ArticleHarm reduction journal2026
"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.
Article in Harm reduction journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03570099 (Naloxone Treatment in Skåne County - Effect on Drug-related Mortality and Overdose-related Complications), which is not on this map. Not yet cited in PubMed.
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Naloxone Treatment in Skåne County - Effect on Drug-related Mortality and Overdose-related Complications
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2 authors.
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Abstract
backgroundPeople with illicit opioid use have a high risk of overdose related morbidity and mortality. A small group of Supersavers (i.e., individuals who have administered naloxone on three or more overdose occasions) carries a substantial burden by managing a high proportion of overdose reversals. Despite their critical role, little is known about how Supersavers' experiences of repeated overdose reversals, their own overdose risks and its mitigation, or the support needed to sustain their engagement. This study examines Supersavers' contextual experiences, their views on risks, responsibility, and overdose engagement, and their need for healthcare support.
methodsSemi-structured interviews were conducted with thirteen Supersavers recruited from Malmö needle and syringe program. Thematic analysis was conducted whereupon analysis was guided by Bourdieu's theories on habitus, capital and field and Rhode's 'risk environment' framework.
resultsSupersavers were deeply committed to helping others and widely recognized for their skills, often having managed multiple overdoses prior to naloxone availability. This responsibility functioned as an embodied readiness to act, reflecting a habitus shaped through repeated exposure and supported by experiential ("street") capital, including technical skills and peer trust. Access to training and naloxone strengthened this capacity, increasing perceived safety and reducing the physical and emotional burden of overdose reversals. While repeated exposure to overdose contributed to normalization, it also involved cumulative emotional strain, and most participants had not sought professional support despite experiencing multiple traumas.
conclusionThese findings show how Supersavers' practices emerge through the interplay of habitus, capital, and risk environment, where engagement is sustained by responsibility yet shaped by structural constraints. Strengthening harm reduction responses requires not only continued access to naloxone and training, but also accessible, context-sensitive healthcare support that addresses both Supersavers' own overdose risk and the emotional burden associated with repeated reversals.
trial registrationNCT03570099, registered on 26 June 2018.
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