scholarly journals MP29: Community based naloxone usability testing

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S52-S53
Author(s):  
S. VandenBerg ◽  
G. Harvey ◽  
J. Martel ◽  
S. Gill ◽  
J. McLaren
Keyword(s):  
Harm Reduction ◽  
Lived Experience ◽  
Motor Vehicle ◽  
Opioid Antagonist ◽  
Opioid Overdose ◽  
Data Sampling ◽  
Art And Design ◽  
University Of Alberta ◽  
Human Centred Design ◽  
The Way

Background: In Alberta in 2016 more people died from an opioid overdose than from motor vehicle crashes. Naloxone is an opioid antagonist - it can reverse an opioid overdose for a period of 30 to 60 minutes. Naloxone kits are available free at emergency departments and community organizations around the province with training provided at the point of pickup. It is possible that training may be refused or may be forgotten and people are often left to rely solely on the instructions included in the kit. Human centred design can improve the way people interact with overdose instructions. Aim Statement: This study will measure the effectiveness and usefulness of prototype community naloxone kit instructions over a six month period of time (2018) in Calgary and Edmonton with the aim to use human centred design principles to improve the way people interpret emergency overdose response directions. Measures & Design: Information design experts engaged people with lived experience to provide a process map outlining the current role that educational materials and instructions for community naloxone kits play in responding to an opioid overdose. Alberta Health Services (AHS) Human Factors, in collaboration with AHS harm reduction developed the protocol and administered pre- and post-questionnaire and specific ‘performance checkpoints’ intended to measure effectiveness and usefulness. A simulated overdose including a mannequin, injection trainer and anatomical paper diagram was designed and a community naloxone kit with instructions setting was provided. Participants were recruited through harm reduction nurses with pre-existing clinical relationships (experienced group), family and friends of people who use opioids and general public (non-experienced) through the University of Alberta Faculty of Art and Design. Evaluation/Results: A total of 30 voluntary participants provided their informed consent and engaged in a simulated overdose scenario using a set of prototype instructions developed by a professional information designer. Through repeated data sampling, the following points were observed and will be integrated in the next iteration of design: It isn't clear to people what opioids are. It isn't clear to people that giving a dose of naloxone will not harm a person, especially if they have not overdosed. Almost none of the participants called 911. People seem to read pictures and text equally in the non-experienced group, but in the experienced group, typically read the pictures. Many participants stated that they knew how to do rescue breaths, but did not perform them correctly. Performing the procedure is a not the same as being asked about how to perform the procedure. Discussion/Impact: Even with new instructional prototypes, many participants identified components that were unclear or confusing. The experienced group made less mistakes than the non-experienced group. They seemed to be more invested or interested in saving a friend's life. These instructions will go through another round of design to incorporate feedback from end users. The final product will be part of a larger provincial emergency medicine initiative that includes participant led design and education around emergency response in opioid overdose settings.

Community Based Naloxone Kits

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Gillian HARVEY ◽  
Stephanie VANDENBERG
Keyword(s):  
Lived Experience ◽  
Motor Vehicle ◽  
User Behavior ◽  
Opioid Antagonist ◽  
Opioid Overdose ◽  
Community Based ◽  
Health Crisis ◽  
Opioid Crisis ◽  
Wide Availability ◽  
Pilot Work

The opioid crisis in Alberta is a public health crisis. In 2016, more people died from an opioid poisoning than from motor vehicle crashes. Naloxone is an opioid antagonist which means that it can reverse an opioid overdose for a period of 30–60 minutes, at which point, the overdose may return. In December 2015, the Take Home Naloxone (THN) Program was rolled out in response to the opioid crisis. Under the renamed the Community Based Naloxone Kit Program (CBNP), naloxone kits are now available free of cost at many pharmacies and community clinics around Alberta. The wide availability has led to a new challenge—that the kits may be used by people who have received little to no training.Some may encounter the kit instructions for the first time when there is an emergency in which they need to administer an injection urgently to someone who has passed out. Studies have found that most overdoses occur in the presence of another person—this provides an opportunity for someone to intervene. People often die from witnessed opioid poisonings because other people do not know what to do to help. A pilot study conducted through community partnerships involved 30 participants in two different urban centres (Edmonton and Calgary) who self identified as either experienced in substance use or friends/family of people with lived experience has revealed some interesting findings.Qualitative observations and data collected in the initial pilot work show that end users are experiencing unique challenges in accessing opioid education and have challenges using instructions on how to administer naloxone in an overdose setting. User testing and observation of user behavior has great potential to support educational material for opioid awareness.Human-centred design approaches that gather information with and about people using antidote kits are urgently needed in order to mitigate risk and ensure successful administration of first aid and naloxone in an emergency.

