Abstract Background Opioid-related overdose death is a public health epidemic in much of the USA, yet little is known about how people who use opioids (PWUO) experience overdose deaths in their social networks. We explore these experiences through a qualitative study of opioid-related overdose death bereavement among PWUO. Methods We recruited 30 adults who inject opioids from a syringe service program in the Midwestern USA and interviewed them using a semi-structured guide that addressed experiences of opioid use, opioid-related overdose, and overdose reversal via the medication naloxone. Interviews were transcribed verbatim and analyzed thematically. Findings Participants described overdose death as ever-present in their social worlds. Most (approximately 75%) reported at least one overdose death in their social network, and many came to consider death an inevitable end of opioid use. Participants described grief shaped by complex social relations and mourning that was interrupted due to involvement with social services and criminal legal systems. They also reported several ways that overdose deaths influenced their drug use, with some increasing their use and others adopting safer drug use practices. Despite the high prevalence of overdose deaths in their social networks, only one participant reported receiving grief support services. Discussion Findings underscore the need for interventions that not only maintain life, such as naloxone distribution, but also improve quality of life by attending to grief related to overdose death bereavement. We discuss policies and practices with the potential to address the unique psychological, social, and structural challenges of grief for this population. 
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                            Experiences of people who use drugs with naloxone administration: a qualitative study
                        
                    
    
            The United States is in the midst of an epidemic of opioid-related overdose deaths. In response, harm reduction programs commonly distribute the opioid antagonist naloxone directly to PWUD so that they can act as first responders when an overdose occurs. Naloxone reverses respiratory depression and can save the life of a person overdosing on opioids. Little research has been conducted about the lived experiences of PWUD who use naloxone, particularly their motivations for carrying it, their experiences serving as first responders to overdoses, and how new communities of care have sprung up around the widespread use of naloxone. To better understand the lived experiences of PWUD, semi-structured interviews were conducted with seventeen syringe exchange participants who currently carry and/or have administered naloxone. In interviews, participants describe taking on the role of peer naloxone administrator as empowering, partially because it contrasts with the powerlessness they recounted in other areas of their lives. Peer administrators also use naloxone in a way that reinforces overdose care among people who use drugs. Future programs distributing naloxone to PWUD should be aware of its potential not only to save lives, but to increase participants’ self-confidence and strengthen the network of overdose care in their communities. 
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                            - Award ID(s):
- 1844715
- PAR ID:
- 10539739
- Publisher / Repository:
- Taylor & Francis Online
- Date Published:
- Journal Name:
- Drugs: Education, Prevention and Policy
- Volume:
- 29
- Issue:
- 1
- ISSN:
- 0968-7637
- Page Range / eLocation ID:
- 54 to 61
- Subject(s) / Keyword(s):
- naloxone PWUD PWID overdose care harm reduction overdose narratives
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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