendant stigma; (2) why did they participate - recounting their motivations to join the study; and (3) what they thought about study processes - reflecting on the OEND materials and study procedures. Accounts revealed a sense of agency as participants confronted the opioid crisis. Our results demonstrate that people experiencing opioid use and overdose and people who care about them are eager and willing to be approached about research at point of care; participants were eager to learn overdose prevention skills and to return for follow-up study sessions. They recounted a range of motivations for participating, the most important of which is the opportunity to actively intervene, save lives and raise awareness. Trial Registration: ClinicalTrials.gov registry (NCT03821649).
加拿大的阿片类药物危机持续升级。纳洛酮能够有效逆转阿片类药物过量服用的影响。我们计划开展一项随机试验，以研究即时过量用药教育和纳洛酮分发（OEND）干预措施在模拟阿片类药物过量场景中对参与者表现的有效性。在试验准备阶段，我们进行了一项可行性研究，其中包括定性过程评估，旨在了解参与者对该研究的OEND工具和程序的看法，以及他们在阿片类药物危机中的生活经历与研究经历的交集。我们采访了23名参与者，包括有阿片类药物使用或过量服用经历的人，以及生活在可能遇到过量用药情况的社区或从事相关服务工作的人。访谈记录的主题分析以污名理论为依据。参与者的叙述描绘了服用阿片类药物的人在日常生活中面临的挑战、经历的巨大损失、遭遇的负面态度以及获得护理的系统性障碍。参与这项研究本身被描述为有意义的。我们通过三个关键主题探讨了参与者的经历：（1）参与者是谁——描述他们与阿片类药物过量、阿片类药物使用及相关污名的经历；（2）他们为什么参与——讲述他们参与研究的动机；（3）他们对研究过程的看法——对OEND材料和研究程序的思考。叙述揭示了参与者面对阿片类药物危机时的能动感。我们的结果表明，有阿片类药物使用和过量服用经历的人以及关心他们的人渴望并愿意在即时护理点接受关于研究的询问；参与者渴望学习过量用药预防技能并回来参加后续研究课程。他们讲述了一系列参与的动机，其中最重要的是有机会积极干预、拯救生命并提高认识。试验注册：ClinicalTrials.gov注册库（NCT03821649）。