Harm Reduction in Prisons

2018 ◽  
Author(s):  
Kathryn Snow ◽  
Michael Levy
Keyword(s):  
Harm Reduction ◽  
Opioid Antagonist ◽  
Opioid Overdose ◽  
International Human Rights Law ◽  
Negative Consequences ◽  
Human Rights Law ◽  
Community Settings ◽  
First Line ◽  
Exchange Programs ◽  
History Of

Interventions intended to minimize the harms of injecting drug use, particularly drug overdose and exposure to blood-borne viruses, have a long history of implementation in some community settings but are frequently unavailable in prisons. The denial of harm reduction measures to prisoners who inject drugs violates their right to non-discriminatory healthcare, as well as other facets of international human rights law. Evidence is available from several programs in diverse settings which demonstrates that it is possible to implement many harm reduction interventions in prisons, that such programs can reduce the risk of drug-related harms, and that concerns regarding unintended negative consequences of such programs are often unfounded. This chapter provides an overview of the key harm reduction measures relevant to the prison setting, with a particular focus on the provision of sterile injecting equipment to prisoners via needle and syringe exchange programs, and on the provision of the opioid antagonist naloxone as first-line treatment for opioid overdose to people while in prison and on leaving prison. The chapter reviews the legal basis for providing these and other harm reduction measures to prisoners, outlines the evidence that supports specific interventions, and highlights topics on which further research is needed.

Changing Law from Barrier to Facilitator of Opioid Overdose Prevention

2013 ◽  
Vol 41 (S1) ◽  
pp. 33-36 ◽  
Author(s):  
Corey Davis ◽  
Damika Webb ◽  
Scott Burris
Keyword(s):  
Motor Vehicle ◽  
Unintentional Injury ◽  
The United States ◽  
Opioid Antagonist ◽  
Opioid Overdose ◽  
Injury Death ◽  
Overdose Prevention ◽  
Vehicle Accidents ◽  
The Brain ◽  
Hispanic White

Drug overdose has recently surpassed motor vehicle accidents to become the leading cause of unintentional injury death in the United States. The epidemic is largely driven by opioids such as oxycodone, hydrocodone, and methadone, which kill more Americans than heroin and cocaine combined. The demographics of overdose have changed over the past few decades as well: according to the latest data, the average overdose victim is now a non-Hispanic white man aged 45-54.These deaths — over 16,000 per year — are almost entirely preventable. Opioid overdose kills by slowly depressing respiration, a process that can take several hours. It can be quickly and effectively reversed by the timely administration of naloxone, an opioid antagonist that works by displacing opioids from the brain receptors to which they attach, reversing their depressant effect. Naloxone, also known as Narcan, has many benefits and minimal risks. Although it is a prescription drug, it is not a controlled substance and has no abuse potential.

scholarly journals Harm Reduction Interventions to Prevent Overdose Deaths

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Jonathan Harris
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Lived Experience ◽  
Public Understanding ◽  
Opioid Overdose ◽  
Current Crisis ◽  
Overdose Prevention ◽  
Prevention Interventions ◽  
Informal Supports ◽  
Overdose Deaths

Overdose deaths have been occurring at high rates in many parts of Canada. From January 2016 (when national surveillance began) to March 2019, an estimated 12,800 Canadians died of an opioid overdose.1 In addition to opioid-related harms, stimulants such as methamphetamine have re-emerged in some regions and are also contributing to the current rise in overdose deaths. COVID-19 has resulted in a more compromised illicit drug supply, and those who use drugs have had limited access to formal and informal supports because of public health measures regarding physical distancing. As a result, overdose deaths have increased during the pandemic. Harm reduction approaches provide a mechanism to prevent overdose deaths and have additional health and public safety benefits. The current crisis has been exacerbated by COVID-19; therefore, it is an appropriate time to consider the entire continuum of harm reduction approaches available to reduce preventable overdose deaths. People with lived experience of drug use should be meaningfully included in policy discussions about harm reduction and overdose prevention interventions. This would enhance the person-centredness of programs and ensure they are reflective of the lived realities of those who use drugs. Although societal attitudes about drug use are changing, harm reduction interventions remain politically contentious. Countering stigma, being prepared to engage with community concerns, and clearly articulating that harm reduction services are intended to complement and not replace drug treatment are all important in enhancing public understanding of harm reduction.

