40
Views
0
CrossRef citations to date
0
Altmetric
Original Articles

Opioid Overdoses and Take-Home Naloxone Interventions: Ethnographic Evidence for Individual-Level Barriers to Treatment of Opioid Use Disorders in Rural Appalachia

, , , , &

References

  • Aguboshim, F. C. (2021). Adequacy of sample size in a qualitative case study and the dilemma of data saturation: A narrative review. World Journal of Advanced Research and Reviews, 10(3), 180–187.
  • Al-Harbi, K. S. (2012). Treatment-resistant depression: Therapeutic trends, challenges, and future directions. Patient Preference and Adherence, 6, 369–388. https://doi.org/10.2147/ppa.s29716
  • Allen, S. T., O’Rourke, A., White, R. H., Schneider, K. E., Kilkenny, M., & Sherman, S. G. (2019). Estimating the number of people who inject drugs in a rural county in Appalachia. American Journal of Public Health, 109(3), 445–450. https://doi.org/10.2105/ajph.2018.304873
  • Allen, S. T., Wedlock, P. T., White, R. H., Schneider, K. E., O’Rourke, A., Ahmad, N., Weir, B. W., Kilkenny, M. E., & Sherman, S. G. (2021). Engagement in drug treatment following nonfatal overdose among people who inject drugs in Appalachia. The International Journal on Drug Policy, 93[, 103176. https://doi.org/10.1016/j.drugpo.2021.103176
  • Appalachian Regional Commission. (n.d.b). Addressing Substance Use Disorder in Appalachia. Retrived from Addressing Substance Use Disorder in Appalachia - Appalachian Regional Commission (arc.gov)
  • Bagley, S. M., Schoenberger, S. F., Waye, K. M., & Walley, A. Y. (2019). A scoping review of post opioid-overdose interventions. Preventive Medicine, 128, 105813. https://doi.org/10.1016/j.ypmed.2019.105813
  • Baker, L. S., Smith, W., Gulley, T., & Tomann, M. M. (2020). Community perceptions of comprehensive harm reduction programs and stigma towards people who inject drugs in rural Virginia. Journal of Community Health, 45(2), 239–244. https://doi.org/10.1007/s10900-019-00732-8
  • Beachler, T., Zeller, T. A., Heo, M., Lanzillotta-Rangeley, J., & Litwin, A. H. (2021). Community attitudes toward opioid use disorder and medication for opioid use disorder in a rural Appalachian County. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 37(1), 29–34. https://doi.org/10.1111/jrh.12503
  • Bennett, A. S., Freeman, R., Des Jarlais, D. C., & Aronson, I. D. (2020). Reasons people who use opioids do not accept or carry no-cost naloxone: Qualitative interview study. JMIR Formative Research, 4(12), e22411. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7787889/. https://doi.org/10.2196/22411
  • Bretteville-Jensen, A. L., Lillehagen, M., Gjersing, L., & Andreas, J. B. (2015). Illicit use of opioid substitution drugs: Prevalence, user characteristics, and the association with non-fatal overdoses. Drug and Alcohol Dependence, 147, 89–96. https://doi.org/10.1016/j.drugalcdep.2014.12.002
  • Bunting, A. M., Oser, C. B., Staton, M., Eddens, K. S., & Knudsen, H. (2018). Clinician identified barriers to treatment for individuals in Appalachia with opioid use disorder following release from prison: a social ecological approach. Addiction science & clinical practice, 13, 1–10.
  • Caudarella, A., Dong, H., Milloy, M. J., Kerr, T., Wood, E., & Hayashi, K. (2016). Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs. Drug and Alcohol Dependence, 162, 51–55. https://doi.org/10.1016/j.drugalcdep.2016.02.024
  • Center for Rural Pennsylvania. (n.d). Rural urban definitions. Retrieved from www.rural.pa.gov/data/rural-urban-definitions.
