A qualitative examination of naloxone access in three states: Connecticut, Kentucky, and Wisconsin.
A qualitative examination of naloxone access in three states: Connecticut, Kentucky, and Wisconsin.
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DOI：
10.1186/s12889-022-13741-5
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发表时间：
2022-07-19
影响因子：
4.5
通讯作者：
Dickson-Gomez, Julia
中科院分区：
文献类型：
--
作者：
Spector, Antoinette L.;Galletly, Carol L.;Christenson, Erika A.;Montaque, H. Danielle Green;Dickson-Gomez, Julia
预防阿片类药物过量死亡仍然是美国公共卫生的优先事项。虽然扩大纳洛酮的可及性是一项国家公共卫生战略，但它主要在州和地方一级实施，其中存在政策，资源和规范的显著差异。本研究的目的是从关键知情人（第一反应者、减少伤害人员和药剂师）的角度研究三个不同州（康涅狄格州、肯塔基州、威斯康星州）纳洛酮使用的社会背景，这些知情人在社区内分配或管理纳洛酮方面发挥一定作用。访谈对象是康涅狄格州、肯塔基州和威斯康星州不同地方（城市、郊区、农村）的关键线人。采访指南探讨了关键的线人与管理或分发纳洛酮的经验，以及他们对阿片类药物过量预防工作在他们的地区的观点。数据分析采用多级归纳编码和比较方法，以确定数据中的主导主题。这三个州的主要知情人都注意到了扩大纳洛酮使用的进展，特别是在使用阿片类药物的人群中，但也描述了不平等现象。与会者还强调了减少危害计划在社区内分发纳洛酮的关键作用，以及通过药店增加纳洛酮获得的障碍。尽管人们对扩大纳洛酮的使用以防止过量死亡的有效性达成了普遍共识，但结果表明，社区仍在努力解决与药物使用和减少危害方法相关的耻辱问题。研究结果表明，通过减少伤害计划针对纳洛酮分布的公共卫生干预措施可以提高当地社区的可及性。解决对使用药物和减少伤害的人的污名化态度的策略也可能促进纳洛酮的扩大努力，总体而言，以及通过药房提高纳洛酮的可负担性和认识的政策。在线版本包含补充材料，可通过10.1186/s12889-022-13741-5获得。
Prevention of opioid-involved overdose deaths remains a public health priority in the United States. While expanding access to naloxone is a national public health strategy, it is largely implemented at the state and local level, where significant variability in policies, resources, and norms exist. The aims of the current study were to examine the social context of naloxone access in three different states (Connecticut, Kentucky, Wisconsin) from the perspectives of key informants (first responders, harm reduction personnel, and pharmacists), who play some role in dispensing or administering naloxone within their communities. Interviews were conducted with key informants who were in different local areas (urban, suburban, rural) across Connecticut, Kentucky, and Wisconsin. Interview guides explored the key informants’ experiences with administering or dispensing naloxone, and their perspectives on opioid overdose prevention efforts in their areas. Data analysis was conducted using multistage inductive coding and comparative methods to identify dominant themes within the data. Key informants in each of the three states noted progress toward expanding naloxone access, especially among people who use opioids, but also described inequities. The key role of harm reduction programs in distributing naloxone within their communities was also highlighted by participants, as well as barriers to increasing naloxone access through pharmacies. Although there was general consensus regarding the effectiveness of expanding naloxone access to prevent overdose deaths, the results indicate that communities are still grappling with stigma associated with drug use and a harm reduction approach. Findings suggest that public health interventions that target naloxone distribution through harm reduction programs can enhance access within local communities. Strategies that address stigmatizing attitudes toward people who use drugs and harm reduction may also facilitate naloxone expansion efforts, overall, as well as policies that improve the affordability and awareness of naloxone through the pharmacy. The online version contains supplementary material available at 10.1186/s12889-022-13741-5.
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DOI：
10.1016/j.japh.2019.11.024
发表时间：
2020-05-01
影响因子：
2.1
作者：
Eldridge, Lori Ann;Agley, Jon;Meyerson, Beth E.
通讯作者：
Meyerson, Beth E.
影响因子：
4.2
作者：
Green, Traci C.;Zaller, Nickolas;Case, Patricia
通讯作者：
Case, Patricia
影响因子：
2.9
作者：
Adams, Alex J.;Weaver, Krystalyn K.
通讯作者：
Weaver, Krystalyn K.
影响因子：
4.4
作者：
Davis, Corey S.;Southwell, Jessica K.;Dailey, Michael W.
通讯作者：
Dailey, Michael W.
影响因子：
12.7
作者：
Davis, Corey S.;Ruiz, Sarah;Walley, Alexander Y.
通讯作者：
Walley, Alexander Y.