In a recent study published in the International Journal of Drug Policy, it was determined that opiate addicts had a high awareness of naloxone (Narcan). However, their attitudes and practices with naloxone were varied and not all addicts were inclined to carry naloxone to prevent overdoses. This study provides us with some insight into the world of the addict and what they are thinking. Here are some key takeaways from this study.
Naloxone (Narcan) Enables Addicts to Increase Opioid Doses
There it is. The ugly side affect of giving Naloxone to anyone and everyone has allowed users to increase their doses without fear of repercussions.
…some participants expressed strong statements that naloxone access changed their use behaviours in term of quantity and frequency. One participant stated that âyou can do plenty more [heroin] if you have Narcan, because the chances of overdosing are much greaterâ (Participant 02, 26 year old female). Several participants described different ways naloxone access changed opioid use patterns. For example, one participant described how a userâs wife would remain sober while he used, âYep, I have it [naloxone]. My wife has it, she stays right next to me, I get high. In case I die, then they give it to meâ (Participant 08, 34 year old male).
Others talked about how naloxone diminished concerns about mortality associated with opioid overdose, such as, âIâve seen people, instead of doing four bags theyâll do eight because theyâve got the Narcan laying aroundâ (Participant 02, 26year old female). These users talked about how naloxone access allowed them to chase a bigger high,
Iâve seen a couple of my friends use it’s like a…[]… just a security. They would get high knowing they have it, knowing they can fall [out], trying to get to that place to be able to fall out [overdose] and then have someone bring them back. (Participant 17, 26 year old male).
Another participant talked about how naloxone was âan excuse just to be more dangerous, I guess, do a bigger shotâ (Participant 02, 26 year old female).
The âsafety netâ aspect of naloxone was particularly important for those who suspected heroin was cut with fentanyl. For example, one participant discussed asking a fellow user to get his naloxone kit ready because he knew the opioid he was about to use had fentanyl in it and was going to use anyway. Others discussed the idea of tolerance dictating if/when naloxone would be needed. One participant felt he did not need to have naloxone available because âwhen youâre consistently buying the same product, you know what you can handle and what you canâtâ (Participant 13, 24 year old male). He continued, talking about the uncertainty with this approach, particularly for users with a lower tolerance.
“but there were certain people, say like me and another buddy, weâd go down with two other people, people who donât have too much of a high tolerance, we go, âOkay, wait âtil we try it first and let you know how it is, and weâre gonna let you know what you can handle.â (Participant 13, 24 year old male).”
Addicts are Engaging in âSurvival Sellingâ
Addicts are Engaging in âSurvival SellingâIt’s not surprise to street cops that heroin addicts will sell to support their habit. Now we have it in a study.
Participants talked about how they would engage in âsurvival selling,â or selling drugs in order to fund their own opioid use, and how they would want to have naloxone while doing so (participants, not researchers, developed and used this term). Selling was fairly common, with five participants (25%) indicating they had sold drugs or participated in âsurvival selling.â Several participants talked about this, particularly those with a longer history of opioid use.
This same person also talked about how she would supply her clients with nalxone and that she had used it multiple times on others in the past year.
Iâve been the one to supply them [naloxone kits], because my fellow users theyâve never tried to reach out and get help, but they have asked me for the kits.” This participant talked about how she had 10 or 11 kits in the past year alone and used seven of them on fellow users.
Addicts are Using While Driving Their Cars
As a Drug Recognition Expert, I’ve made over 1,000 arrests for drugged driving. I’ve learned that addicts are often driving under the influence and are using while driving. This puts all of us at risk. This excerpt from the study shows the depth of the problem.
…participants talked about how they would keep naloxone kits in their cars, âthrow it in their glove box, or in their centre consoleâ (Participant 09, 27 year old male). This is particularly important as participants described an urgency to use opioids, and preferred to use in locations that were quickly available. For some participants this meant they would use in the car. While some would use when the car was stationary, others talked about using opioids while driving, including one participant who talked about how âpeople that sniff it, you can just drive down the road, have someone hold the wheel, hurry up, snort it, and youâre done. Itâs not the smartest thing to do, but a lot of people do itâ (Participant 08, 34 year old male). Therefore, keeping naloxone in the car may provide a quick access point for such individuals, despite potentially risky driving behaviours (such as using opioids while operating a vehicle) that may result.
