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An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases

The street homeless, those who spend their nights either in shelters or unofficial camps, whether in tents on a street or in society’s hidden spaces such as beneath an overpass, face multiple challenges beyond finding a safe place to sleep. Of further concern is how official actions can worsen these...

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Autores principales: Durieux, Jared, Curtis, Andrew, Mirka, Melissa, Jefferis, Eric, Felix, Chaz, Essel, Baaba
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954857/
https://www.ncbi.nlm.nih.gov/pubmed/35328837
http://dx.doi.org/10.3390/ijerph19063149
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author Durieux, Jared
Curtis, Andrew
Mirka, Melissa
Jefferis, Eric
Felix, Chaz
Essel, Baaba
author_facet Durieux, Jared
Curtis, Andrew
Mirka, Melissa
Jefferis, Eric
Felix, Chaz
Essel, Baaba
author_sort Durieux, Jared
collection PubMed
description The street homeless, those who spend their nights either in shelters or unofficial camps, whether in tents on a street or in society’s hidden spaces such as beneath an overpass, face multiple challenges beyond finding a safe place to sleep. Of further concern is how official actions can worsen these situations, through day-to-day activities or planned intervention strategies. In this paper we explore how a planned intervention may be negatively perceived—even as a form of “structural violence”—and may prevent Narcan (naloxone) use to stop an overdose related death in the Skid Row of Los Angeles. Data for this study consisted of a combination of Spatial Video Geonarratives (SVGs) and 325 incident reports from the Homeless Health Care Los Angeles Center for Harm Reduction (HHCLA-HRC) between November 2014 and December 2015. Chi-square and simple logistic regression models were used to examine the association between fear-of-arrest and other covariates of interest. Mapping results are presented with different sets of shapefiles created for (1) all Narcan uses, (2) all homeless, (3) all homeless with a worry about being arrested, (4) all Narcan uses where an ambulance attended, (5) and the same as 4 but also with police attendance. In the multivariable model, the estimated adjusted odds of fear-of-arrest is over three times higher among Narcan users ages 30–39 when compared to users under the age of 30. Analyzing the association of calling 9-1-1 on Narcan user demographics, socio-contextual characteristics, and overdose victim demographics, the crude estimated probability of calling 9-1-1 for Narcan users aged 50 and older is nearly three times higher when compared to Narcan users aged 19–29. Conclusion: Results suggest that the fear-of-arrest and calling 9-1-1 during an overdose is still a concern among Narcan users despite protective legislation and access to harm reduction resources.
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spelling pubmed-89548572022-03-26 An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases Durieux, Jared Curtis, Andrew Mirka, Melissa Jefferis, Eric Felix, Chaz Essel, Baaba Int J Environ Res Public Health Article The street homeless, those who spend their nights either in shelters or unofficial camps, whether in tents on a street or in society’s hidden spaces such as beneath an overpass, face multiple challenges beyond finding a safe place to sleep. Of further concern is how official actions can worsen these situations, through day-to-day activities or planned intervention strategies. In this paper we explore how a planned intervention may be negatively perceived—even as a form of “structural violence”—and may prevent Narcan (naloxone) use to stop an overdose related death in the Skid Row of Los Angeles. Data for this study consisted of a combination of Spatial Video Geonarratives (SVGs) and 325 incident reports from the Homeless Health Care Los Angeles Center for Harm Reduction (HHCLA-HRC) between November 2014 and December 2015. Chi-square and simple logistic regression models were used to examine the association between fear-of-arrest and other covariates of interest. Mapping results are presented with different sets of shapefiles created for (1) all Narcan uses, (2) all homeless, (3) all homeless with a worry about being arrested, (4) all Narcan uses where an ambulance attended, (5) and the same as 4 but also with police attendance. In the multivariable model, the estimated adjusted odds of fear-of-arrest is over three times higher among Narcan users ages 30–39 when compared to users under the age of 30. Analyzing the association of calling 9-1-1 on Narcan user demographics, socio-contextual characteristics, and overdose victim demographics, the crude estimated probability of calling 9-1-1 for Narcan users aged 50 and older is nearly three times higher when compared to Narcan users aged 19–29. Conclusion: Results suggest that the fear-of-arrest and calling 9-1-1 during an overdose is still a concern among Narcan users despite protective legislation and access to harm reduction resources. MDPI 2022-03-08 /pmc/articles/PMC8954857/ /pubmed/35328837 http://dx.doi.org/10.3390/ijerph19063149 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Durieux, Jared
Curtis, Andrew
Mirka, Melissa
Jefferis, Eric
Felix, Chaz
Essel, Baaba
An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases
title An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases
title_full An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases
title_fullStr An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases
title_full_unstemmed An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases
title_short An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases
title_sort exploration of narcan as a harm reduction strategy and user’s attitudes toward law enforcement involvement in overdose cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954857/
https://www.ncbi.nlm.nih.gov/pubmed/35328837
http://dx.doi.org/10.3390/ijerph19063149
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