Naloxone Stigma Among People Who Use Drugs: Characteristics and Associations With Stigma Toward Medication for Opioid Use Disorder.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-09-04 DOI:10.1097/ADM.0000000000001377
Devin E Banks, Xiao Li, Brandon Park, Rachel P Winograd, Patricia Cavazos-Rehg
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Abstract

Objectives: Widespread naloxone distribution is key to mitigating opioid-related morbidity, but stigma remains a barrier. Naloxone stigma among providers, emergency responders, and the public is well-documented and associated with treatment and policy preferences, but little is known about naloxone stigma among people who use drugs (PWUD), who may be overdose first responders. This study examines naloxone stigma, its correlates, and its association with stigma toward medication for opioid use disorder (MOUD) among PWUD.

Methods: We recruited 293 individuals with a history of substance misuse from facilities that provide substance use and/or health care services (retained n = 195, 54% women, 75% White). Participants completed self-report measures, including the 5-item Naloxone-Related Risk Compensation Beliefs scale.

Results: One in 5 respondents agreed with beliefs that access to naloxone leads to more opioid use and less treatment seeking and is "enabling." Those with nonopioid drug misuse, without prior overdose, and with fewer recovery attempts endorsed more naloxone stigma. Opioid misuse, prior overdose, and MOUD utilization were also inversely associated with MOUD stigma. There were no demographic differences in either stigma type. Naloxone stigma was positively associated with MOUD stigma in adjusted models.

Conclusions: This is the first study to quantitatively examine naloxone stigma among PWUD. Findings emphasize the potential role of overdose education and naloxone distribution among those earlier in the substance use disorder course and who use nonopioid drugs. They support integrating MOUD stigma interventions into current overdose education and naloxone distribution targeted at PWUD to increase the acceptance and uptake of both medications.

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吸毒者对纳洛酮的成见:吸毒者对纳洛酮的成见:对阿片类药物使用障碍的成见的特征和关联。
目标:广泛分发纳洛酮是降低阿片类药物相关发病率的关键,但耻辱感仍是一个障碍。纳洛酮在医疗服务提供者、急救人员和公众中的耻辱感是有据可查的,并且与治疗和政策偏好相关,但对于可能是用药过量第一响应者的吸毒者(PWUD)的纳洛酮耻辱感却知之甚少。本研究探讨了纳洛酮耻辱感及其相关性,以及纳洛酮耻辱感与吸毒者对阿片类药物使用障碍(MOUD)的耻辱感之间的关联:我们从提供药物使用和/或医疗保健服务的机构中招募了 293 名有药物滥用史的人(保留 n = 195,54% 为女性,75% 为白人)。参与者完成了自我报告测量,包括 5 项纳洛酮相关风险补偿信念量表:每 5 名受访者中就有 1 人同意这样的观点,即获得纳洛酮会导致更多阿片类药物的使用,减少寻求治疗的次数,并且是 "有利的"。非阿片类药物滥用者、无吸毒过量前科者和康复尝试较少者更认同纳洛酮耻辱感。阿片类药物滥用、既往用药过量和使用 MOUD 也与 MOUD 成见成反比。两种鄙视类型均无人口统计学差异。在调整模型中,纳洛酮鄙视与MOUD鄙视呈正相关:这是第一项定量研究 PWUD 中纳洛酮污名化的研究。研究结果强调了在药物使用障碍早期和使用非阿片类药物的人群中开展用药过量教育和发放纳洛酮的潜在作用。他们支持将 MOUD 耻辱干预措施纳入当前针对吸毒成瘾者的用药过量教育和纳洛酮发放工作中,以提高这两种药物的接受度和使用率。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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