Evidence map›Paper›PMID 39278156›Full record

ArticleThe International journal on drug policy2024

A mixed methods study to inform fatal overdose prevention in San Diego, California: Perspectives from people who use drugs.

Katie Bailey, Arielle Schecter, William H Eger, Chad C J Justin Valasek, Steffanie A Strathdee, Amy Knox, Alicia Harvey-Vera, Carlos F Vera, Shira M Goldenberg, Angela Robertson Bazzi and 1 more

Abstract read
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In one paragraph

Article in The International journal on drug policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Katie BaileySchool of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
Arielle SchecterDepartment of Family Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
William H EgerSchool of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; School of Social Work, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
Chad C J Justin ValasekSchool of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
Steffanie A StrathdeeSchool of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: sstrathdee@health.ucsd.edu.
Amy KnoxHarm Reduction Coalition of San Diego, "On Point", 5565 Grossmont Center Drive, Bldg 1, Suite 214, La Mesa, CA 91942, USA.
Alicia Harvey-VeraSchool of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
Carlos F VeraSchool of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
Shira M GoldenbergSchool of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, USA.
Angela Robertson BazziHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
Peter J DavidsonSchool of Medicine, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.

Funding

VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SUSAN JANET LITTLE · 1994 to 2026
$78.4M
Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Marketsand Drug TourismR01DA049644 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI STRATHDEE, STEFFANIE A. · 2020 to 2024
$8.2M
Training Program in Substance Use, HIV and Related InfectionsT32DA023356 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Natasha Martin, Steffanie A Strathdee · 2007 to 2026
$7.8M
NIAID NIH HHS P30 AI036214NIDA NIH HHS R01 DA049644NIDA NIH HHS T32 DA023356
6 · The paper itself

Abstract

backgroundIn the United States, community overdose education and naloxone distribution (OEND) programs have demonstrated efficacy in reducing opioid-related mortality. OEND programs have expanded across San Diego County, California, but differential naloxone accessibility among people who use drugs (PWUD) has not been assessed. We examined factors that shape individual naloxone accessibility in San Diego.

methodsWe employed a convergent parallel mixed methods design using surveys (n = 194) and qualitative interviews (n = 20). Ordinal logistic regression examined factors associated with individual naloxone accessibility (i.e., the frequency with which participants could access naloxone within five minutes, categorized as never, sometimes, or always). Qualitative interviews explored participant perceptions of naloxone accessibility and whether and how they maintained naloxone. We organized multilevel findings into a modified social-ecological model.

resultsIn quantitative and qualitative samples, participants were majority male (72 % and 70 % respectively), non-White race/ethnicity (55 % and 75 %), with an average age around 42 years. In the quantitative sample, 24 % never had personally accessible naloxone, 52 % sometimes did, and 24 % always did. Factors independently associated with individual naloxone accessibility were female gender (Adjusted Odds Ratio [AdjOR]: 2.51, 95 % Confidence Interval [CI]: 1.31-4.85), monthly income <$500 (AdjOR: 0.42, 95 %CI:0.19, 0.90), witnessing an overdose (AdjOR: 3.51, 95 %CI:1.67-7.55), and knowing where to get free naloxone (AdjOR: 3.44, 95 %CI: 1.79-6.75). Qualitative data suggested that naloxone was generally easy to acquire in San Diego due to community harm reduction outreach and mutual aid among peers, albeit community barriers including distance to harm reduction providers and frequent relocation/displacement for those experiencing homelessness. Individual attitudes toward overdose risk, naloxone, and community responsibility contributed to varied individual naloxone accessibility.

conclusionsThis study highlights multilevel factors influencing individual naloxone accessibility among people who use drugs in San Diego, emphasizing the importance of harm reduction outreach and peer-to-peer support. We identified opportunities for interventions that address both individual attitudes and community-level barriers to improve naloxone accessibility.

Indexed as

Drug OverdoseHealth Services AccessibilityNaloxoneNarcotic AntagonistsAdultCaliforniaDrug UsersFemaleHumansMaleMiddle AgedOpioid-Related DisordersSurveys and QuestionnairesYoung AdultNaloxoneNarcotic AntagonistsHarm reductionNaloxoneOverdose preventionPeople who use drugs

Identifiers

PMID39278156
PMCPMC11789787

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.