Patient perspectives of barriers to naloxone obtainment and use in a primary care, underserved setting: A qualitative study

Background: Gaps in naloxone obtainment and use are not well studied, particularly among minoritized groups. Objective: To describe patient perspectives that serve as barriers to naloxone obtainment and the number of patients who obtained naloxone in a primarily African American population in a primary care, underserved setting. Methods: This qualitative study conducted semi-structured interviews and included 36 adults who were prescribed naloxone at a federally qualified health center using convenience sampling. Participants answered survey questions describing naloxone acceptability, perceived risk for overdose, and barriers to naloxone use. Results: Sixty-nine percent of the patients were Black or African American. The majority of patients attempted to fill their naloxone at a local pharmacy (69%) and reported no difficulties (88%). Five major themes revealed: overall positive views of naloxone because it saves lives; existing knowledge gaps related to indications for naloxone prescription; stigma surrounding receiving a naloxone prescription; inadequacies of the patient education provided; and the role providers play in naloxone receptivity Conclusions: Among a majority African American population, many perceived naloxone to be lifesaving. However, stigmatizing perceptions and inability to recall patient education contribute to a perception of low overdose risk. Further research describing the impact of the opioid epidemic on underrepresented groups is necessary.