Attitudes toward and experience with naloxone among people who use drugs in the Southeastern United States.

Background: The opioid epidemic presses on as a significant public health issue in the U.S., with particularly high overdose death rates in the Southeast. Naloxone is the standard of care for reversing opioid overdose; however, many people who use drugs (PWUD) experience barriers to naloxone use. This cross-sectional survey study aims to describe awareness of, experience with, willingness, barriers, and distribution strategies for naloxone among PWUD in the Southeast.

Methods: Data were obtained from a larger implementation survey study. Descriptive analyses focused on N = 381 people in substance use treatment programs, syringe services programs, and sexually transmitted infection clinics who reported non-prescription opioid use in the past 12 months and completed a naloxone-related questionnaire.

Results: Most PWUD reported using opioids daily (60-62 %). 82 % had previously heard of naloxone, but only 43 % reported having received any type of training to use it. On a 5-point scale, PWUD without prior training (n = 219) reported being very willing to be trained to use naloxone on someone who overdoses (Mdn=5.00, IQR=2.00). Among all PWUD, not knowing where to go for naloxone training was the only barrier to using naloxone that was endorsed with certainty (Mdn=4.00, IQR=2.00). PWUD endorsed three strategies to improve naloxone distribution, including wanting their site to offer naloxone training (Mdn=4.00, IQR=1.00), increased access to naloxone education (Mdn=4.00, IQR=1.00), and connecting people to training programs (Mdn=4.00, IQR=1.00).

Conclusion: This study suggests that improvements are still needed in the saturation of naloxone training and distribution among PWUD, including in settings that provide non-opioid related services.