  • Chang, K. C., Lin, C. Y., Chang, C. C., Ting, S. Y., Cheng, C. M., & Wang, J. D. (2019). Psychological distress mediated the effects of self-stigma on quality of life in opioid-dependent individuals: A cross-sectional study. PLoS One, 14(2), e0211033. https://doi.org/10.1371/journal.pone.0211033
  • Cheetham, A., Picco, L., Barnett, A., Lubman, D. I., & Nielsen, S. (2022). The impact of stigma on people with opioid use disorder, opioid treatment, and policy. Substance Abuse and Rehabilitation, 13, 1–12. https://doi.org/10.2147/SAR.S304566
  • Creasy, S. L., Thompson, J. R., Mair, C. F., & Burke, J. G. (2021). Understanding polarizing community perspectives on harm reduction strategies: Challenges to addressing the opioid crisis in Appalachian Pennsylvania. Journal of Appalachian Health, 3(4), 74–88. https://doi.org/10.1056/nejmoa1302507
  • Ellis, K., Walters, S., Friedman, S. R., Ouellet, L. J., Ezell, J., Rosentel, K., & Pho, M. T. (2020). Breaching trust: A qualitative study of healthcare experiences of people who use drugs in a rural setting. Frontiers in Sociology, 5, 593925. https://doi.org/10.3389/fsoc.2020.593925
  • Ezell, J. M., Walters, S., Friedman, S. R., Bolinski, R., Jenkins, W. D., Schneider, J., Link, B., & Pho, M. T. (2021). Stigmatize the use, not the user? Attitudes on opioid use, drug injection, treatment, and overdose prevention in rural communities. Social Science & Medicine (1982), 268, 113470. https://doi.org/10.1016/j.socscimed.2020.113470
  • Fadanelli, M., Cloud, D. H., Ibragimov, U., Ballard, A. M., Prood, N., Young, A. M., & Cooper, H. L. (2020). People, places, and stigma: A qualitative study exploring the overdose risk environment in rural Kentucky. The International Journal on Drug Policy, 85, 102588. https://doi.org/10.1016/j.drugpo.2019.11.001
  • Farhoudian, A., Razaghi, E., Hooshyari, Z., Noroozi, A., Pilevari, A., Mokri, A., Reza Mohammadi, M., & Malekinejad, M. (2022). Barriers and facilitators to substance use disorder treatment: An overview of systematic reviews. Substance Abuse: Research and Treatment, 16(7), 11782218221118462. https://doi.org/10.1177/11782218221118462
  • Goldbarg, R. N., & Brown, E. J. (2010). Gender, personal networks, and drug use among rural African Americans. International Quarterly of Community Health Education, 30(1), 41–54. https://doi.org/10.2190/IQ.30.1.d
  • Guest, G., Namey, E., & Chen, M. (2020). A simple method to assess and report thematic saturation in qualitative research. PLoS One, 15(5), e0232076. https://doi.org/10.1371/journal.pone.0232076
  • Havens, J. R., Oser, C. B., Knudsen, H. K., Lofwall, M., Stoops, W. W., Walsh, S. L., Leukefeld, C. G., & Kral, A. H. (2011). Individual and network factors associated with non-fatal overdose among rural Appalachian drug users. Drug and Alcohol Dependence, 115(1-2), 107–112. https://doi.org/10.1016/j.drugalcdep.2010.11.003
  • Hawk, K., Grau, L. E., Fiellin, D. A., Chawarski, M., O’Connor, P. G., Cirillo, N., … & D’Onofrio, G. (2021). A qualitative study of emergency department patients who survived an opioid overdose: Perspectives on treatment and unmet needs. Academic Emergency Medicine, 28(5), 542–552.
