Evidence map›Paper›PMID 42053203›Full record

ArticleAddiction (Abingdon, England)2026

'If you've ever experienced it, you'd feel differently': Exploring willingness and skepticism toward using higher dose naloxone products among people who use drugs in Maryland, United States.

Laura N Sisson, Richard S Rousch, Lucas G Hill, Claire M Zagorski, Tricia Triece, Saba Rouhani, Jill Owczarzak, Susan G Sherman, Kristin E Schneider

Abstract read
In one paragraph

Article in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

9 authors.

Laura N SissonDepartment of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.ORCID https://orcid.org/0000-0002-6964-8150
Richard S RouschDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Lucas G HillSchool of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.ORCID https://orcid.org/0000-0001-5958-0159
Claire M ZagorskiCollege of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
Tricia TrieceDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Saba RouhaniCollege of Global Public Health, New York University, New York, NY, USA.
Jill OwczarzakDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Susan G ShermanDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Kristin E SchneiderDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.

Funding

Bloomberg American Health Initiative
6 · The paper itself

Abstract

BACKGROUND AND

aimsHigher dose naloxone products (HDN) have recently been approved and marketed in the United States; however, evidence on the relative advantage of these products to standard 4 mg products has not been substantiated by prior research. People who use drugs are the primary beneficiaries and consumers of naloxone products. This study aimed to characterize their willingness to use HDN products and technical understanding of these products. DESIGN AND MEASUREMENTS: We conducted in-depth interviews with syringe service program clients following an interview guide. Interviews were recorded and transcribed before being analyzed using a hybrid deductive-inductive qualitative approach.

settingInterviews were conducted in partnership with community-based syringe service programs in three distinct regions of the state of Maryland, USA: a rural county, Baltimore city and a surrounding suburban community.

participantsTwenty-two interviews were completed. All participants had used opioids and responded to an overdose using naloxone in the past 3 months. The majority of participants were men (73%), non-Hispanic white (64%) and currently experiencing housing instability (59%).

findingsParticipants demonstrated high willingness to use HDN, motivated by volatility in the local drug supply and perceived inefficiency of naloxone against potent synthetic opioids. Participants believed that the relative advantage of HDN was that it would reverse overdoses more quickly than existing products; however, many participants wanted increased control in overdose situations, including the ability to titrate and combine dosages to reduce the severity of precipitated withdrawal. Skepticism towards HDN products was rooted in general skepticism of pharmaceutical companies, as well as the belief that perceptions of lower dose naloxone being ineffective could be attributed to user error.

conclusionsDevelopment of novel overdose reversal products should be informed by the experiences of primary consumers and beneficiaries of these products. A high level of transparency is needed in the marketing of these products to promote consumer trust and confidence in their safety and utility.

Indexed as

Drug OverdoseNaloxoneNarcotic AntagonistsOpioid-Related DisordersAdultFemaleHumansMaleMarylandMiddle AgedYoung AdultNaloxoneNarcotic Antagonistshigh dosenaloxoneopioidsoverdosepharmaceutical mistrustqualitativexylazine

Identifiers

PMID42053203
PMCPMC13486917

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.