Falling out and getting back up: Women's opiate overdose experiences and Naloxone accessibility

Background: A variety of factors contribute to accidental overdose; fatal overdose usually does not happen instantaneously.  In recent years, legislation to make opiate antagonists, such as Naloxone, more readily available has proliferated. The extant literature on opiate overdoses have overlooked or neglected the topic of gender. Understanding the interplay of gender and opiate overdose and treatment is essential to the reduction of overdose mortality.  Methods:  This exploratory study delves into the subjective experiences of women with opiate overdose and reversal via Naloxone. A non-profit community partner, that offers harm reduction services and overdose reversal training, participated in the research process. The community partner identified opiate overdose a key component. Participants included individuals who identified as women, ages 18 and older, and who injected opiates within the past 30 days. Demographic surveys and semi-structured interviews collected data on opiate overdose experiences and knowledge, attitudes, and beliefs about Naloxone. Thematic analysis identified commonalities among participant responses. Results: Dominant themes referred to participants witnessing another person overdosing and the steps taken to address the overdose.  Additional themes regarded participants own overdose experiences, when applicable, their reactions, and the actions of others, and finally, not hesitating to save a life when Naloxone is available.  Conclusions: These results provide information important to the development of opiate antagonist programs that include peer-delivery and the implementation/ evaluation of Naloxone policies.  In particular, these results are important to the performance development and service delivery of the current overdose mortality prevention efforts of the harm reduction partner.