scholarly journals Civil society involvement in harm reduction drug policy: reflections on the past, expectations for the future

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aileen O’Gorman ◽  
Eberhard Schatz
Keyword(s):  
Civil Society ◽  
Harm Reduction ◽  
Lived Experience ◽  
Political Institutions ◽  
Drug Policy ◽  
Policy Development ◽  
Policy Decision ◽  
People Who Use Drugs ◽  
Annual Conference ◽  
Health Crisis

Abstract Background A range of civil society organisations (CSOs) such as drug user groups, non-governmental/third sector organisations and networks of existing organisations, seek to shape the development of drugs policy at national and international levels. However, their capacity to do so is shaped by the contexts in which they operate nationally and internationally. The aim of this paper is to explore the lived experience of civil society participation in these contexts, both from the perspective of CSOs engaged in harm reduction advocacy, and the institutions they engage with, in order to inform future policy development. Methods This paper is based on the presentations and discussions from a workshop on ‘Civil Society Involvement in Drug Policy hosted by the Correlation - European Harm Reduction Network at the International Society for the Study of Drugs Policy (ISSDP) annual conference in Paris, 2019. In the aftermath of the workshop, the authors analysed the papers and discussions and identified the key themes arising to inform CSI in developing future harm reduction policy and practice. Results Civil society involvement (CSI) in policy decision-making and implementation is acknowledged as an important benefit to representative democracy. Yet, the accounts of CSOs demonstrate the challenges they experience in seeking to shape the contested field of drug policy. Negotiating the complex workings of political institutions, often in adversarial and heavily bureaucratic environments, proved difficult. Nonetheless, an increase in structures which formalised and resourced CSI enabled more meaningful participation at different levels and at different stages of policy making. Conclusions Civil society spaces are colonised by a broad range of civil society actors lobbying from different ideological standpoints including those advocating for a ‘drug free world’ and those advocating for harm reduction. In these competitive arena, it may be difficult for harm reduction orientated CSOs to influence the policy process. However, the current COVID-19 public health crisis clearly demonstrates the benefits of partnership between CSOs and political institutions to address the harm reduction needs of people who use drugs. The lessons drawn from our workshop serve to inform all partners on this pathway.

scholarly journals Designing a Graphic Novel: Engaging Community, Arts, and Culture Into Public Health Initiatives

2021 ◽  
Vol 22 (1_suppl) ◽  
pp. 35S-43S
Author(s):  
Sarah Febres-Cordero ◽  
Athena D. F. Sherman ◽  
Joseph Karg ◽  
Ursula Kelly ◽  
Lisa M. Thompson ◽  
...  
Keyword(s):  
Public Health ◽  
Service Industry ◽  
Community Setting ◽  
Graphic Novel ◽  
Community Advisory Board ◽  
Opioid Antagonist ◽  
Dissemination And Implementation ◽  
Opioid Overdose ◽  
Negative Stereotypes ◽  
Community Based Research

The opioid epidemic was declared a national public health emergency in 2017. In Georgia, standing orders for the opioid antagonist, naloxone, have been implemented to reduce mortality from opioid overdoses. Service industry workers in the Atlanta, Georgia, inner-city community of Little Five Points (L5P) have access to naloxone, potentially expanding overdose rescue efforts in the community setting. To explore the issues facing L5P, our research brings together qualitative descriptive inquiry, ethnography, community-based research, a community advisory board, and a local artist to maximize community dissemination of research findings through a graphic novel that describes encountering an opioid overdose. This format was chosen due to the ethical responsibility to disseminate in participants’ language and for its potential to empower and educate readers. This article describes the process of working on this study with the community and a local artist to create sample pages that will be tested for clarity of the message in a later phase. Working with an artist has revealed that while dissemination and implementation for collaboration begin before findings are ready, cross-collaboration with the artist requires early engagement, substantial funding, artist education in appropriate content, and member checking to establish community acceptability altering illustrations that reinforce negative stereotypes. By sharing the experiences of actions taken during an opioid overdose in L5P through a graphic novel, we can validate service industry workers’ experiences, acknowledge their efforts to contribute to harm reduction, and provide much-needed closure to those who encounter opioid overdoses in the community.

