Laura Brandt
Laura Brandt1,2, Aimee Campbell1,2, Jermaine Jones1,2, Suky Martinez1,2, Joanne Neale3,4,5, Stephen Parkin3, Caral Brown3, John Strang3,5, Sandra Comer1,2. 1Columbia University Irving Medical Center (CUIMC), United States; 2New York State Psychiatric Institute (NYSPI), Division on Substance Use Disorders, United States; 3National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom; 4Centre for Social Research in Health, University of New South Wales, Australia; 5South London and Maudsley NHS Foundation Trust, United Kingdom.
Background: Our aim was to explore emotional reactions to intervening in an overdose event from the perspective of individuals who use opioids (peer responders).
Methods: For this qualitative sub-study of a randomized controlled trial (RCT), data from 61 interviews were analyzed thematically using an inductive approach.
Results: Peer responders had diverse emotional reactions following the overdose event. For some, positive aspects of this experience prevailed. They were grateful that the person who overdosed survived, they felt fortunate about having been in the right place at the right time, and some described a sense of pride in relation to their ability to help. Others expressed ambivalence about being involved in these challenging situations or described a certain emotional blunting to this kind of experience. Having been involved in an overdose reversal also prompted challenging self-reflection, with responders re-considering their own opioid use. Although participants seldom referred to the overdose event as an exclusively negative experience, some reported distress and frustration related to negative reactions (including anger and even aggression) by the person who overdosed. Many peer responders perceived it as their duty to use naloxone again if required. However, some had mixed feelings toward this responsibility, which may have been related to negative experiences with previous intervention efforts.
Conclusions: The capacity of people who use opioids to help reduce the harms associated with opioid overdose is experienced as empowering by some. Nonetheless, engaging peer responders in strategies to reduce opioid-related mortality should be coupled with appropriate resources to process their experiences.