Often Overlooked Barriers to Naloxone Use in a Small Rural Southwest US County

Background: Rio Arriba County, New Mexico, USA, has one of the highest per capita opioid overdose death rates in the country despite the many resources being put toward harm reduction efforts, especially the promotion of naloxone as an OOD reversal tool. To understand if there are barriers to the use of naloxone in the county, and to understand what those barriers might be, a study was conducted involving two groups of stakeholders: people who use opioids and first responders. Methods: Two, 1-hour focus groups were used combined with thematic analysis to understand the perspective of county stakeholders who see OODs take place in the region. Results: After thematic analysis, the primary themes identified included Stigma, Accessibility, and Education and Training. Those who use opioids suggest barriers to naloxone use include avoidance of law enforcement, lack of it when it is most needed, reluctance to carrying it, and lack of training about how and when to use it. Conclusions: Based on the results, researchers recommended redefining accessibility, training in Good Samaritan laws especially for law enforcement, and general training and education for the public, including businesses so that they make naloxone accessibility in the community.