  • Hawk, K., McCormack, R., Edelman, E. J., Coupet, E., Toledo, N., Gauthier, P., … & D’Onofrio, G. (2022). Perspectives about emergency department care encounters among adults with opioid use disorder. JAMA Network Open, 5(1), e2144955–e2144955. https://doi.org/10.1001/jamanetworkopen.2021.44955
  • Hennink, M., & Kaiser, B. N. (2022). Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Social Science & Medicine (1982), 292, 114523. https://doi.org/10.1016/j.socscimed.2021.114523
  • Jacka, B. P., Ziobrowski, H. N., Lawrence, A., Baird, J., Wentz, A. E., Marshall, B. D. L., Wightman, R. S., Mello, M. J., Beaudoin, F. L., & Samuels, E. A. (2022). Implementation and maintenance of an emergency department naloxone distribution and peer recovery specialist program. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 29(3), 294–307. https://doi.org/10.1111/acem.14409
  • Kahn, L. S., Wozniak, M., Vest, B. M., & Moore, C. (2022). “Narcan encounters:” overdose and naloxone rescue experiences among people who use opioids. Substance Abuse, 43(1), 113–126. https://doi.org/10.1080/08897077.2020.1748165
  • Kaczorowski, J., Bilodeau, J., M Orkin, A., Dong, K., Daoust, R., & Kestler, A. (2020). Emergency department–initiated interventions for patients with opioid use disorder: A systematic review. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 27(11), 1173–1182. https://doi.org/10.1111/acem.14054
  • Katzman, J. G., Takeda, M. Y., Greenberg, N., Moya Balasch, M., Alchbli, A., Katzman, W. G., Salvador, J. G., & Bhatt, S. R. (2020). Association of take-home naloxone and opioid overdose reversals performed by patients in an opioid treatment program. JAMA Network Open, 3(2), e200117-e200117. https://doi.org/10.1001/jamanetworkopen.2020.0117
  • Kedia, S. K., Schmidt, M., Dillon, P. J., Arshad, H., & Yu, X. (2021). Substance use treatment in Appalachian Tennessee amid COVID-19: Challenges and preparing for the future. Journal of Substance Abuse Treatment, 124, 108270. https://doi.org/10.1016/j.jsat.2020.108270
  • Khatri, U. G., Samuels, E. A., Xiong, R., Marshall, B. D., Perrone, J., & Delgado, M. K. (2022). Variation in emergency department visit rates for opioid use disorder: Implications for quality improvement initiatives. The American Journal of Emergency Medicine, 51, 331–337. https://doi.org/10.1001/jamanetworkopen.2020.5852
  • Kruis, N. E., McLean, K., & Perry, P. (2021). Exploring first responders’ perceptions of medication for addiction treatment: Does stigma influence attitudes? Journal of Substance Abuse Treatment, 131, 108485. https://doi.org/10.1016/j.jsat.2021.108485
  • Kruis, N. E., McLean, K., Perry, P., & Nackley, M. K. (2022). First responders’ views of naloxone: Does stigma matter? Substance Use & Misuse, 57(10), 1534–1544. https://doi.org/10.1080/10826084.2022.2092150
  • Lai, J. T., Goldfine, C. E., Chapman, B. P., Taylor, M. M., Rosen, R. K., Carreiro, S. P., & Babu, K. M. (2021). Nobody wants to Be Narcan’d: A pilot qualitative analysis of drug users’ perspectives on naloxone. The Western Journal of Emergency Medicine, 22(2), 339–345. https://doi.org/10.5811/westjem.2020.10.48768
  • Martin, A., Butler, K., Chavez, T., Herring, A., Wakeman, S., Hayes, B. D., & Raja, A. (2020). Beyond buprenorphine: Models of follow-up care for opioid use disorder in the emergency department. The Western Journal of Emergency Medicine, 21(6), 257–263. https://doi.org/10.5811/westjem.2020.7.46079
  • McGuire, A. B., Powell, K. G., Treitler, P. C., Wagner, K. D., Smith, K. P., Cooperman, N., Robinson, L., Carter, J., Ray, B., & Watson, D. P. (2020). Emergency department-based peer support for opioid use disorder: Emergent functions and forms. Journal of Substance Abuse Treatment, 108, 82–87. https://doi.org/10.1016/j.jsat.2019.06.013
  • Macmadu, A., Gurka, K. K., Linn, H. I., Smith, G. S., & Feinberg, J. (2023). Factors associated with non-evidence-based overdose responses among people who use prescription opioids non-medically in rural Appalachia. Substance Use & Misuse, 58(2), 163–170. https://doi.org/10.1080/10826084.2022.2135967
  • Meit, M., Heffernan, M., & Tanenbaum, E. (2019). Investigating the impact of the diseases of despair in Appalachia. Journal of Appalachian Health, 1(2), 7–18. https://doi.org/10.13023/jah.0102.02.
