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“They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto

BACKGROUND: Amid increasing opioid overdose deaths in Canada since 2010 and a changing naloxone access landscape, there is a need for up-to-date research on Canadian women’s experiences with opioids. Studies on Canadian take-home naloxone programs are promising, but research beyond these programs is...

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Autores principales: Macleod, Emilie R., Tajbakhsh, Iren, Hamilton-Wright, Sarah, Laliberte, Nancy, Wiese, Jessica L., Matheson, Flora I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980746/
https://www.ncbi.nlm.nih.gov/pubmed/33743756
http://dx.doi.org/10.1186/s13011-021-00360-3
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author Macleod, Emilie R.
Tajbakhsh, Iren
Hamilton-Wright, Sarah
Laliberte, Nancy
Wiese, Jessica L.
Matheson, Flora I.
author_facet Macleod, Emilie R.
Tajbakhsh, Iren
Hamilton-Wright, Sarah
Laliberte, Nancy
Wiese, Jessica L.
Matheson, Flora I.
author_sort Macleod, Emilie R.
collection PubMed
description BACKGROUND: Amid increasing opioid overdose deaths in Canada since 2010 and a changing naloxone access landscape, there is a need for up-to-date research on Canadian women’s experiences with opioids. Studies on Canadian take-home naloxone programs are promising, but research beyond these programs is limited. Our study is the first to focus on women’s experiences and perspectives on the opioid crisis in Ontario, Canada’s most populous province, since the opioid crisis began in 2010. OBJECTIVE: Our objective was to address research knowledge gaps involving Canadian women with criminal justice involvement who use opioids, and identify flaws in current policies, responses, and practices. While the opioid overdose crisis persists, this lack of research inhibits our ability to determine whether overdose prevention efforts, especially involving naloxone, are meeting their needs. METHODS: We conducted semi-structured, qualitative interviews from January to April 2018 with 10 women with experience of opioid use. They were recruited through the study’s community partner in Toronto. Participants provided demographic information, experiences with opioids and naloxone, and their perceptions of the Canadian government’s responses to the opioid crisis. Interviews were transcribed verbatim and inductive thematic analysis was conducted to determine major themes within the data. RESULTS: Thematic analysis identified seven major concerns despite significant differences in participant life and opioid use experiences. Participants who had used illicit opioids since naloxone became available over-the-counter in 2016 were much more knowledgeable about naloxone than participants who had only used opioids prior to 2016. The portability, dosage form, and effects of naloxone are important considerations for women who use opioids. Social alienation, violence, and isolation affect the wellbeing of women who use opioids. The Canadian government’s response to the opioid crisis was perceived as inadequate. Participants demonstrated differing needs and views on ideal harm reduction approaches, despite facing similar structural issues surrounding stigma, addiction management, and housing. CONCLUSIONS: Participants experienced with naloxone use found it to be useful in preventing fatal overdose, however many of their needs with regards to physical, mental, and social health, housing, harm reduction, and access to opioid treatment remained unmet. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13011-021-00360-3.
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spelling pubmed-79807462021-03-22 “They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto Macleod, Emilie R. Tajbakhsh, Iren Hamilton-Wright, Sarah Laliberte, Nancy Wiese, Jessica L. Matheson, Flora I. Subst Abuse Treat Prev Policy Research BACKGROUND: Amid increasing opioid overdose deaths in Canada since 2010 and a changing naloxone access landscape, there is a need for up-to-date research on Canadian women’s experiences with opioids. Studies on Canadian take-home naloxone programs are promising, but research beyond these programs is limited. Our study is the first to focus on women’s experiences and perspectives on the opioid crisis in Ontario, Canada’s most populous province, since the opioid crisis began in 2010. OBJECTIVE: Our objective was to address research knowledge gaps involving Canadian women with criminal justice involvement who use opioids, and identify flaws in current policies, responses, and practices. While the opioid overdose crisis persists, this lack of research inhibits our ability to determine whether overdose prevention efforts, especially involving naloxone, are meeting their needs. METHODS: We conducted semi-structured, qualitative interviews from January to April 2018 with 10 women with experience of opioid use. They were recruited through the study’s community partner in Toronto. Participants provided demographic information, experiences with opioids and naloxone, and their perceptions of the Canadian government’s responses to the opioid crisis. Interviews were transcribed verbatim and inductive thematic analysis was conducted to determine major themes within the data. RESULTS: Thematic analysis identified seven major concerns despite significant differences in participant life and opioid use experiences. Participants who had used illicit opioids since naloxone became available over-the-counter in 2016 were much more knowledgeable about naloxone than participants who had only used opioids prior to 2016. The portability, dosage form, and effects of naloxone are important considerations for women who use opioids. Social alienation, violence, and isolation affect the wellbeing of women who use opioids. The Canadian government’s response to the opioid crisis was perceived as inadequate. Participants demonstrated differing needs and views on ideal harm reduction approaches, despite facing similar structural issues surrounding stigma, addiction management, and housing. CONCLUSIONS: Participants experienced with naloxone use found it to be useful in preventing fatal overdose, however many of their needs with regards to physical, mental, and social health, housing, harm reduction, and access to opioid treatment remained unmet. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13011-021-00360-3. BioMed Central 2021-03-20 /pmc/articles/PMC7980746/ /pubmed/33743756 http://dx.doi.org/10.1186/s13011-021-00360-3 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Macleod, Emilie R.
Tajbakhsh, Iren
Hamilton-Wright, Sarah
Laliberte, Nancy
Wiese, Jessica L.
Matheson, Flora I.
“They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto
title “They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto
title_full “They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto
title_fullStr “They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto
title_full_unstemmed “They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto
title_short “They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto
title_sort “they’re not doing enough.”: women’s experiences with opioids and naloxone in toronto
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980746/
https://www.ncbi.nlm.nih.gov/pubmed/33743756
http://dx.doi.org/10.1186/s13011-021-00360-3
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