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

Jared Durieux, Andrew Curtis, Melissa Mirka, Eric Jefferis, Chaz Felix and Baaba Essel
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Jared Durieux: College of Public Health, Kent State University, Kent, OH 44242, USA
Andrew Curtis: Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
Melissa Mirka: College of Public Health, Kent State University, Kent, OH 44242, USA
Eric Jefferis: College of Public Health, Kent State University, Kent, OH 44242, USA
Chaz Felix: Tulare County Health and Human Services Agency, Visalia, CA 93277, USA
Baaba Essel: College of Public Health, Kent State University, Kent, OH 44242, USA

IJERPH, 2022, vol. 19, issue 6, 1-13

Abstract: 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.

Keywords: homeless; naloxone; Narcan; spatial video geonarratives; skid row; police; harm reduction (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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