Stigma and criminal-legal systems: “wear a badge, they think they’re better than everyone else”
overdose, arrest, trauma
ARREST
Stigma codified and perpetuated by law enforcement obstructed some participants’ comfort with carrying naloxone. Because all participants were criminal-legal system involved, relationships with law enforcement were rooted in prior conflict and experienced trauma. Several participants (n = 5) described law enforcement stigma as something that had made them hesitant to carry naloxone:There's times I have been stopped, afraid the law would try to charge me with something... But [that was] before I got into the CARE2HOPE. Once I got into this program, it lightened my feelings up on if I got stopped, because [Narcan] actually helps people…I realized not to worry if I've got it, because it's actually to help people.– Male, County 7In this participant’s case, the intervention mitigated the impact of police stigma. Through engaging with naloxone training, he both enhanced his positive feelings toward naloxone and reduced his fear of consequences to carrying it. Another participant explained that the desire to be prepared to respond to overdose outweighed the fear of arrest: Community-level stigma, defined as experienced and anticipated judgment from community members, was less salient to participants’ decisions to carry naloxone. Some reported that carrying naloxone was normalized in his community, stating, In addition to stigma, participants who opted not to carry naloxone (n = 10) offered various reasons for their decision. Two participants explained that their preference not to carry naloxone was rooted in a desire to distance themselves from social network members who use drugs: “I keep [my naloxone] at home… I don’t mess with nobody that does drugs. I stay away from them.” Others (n = 5) simply expressed a preference for keeping naloxone in their drawer or medicine cabinet. One participant explained that she was currently residing in a crisis stabilization center and was unable to carry naloxone:Where I’m at in this crisis home right now, there’s not really a need [to carry naloxone]. They also have to lock it up. I’m not really allowed to have anything… I can get [the naloxone] if I need it, but I can’t carry it.– Female, County 7While some participants’ experiences 