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

Author

Listed:
  • 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)

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.

Suggested Citation

  • Jared Durieux & Andrew Curtis & Melissa Mirka & Eric Jefferis & Chaz Felix & Baaba Essel, 2022. "An Exploration of Narcan as a Harm Reduction Strategy and User’s Attitudes toward Law Enforcement Involvement in Overdose Cases," IJERPH, MDPI, vol. 19(6), pages 1-13, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:6:p:3149-:d:766137
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    References listed on IDEAS

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    1. Quan-Hoang Vuong & Tam-Tri Le & Viet-Phuong La & Huyen Thanh Thanh Nguyen & Manh-Toan Ho & Quy Khuc & Minh-Hoang Nguyen, 2022. "Covid-19 vaccines production and societal immunization under the serendipity-mindsponge-3D knowledge management theory and conceptual framework," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-12, December.
    2. Majid Ezzati & Ari B Friedman & Sandeep C Kulkarni & Christopher J L Murray, 2008. "The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States," PLOS Medicine, Public Library of Science, vol. 5(4), pages 1-12, April.
    3. DeVerteuil, Geoffrey, 2015. "Conceptualizing violence for health and medical geography," Social Science & Medicine, Elsevier, vol. 133(C), pages 216-222.
    4. Andrew Curtis & Chaz Felix & Susanne Mitchell & Jayakrishnan Ajayakumar & Peter R. Kerndt, 2018. "Contextualizing Overdoses in Los Angeles's Skid Row between 2014 and 2016 by Leveraging the Spatial Knowledge of the Marginalized as a Resource," Annals of the American Association of Geographers, Taylor & Francis Journals, vol. 108(6), pages 1521-1536, November.
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