ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2023
"I've been to more of my friends' funerals than I've been to my friends' weddings": Witnessing and responding to overdose in rural Northern New England.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 21 citations in OpenAlex.
- Article
- "You've involved us knowing that we don't think about the law like you": a qualitative study on Supersavers' perspective of overdose engagement in Skåne county, South Sweden.Harm reduction journal · 2026Article
- Correlates of Rural Naloxone Possession Among People Who Use Drugs: A Multi-State Cross-Sectional Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Understanding the role of overdose witnesses: responses and characteristics of people who inject drugs in Oakland and San Francisco.Harm reduction journal · 2026Article
- Examining trends in polydrug overdose deaths across rural Midwest counties in the United States, 2022 through 2024.Drug and alcohol dependence · 2025Article
- Predictors of non-transport by emergency medical services after a nonfatal opioid overdose: a national analysis.Health affairs scholar · 2025Article
- "I don't let anybody die on my watch": perspectives on the intersection of community overdose response and emergency medical services among people who use drugs in Seattle, WA.Harm reduction journal · 2025Article
- Strategies used to reduce harms associated with fentanyl exposure among rural people who use drugs: multi-site qualitative findings from the rural opioid initiative.Harm reduction journal · 2024Article
- "Expected to happen": perspectives on post-release overdose from recently incarcerated people with opioid use disorder.Harm reduction journal · 2024Article
- Overdose responses among rural people who use drugs: A multi-regional qualitative study.Harm reduction journal · 2024Article
- Association of spatial proximity to fixed-site syringe services programs with HCV serostatus and injection equipment sharing practices among people who inject drugs in rural New England, United States.Harm reduction journal · 2024Article
- Exploring trauma and wellbeing of people who use drugs after witnessing overdose: A qualitative study.The International journal on drug policy · 2023Article
- Opioid-related mortality: Dynamic temporal and spatial trends by drug type and demographic subpopulations, Massachusetts, 2005-2021.Drug and alcohol dependence · 2023Article
- I Don't Believe a Person Has to Die When Trying to Get High: Overdose Prevention and Response Strategies in Rural Illinois.International journal of environmental research and public health · 2023Article
- HCV serostatus and injection sharing practices among those who obtain syringes from pharmacies and directly and indirectly from syringe services programs in rural New England.Addiction science & clinical practice · 2023Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
purposeOverdose is a leading cause of death among people who use drugs (PWUDs), but policies to reduce fatal overdose have had mixed results. Summaries of naloxone access and Good Samaritan Laws (GSLs) in prior studies provide limited information about local context. Witnessing overdoses may also be an important consideration in providing services to PWUDs, as it contributes to post traumatic stress disorder (PTSD) symptoms, which complicate substance use disorder treatment.
methodsWe aim to estimate the prevalence and correlates of witnessing and responding to an overdose, while exploring overdose context among rural PWUD. The Drug Injection Surveillance and Care Enhancement for Rural Northern New England (DISCERNNE) mixed-methods study characterized substance use and risk behaviors in 11 rural Massachusetts, Vermont, and New Hampshire counties between 2018 and 2019. PWUD completed surveys (n = 589) and in-depth interviews (n = 22).
findingsAmong the survey participants, 84% had ever witnessed an overdose, which was associated with probable PTSD symptoms. Overall, 51% had ever called 911 for an overdose, though some experienced criminal legal system consequences despite GSL. Although naloxone access varied, 43% had ever used naloxone to reverse an overdose.
conclusionsPWUD in Northern New England commonly witnessed an overdose, which they experienced as traumatic. Participants were willing to respond to overdoses, but faced barriers to effective overdose response, including limited naloxone access and criminal legal system consequences. Equipping PWUDs with effective overdose response tools (education and naloxone) and enacting policies that further protect PWUDs from criminal legal system consequences could reduce overdose mortality.
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