"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.

The implementation of harm reduction strategies, such as take-home naloxone, has led to people who use drugs (PWUD) playing a crucial role in responding to overdose events. However, their perspectives on overdose response are often underrepresented in public health policy and practice. To address this gap, a community-based research team, known as the Research with Expert Advisors on Drug Use (READU) team, conducted a study to examine PWUD's perspectives on first response services for overdose. The team, which includes both academically trained researchers and individuals with lived experience of drug use, conducted 13 semi-structured interviews with PWUD in King County. The goal of the study was to understand how PWUD can be better supported in their role as overdose responders and to identify ways to improve interactions between PWUD and emergency medical services (EMS). The study's findings highlight the importance of PWUD in overdose response, with many participants having successfully reversed an overdose themselves. However, the data also reveals that PWUD have mixed feelings about EMS involvement in overdose response, citing concerns about stigma and coercion. Furthermore, the study found that police response to overdose events can have a negative impact on peer overdose response, with participants reporting past experiences of arrest and harassment by police during overdose response. This has led to a reluctance among PWUD to call 911 during an overdose, highlighting the need for improved interactions between EMS and PWUD. The study suggests that addressing these concerns and improving relationships between EMS and PWUD could have a positive impact on future responses, including increasing PWUD's willingness to call for help during an overdose. By centering the perspectives of PWUD, this study provides valuable insights into how to better support this critical group of individuals in their role as overdose responders. Link: https://pubmed.ncbi.nlm.nih.gov/40156033/