THE WOMAN'S PART: THE SPEAKING BELOVED IN ROMAN ELEGY

2013 ◽  
Vol 63 (1) ◽  
pp. 329-338 ◽  
Author(s):  
Megan O. Drinkwater
Keyword(s):  
Gender Roles ◽  
Lived Experience ◽  
First Century ◽  
Power Structures ◽  
Love Affair ◽  
Gender Inequity ◽  
The Way

Roman elegy is well known for its reversal of traditional Roman gender roles: women are presented in positions of power, chiefly but not exclusively erotic, that bear little or no relation to women's lived experience in the first centuryb.c.e. Yet the way elegy presents the beloved in a position of power over her lover, as Sharon James has observed, ‘retains standard Roman social and power structures, thus suggesting an inescapable inequity even within a private love affair: rather than sharing goals and desires, lover and beloved are placed in a gendered opposition … Hence resistant reading by thedominais an anticipated and integral part of the genre’. James's remark is indeed correct for each of the instances in which thedomina, or female beloved, speaks directly. When she does so, as James also shows, she speaks at cross-purposes with her lover, following a script that is designed ‘to destabilize him’ in an attempt to keep his interest. Yet what has not been noticed is that when the beloved is instead male, the situation is quite different. Tibullus' Marathus in poem 1.8, our sole example of a male elegiac beloved-turned-speaker, is the exception that proves the fundamental rule of gender inequity. Marathus, that is, when given the opportunity to speak, does in fact share the aims of a male lover, albeit in pursuit of his ownpuella. When the gendered opposition so integral to elegy is erased, the beloved no longer protests against the strictures of the genre; when both are male, lover and beloved alike are entitled to speak as elegiac lovers.

scholarly journals LISTENING TO LAW

2017 ◽  
Vol 33 (1) ◽  
pp. 47
Author(s):  
Robert YELḰÁTŦE Clifford
Keyword(s):  
Lived Experience ◽  
Indigenous People ◽  
Place Identity ◽  
Law School ◽  
Legal Tradition ◽  
Self Reflection ◽  
Donne Lieu ◽  
The Way

My journey to better understand and to live my own WSÁNEĆ legal tradition has always been both complex and incredibly rewarding.  This journey has, at times, also come with its challenges and tensions, including through law school and academia.  Through the use of story I reflect upon this path of learning, and many of my own thoughts and experiences along the way.  I have learned, and continue to learn, from many different people along this path, and I am so grateful to each of them.  While this story is primarily a self-reflection, the themes and tensions that the character of this story (Cedar) embodies may resonant with many Indigenous people.  These themes include family, community, place, identity, stories, law and culture.  Each of these themes comes together and to life in this story through lived experience and my own empowering moments of living and coming to better understand WSÁNEĆ law.  Ultimately, writing this story helped me in a moment when I needed it.  My hope is that you too can find something helpful and rewarding within this story, and that you can use that along your own path. Le périple que j’ai fait pour mieux comprendre et vivre ma propre tradition juridique dans la communauté WSÁNEĆ a toujours été à la fois complexe et incroyablement enrichissant. Bien entendu, cette expérience a également donné lieu à des défis et des tensions, notamment à l’école de droit et dans le milieu universitaire. À l’aide d’un récit, je décris mon cheminement et bon nombre de mes propres réflexions et expériences connexes. Tout au long de mon parcours, j’ai appris et je continue d’apprendre auprès de nombreuses personnes différentes et je leur en suis infiniment reconnaissant. Bien que ce récit soit d’abord et avant tout une autoréflexion, il se pourrait que de nombreux Autochtones retrouvent une part d’eux-mêmes dans les thèmes abordés et les tensions vécues par le personnage central (Cedar). Qu’il s’agisse de la famille, de la communauté, du lieu, de l’identité, du droit ou de la culture, j’aborde chacun de ces thèmes en décrivant des expériences réelles et le cheminement qui m’a permis de mieux comprendre la loi WSÁNEĆ. En définitive, l’écriture de ce récit s’est révélée une expérience positive pour moi à un moment où j’avais besoin d’aide. J’espère que vous trouverez à votre tour des éléments utiles et éclairants dans ce récit et que vous pourrez vous en inspirer au cours de votre propre cheminement. 

