Recipient reaction: “now they’re sober and they’re broke”
anger, overdose, adverse recipient reaction
WASTED, SAID
Participants expressed that when they used naloxone to reverse someone’s overdose, they were often met with anger and frustration upon the recipient’s revival. Participants offered various explanations for these reactions, including loss of high, acute withdrawal symptoms, and frustration of having spent limited funds on drugs they can no longer feel the effects of.Several participants had experienced overdose reversal themselves and empathized with their peers’ response. Apprehension about administering naloxone was often rooted in first-hand knowledge of overdose reversal discomfort. Participants described rapid-onset withdrawal symptoms associated with overdose reversal. One participant explained that she had been angry with people in the past for using naloxone on her because, Often, recipients’ negative reactions to overdose reversal stemmed from the loss of high in addition to the physiological withdrawal symptoms described above. Nine participants spoke to recipients’ Some participants (n = 3) explained that the recipients’ reactions upon revival were driven in part by feelings of having lost or “wasted” money, a feature of the Some of them are just like, "That's the only money I got. If you Narcan me and I go back to being completely sober, I'm going to be mad because, pretty much, I bought those drugs for nothing. I'm not going to feel them, and I'm not going to be able to get anymore," which, even as an addict, it's crazy to me. I just couldn't imagine being in that min7dset and thinking that that high is more important than me waking up.– Female, County 4Participants often administered naloxone Two participants said that anticipation of the recipient’s reaction made them delay naloxone administration or exhaust alternative options prior to trying naloxone. One participant explicitly stated that naloxone was a last resort: Participants overcame barriers to administering naloxone by weighing the consequences of naloxone administration (e.g., adverse recipient reaction) against the consequences of doing nothing (fatal overdose). The C2H intervention helped participants overcome barriers by providing access to naloxone (reducing scarcity, actual and perceived), increasing confidence in naloxone administration through training, and reducing fear of 