I Don’t Believe a Person Has to Die When Trying to Get High: Overdose Prevention and Response Strategies in Rural Illinois

Suzan M. Walters (), Marisa Felsher, David Frank, Jessica Jaiswal, Tarlise Townsend, Brandon Muncan, Alex S. Bennett, Samuel R. Friedman, Wiley Jenkins, Mai T. Pho, Scott Fletcher and Danielle C. Ompad
Additional contact information
Suzan M. Walters: Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA
Marisa Felsher: College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA
David Frank: Center for Drug Use and HIV/HCV Research, New York, NY 10003, USA
Jessica Jaiswal: Department of Health Science, University of Alabama, Tuscaloosa, AL 35487, USA
Tarlise Townsend: Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
Brandon Muncan: Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
Alex S. Bennett: Center for Drug Use and HIV/HCV Research, New York, NY 10003, USA
Samuel R. Friedman: Center for Drug Use and HIV/HCV Research, New York, NY 10003, USA
Wiley Jenkins: Department of Population Science and Policy, SIU School of Medicine, Springfield, IL 62702, USA
Mai T. Pho: Department of Medicine, University of Chicago, Chicago, IL 60637, USA
Scott Fletcher: The Community Action Place, Murphysboro, IL 62966, USA
Danielle C. Ompad: Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA

IJERPH, 2023, vol. 20, issue 2, 1-14

Abstract: Background: Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths. Methods: Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service providers) from rural southern Illinois. Data were analyzed using constant comparison and theoretical sampling methods. Results: Participants were concerned about the growing presence of fentanyl in both opioids and stimulants, and many disclosed overdose experiences. Strategies participants reported using to lower overdose risk included purchasing drugs from trusted sellers and modifying drug use practices by partially injecting and/or changing the route of transmission. Approximately half of persons who inject drugs sampled had heard of fentanyl test strips, however fentanyl test strip use was low. To reverse overdoses, participants reported using cold water baths. Use of naloxone to reverse overdose was low. Barriers to naloxone access and use included fear of arrest and opioid withdrawal. Conclusions: People who inject drugs understood fentanyl to be a potential contaminant in their drug supply and actively engaged in harm reduction techniques to try to prevent overdose. Interventions to increase harm reduction education and information about and access to fentanyl test strips and naloxone would be beneficial.

Keywords: overdose; fentanyl; people who inject drugs; harm reduction; polydrug use (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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