‘We are the first responders’: overdose response experiences and perspectives among peers in British Columbia

Abstract

Aims

Peers, i.e. people with lived/living experience of substance use, are at the forefront of harm reduction initiatives in British Columbia, yet they often lack recognition for their contributions. This study aims to understand the role of peers in overdose response settings and their experiences interacting with emergency service providers (ESPs) within the context of the Good Samaritan Drug Overdose Act (GSDOA).

Methods

Telephone interviews were conducted with 42 people aged 16 years and older, who were likely to witness and respond to overdoses. Participants were asked about their experiences witnessing or responding to overdoses, and interactions with ESPs. Interview transcripts were analyzed thematically.

Findings

Peers were often the first to respond to overdoses due to their positioning and saw themselves as having unique expertise in responding to overdoses and connecting with other people who use substances. However, peers perceived several barriers that impacted their ability to respond, including stigmatizing attitudes toward ESPs, lack of recognition, and lack of adequate resources.

Conclusions

While policies, such as the GSDOA are in place to promote calling 9-1-1, peers feel confident and competent in responding to overdoses and often consider calling 9-1-1 a waste of resources. There is a need to better recognize and support peers as first responders in overdose contexts.

Keywords:

• First responder
• peers
• overdose response

Acknowledgments

We would like to thank the participants, peer research assistants, and the peer advisors from the Professionals for Ethical Engagement (PEEP) and Peer2Peer for their contributions. We would also like to acknowledge the Harm Reduction Services team at the British Columbia Centre for Disease Control (BCCDC) for their operational support with this project. We are indebted to the people with lived/living experiences across the province who are dedicated to being on the frontline to save lives from drug overdoses during the ongoing dual public health emergencies in BC. We also respectfully acknowledge that we live and work on the unceded traditional territory of the Coast Salish Peoples, including the traditional territories of xʷməθkwəy̓əm (Musqueam), Sḵwxw̱u7mesh (Squamish), and Səlἰ lwətaɬ) Nations.

Ethical approval

The study received Behavioral Research Ethics approval from the University of British Columbia Research Ethics Board (REB #: H19-01842). All interview participants provided fully informed verbal consent for participation.

Health and safety

All mandatory health and safety procedures have been complied with in the course of conducting this study.

Author contributions

JB is the principal investigator for this study. JX was involved in data collection. ZM, JL, EA, and JX conducted the initial coding. ZM and JL did the thematic analysis and interpretation for this manuscript. ZM, JL, and AG wrote the initial draft of the manuscript. ZM, JL, JX, BP, EA, SB, JB, and AG reviewed and edited the manuscript. All authors read and approved the final version.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Notes

1 In recent studies in British Columbia (31, 40), several individuals with lived/ living experience indicated that they find the term ‘peer’ derogatory and suggested the use of the term ‘experiential worker’ or ‘people with lived/ living experience (PWLLE)’ instead. However, given that the term ‘peer’ is still widely recognized internationally and used in literature, we have used this term as well.

Additional information

Funding

This work was supported by the BC Ministry of Health. The funders had no role in the study design, data collection, analysis, and interpretation of data or in the writing of the manuscript.