scholarly journals “Man-as-Environment”: Spatialising Racial and Natural Otherness in Caryl Phillips’s A Distant Shore and In the Falling Snow // “Man-as-Environment”: Espacializar la alteridad racial y natural en dos novelas de Caryl Phillips

2014 ◽  
Vol 5 (1) ◽  
pp. 155-174
Author(s):  
Jessica Maufort
Keyword(s):  
Social Justice ◽  
Lived Experience ◽  
Sense Of Place ◽  
Postcolonial Studies ◽  
Caryl Phillips ◽  
The Absolute ◽  
British Novels ◽  
De Man ◽  
City Of London ◽  
The Way

Examining Caryl Phillips’s later fiction (A Distant Shore and In the Falling Snow) through the characters’ lived experience of their environment, this article seeks to pave the way toward a mutually enriching dialogue between postcolonial studies and urban ecocriticism. Phillips’s British novels show how Western racist/colonial underpinnings that persist in a postcolonial context are manifest in the phenomenon of spatialisation of race. The latter devises separate spaces of Otherness, imbued with savage connotations, where the undesirable Other is ostracised. The enriching concept of “man-in-environment” is thus reconfigured so that the postcolonial subject’s identity is defined by such bias-constructed dwelling-places. Consequently, the Other’s sense of place is a highly alienated one. The decayed suburban nature and the frightening/impersonal city of London are also “othered” entities with which the protagonists cannot interrelate. My “man-as-environment” concept envisions man and place as two subjected Others plagued by spatialisation of Otherness. The latter actually debunks the illusion of a postcolonial British Arcadia, as the immigrants’ plight is that of an antipastoral disenchantment with England. The impossibility of being a “man-in-place” in a postcolonial context precisely calls for a truly reconciling postpastoral relationship between humans and place, a relationship thus informed by the absolute need for environmental and social justice combined. Resumen Analizando las últimas novelas de Caryl Phillips (A Distant Shore y In the Falling Snow) a través de la experiencia del (medio)ambiente que viven los personajes, este artículo persigue enriquecer el diálogo entre los estudios postcoloniales y la ecocrítica urbana. Las ficciones británicas de Phillips desvelan cómo las bases racistas/coloniales occidentales que persisten en un contexto poscolonial se hacen evidentes en el fenómeno de la espacialización racial. Éste elabora espacios aparte de alteridad, impregnados de salvajes connotaciones, donde el indeseable “Otro” es excluido. El enriquecedor concepto de “man-in-environment” es reconfigurado de manera que la identidad del sujeto poscolonial acaba definiéndose por tan sesgados lugares de residencia. En consecuencia, el sentido del espacio del “Otro” está muy alienado. La decadente naturaleza suburbana y la aterradora e impersonal ciudad de Londres son también entidades ajenas con las cuales los protagonistas no pueden interactuar. Mi concepto de “man-as-environment” concibe al hombre y al lugar como dos “Otros” sometidos, acosados por la espacialización de la alteridad. Esto último desacredita la ilusión de una Arcadia poscolonial británica, en tanto que los aprietos de los emigrantes es tal que se crea un desencanto antipastoril con Inglaterra. La imposibilidad de ser un “man-in-place” en un contexto poscolonial demanda precisamente una auténtica y reconciliadora relación postpastoril entre hombres y lugares, es decir, una relación caracterizada por la absoluta necesidad de aunar justicia social y medioambiental. 

A Life Lived

2017 ◽  
Author(s):  
Jin Y. Park
Keyword(s):  
Lived Experience ◽  
Buddhist Philosophy ◽  
Western Philosophy ◽  
Philosophy Of Life ◽  
Different Dimensions ◽  
Male Dominated ◽  
The Way

Chapter 7 aims to identify the nature of women’s Buddhist philosophy. Iryŏp’s approach to Buddhism also directs us to different dimensions in which women encounter Buddhist philosophy, which is identified as narrative philosophy, philosophy of life, based on lived experience. By examining Kim Iryŏp’s life and philosophy as a paradigmatic example of women’s philosophy in connection with Buddhism, this chapter brings attention to the way women engage with Buddhism and philosophy and offers a way of philosophizing that challenges the male dominated and Western philosophy based mode of philosophizing.

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