A rapid-cycle assessment strategy for understanding the opioid overdose epidemic in local communities
| Autor: | Eric G. Hulsey, Daly Trimble, Nicole Paul, Judy C. Chang, Aaron Arnold, Puneet Gill, Raisa Roberto, Shelcie Fabre, Karen A. Hacker, Simone P Taubenberger, Noelle Spencer, Bhavita Jagessar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Psychological intervention 030508 substance abuse Medicine (miscellaneous) 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Psychiatry Harm reduction Naloxone business.industry Opioid overdose Opioid-Related Disorders medicine.disease United States Rapid assessment Analgesics Opioid Opiate Overdose Psychiatry and Mental health Opioid Drug Overdose 0305 other medical science business medicine.drug |
| Zdroj: | Substance Abuse. 42:888-895 |
| ISSN: | 1547-0164 0889-7077 |
| DOI: | 10.1080/08897077.2021.1891601 |
| Popis: | Background Certain communities in the United States experience greater opioid-involved overdose mortality than others. Interventions to stem overdose benefit from contextual understandings of communities’ needs and strengths in addressing the opioid crisis. This project aims to understand multiple stakeholder perspectives on the opioid epidemic in communities disproportionately affected by opioid-involved overdose mortality. Methods We performed a rapid-cycle qualitative assessment study utilizing in-depth interviews with community stakeholders and observations of community meetings in eight communities in Allegheny County, Pennsylvania, USA, disproportionately impacted by opioid-involved overdose mortality. Stakeholder categories included: current and past illicit users of opioids; medical and social service providers; emergency medical services; law enforcement; spouse or other family members of illicit users/former users of opioids; government officials; school officials; community members. Content analysis was utilized to identify themes and answer study questions. Regular feedback to stakeholders was provided to support targeted interventions. Results We performed semi-structured, in-depth interviews with 130 community stakeholders and 29 community meeting observations in 2018–2019. Participants perceived similar economic and social determinants as origins of the opioid overdose epidemic including lack of economic resources, loss of jobs, transient populations and dilapidated housing. However, they differed in their awareness of and attention to the epidemic. Awareness was dependent on the visibility of opioid use (presence of paraphernalia litter, location of drug users, media coverage, and relationship to users). Overall, there was good knowledge of naloxone for opioid overdose reversal but less knowledge about local syringe services programs. Perceptions of harm reduction efforts were ambivalent. Conclusions Members of communities impacted by the opioid epidemic perceived that economic downturn was a major factor in the opioid overdose epidemic. However, the varied beliefs within and between communities suggest that interventions need to be tailored according to the cultural norms of place. |
| Databáze: | OpenAIRE |
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