Perspectives of opioid users on overdose recognition, naloxone administration, and attitudes.

Background: There has been a rise in opioid overdose deaths, despite harm reduction efforts like naloxone distribution. Naloxone is effective but underused due to knowledge gaps and stigma. Aim: To assess opioid users' knowledge regarding overdose and attitudes, experiences toward naloxone. Materials and Methods: This cross-sectional study was conducted from August 2024 to May 2025 at a Deaddiction center. Participants with opioid use disorder were interviewed using a semistructured performa and the Brief Opioid Overdose Knowledge questionnaire to assess opioid users' knowledge and attitudes toward naloxone. Results: Our study involved 501 participants, mostly males (mean age = 27.16 years) with substance use averaging 6.5 years. Nearly half had overdose history, with serious outcomes common. Knowledge, overdose recognition, and overdose response scores varied significantly based on factors like history of overdose, awareness and use of naloxone, education, and socioeconomic status. Knowledge about naloxone was low, with mixed attitudes and significant barriers like stigma and poor access. Conclusion: Our study reveals that despite naloxone's proven efficacy in reversing opioid overdoses, its use is limited by stigma, poor awareness, and restricted access. Enhancing harm reduction education and destigmatization through tailored community interventions is vital to preventing overdose fatalities.