  • Olfson, M., Wall, M., Wang, S., Crystal, S., & Blanco, C. (2018). Risks of fatal opioid overdose during the first year following nonfatal overdose. Drug and Alcohol Dependence, 190, 112–119. https://doi.org/10.1016/j.drugalcdep.2018.06.004
  • Otachi, J. K., Vundi, N., & Surratt, H. L. (2020). Examining factors associated with non-fatal overdose among people who inject drugs in rural Appalachia. Substance Use & Misuse, 55(12), 1935–1942. https://doi.org/10.1080/10826084.2020.1781179
  • Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality & Quantity, 52(4), 1893–1907. https://doi.org/10.1007/s11135-017-0574-8
  • Schalkoff, C. A., Lancaster, K. E., Gaynes, B. N., Wang, V., Pence, B. W., Miller, W. C., & Go, V. F. (2020). The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases. Substance Abuse, 41(1), 35–69. https://doi.org/10.1080/08897077.2019.1635555
  • Sigmon, S. C. (2014). Access to treatment for opioid dependence in rural America: Challenges and future directions. JAMA Psychiatry, 71(4), 359–360. https://doi.org/10.1001/jamapsychiatry.2013.4450
  • Snell-Rood, C., Willging, C., Showalter, D., Peters, H., & Pollini, R. A. (2021). System-level factors shaping the implementation of “hub and spoke” systems to expand MOUD in rural areas. Substance Abuse, 42(4), 716–725. https://doi.org/10.1080/08897077.2020.1846149
  • Stewart, M. T., Coulibaly, N., Schwartz, D., Dey, J., & Thomas, C. P. (2021). Emergency department–based efforts to offer medication treatment for opioid use disorder: What can we learn from current approaches? Journal of Substance Abuse Treatment, 129, 108479. https://doi.org/10.1016/j.jsat.2021.108479
  • Stone, E. M., Kennedy-Hendricks, A., Barry, C. L., Bachhuber, M. A., & McGinty, E. E. (2021). The role of stigma in US primary care physicians’ treatment of opioid use disorder. Drug and Alcohol Dependence, 221, 108627. https://doi.org/10.1016/j.drugalcdep.2021.108627
  • Strang, J., McDonald, R., Campbell, G., Degenhardt, L., Nielsen, S., Ritter, A., & Dale, O. (2019). Take-home naloxone for the emergency interim management of opioid overdose: The public health application of an emergency medicine. Drugs, 79(13), 1395–1418. https://doi.org/10.1007/s40265-019-01154-5
  • U.S. Government Accountability Office. (2021). Drug Misuse: Most States Have Good Samaritan Laws and Research Indicates They May Have Positive Effects. GAO-21-243. Washington, DC: 1–57.
  • Walker, D. M., Lefebvre, R. C., Davis, A., Shiu-Yee, K., Chen, S., Jackson, R. D., Helme, D. W., Oga, E. A., Oser, C. B., Stotz, C., Balvanz, P., Asman, K., Holloway, J., Lewis, N., & Knudsen, H. K. (2024). Differences in perceptions of community stigma towards opioid use disorder between community substance use coalition members and the general public. Journal of Substance Use and Addiction Treatment, 158, 209276. https://doi.org/10.1016/j.josat.2023.209276
  • Whipple, C. R., Kaynak, Ö., Kruis, N. E., Saylor, E., Bonnevie, E., & Kensinger, W. S. (2023). Opioid use disorder stigma and support for harm reduction in rural counties. Substance Use & Misuse, 58(14), 1818–1828. https://doi.org/10.1080/10826084.2023.2250434
  • Young, A. M., Rudolph, A. E., Quillen, D., & Havens, J. R. (2014). Spatial, temporal and relational patterns in respondent-driven sampling: Evidence from a social network study of rural drug users. Journal of Epidemiology and Community Health, 68(8), 792–798. https://doi.org/10.1136/jech-2014-203935
  • Zamawe, F. C. (2015). The implication of using NVivo software in qualitative data analysis: Evidence-based reflections. Malawi Medical Journal: The Journal of Medical Association of Malawi, 27(1), 13–15. https://doi.org/10.4314/mmj.v27i1.4
  • Zeller, T. A., Beachler, T., Diaz, L., Thomas, R. P., Heo, M., Lanzillotta-Rangeley, J., & Litwin, A. H. (2022). Attitudes toward syringe exchange programs in a rural Appalachian community. Journal of Addictive Diseases, 40(2), 227–234. https://doi.org/10.1080/10550887.2021.1979837
  • Zibbell, J., Howard, J., Clarke, S. D., Ferrell, A., & Karon, S. (2019). Non-fatal opioid overdose and associated health outcomes: Final summary report. US Department of Health and Human Services, 33, 1–23.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.