Understanding women's perspectives on take-home naloxone to support equitable overdose prevention

Since the late 1990s, Australia has experienced increasing number of opioid overdose hospital admissions and deaths. One response has been the implementation of take-home naloxone initiatives, which involve providing naloxone (a drug that reverses opioid overdose) products and training to those most likely to encounter overdose.

Despite its life-saving potential, the administration of naloxone can precipitate opioid withdrawal, an experience associated with a range of undesirable outcomes including nausea, body aches, shivering, confusion, irritability, anger, restlessness and headaches. Naloxone’s potential for producing uncomfortable withdrawal symptoms has also been linked to distress, aggression and, occasionally, violence during revival from overdose. Research suggests that concerns about withdrawal impact naloxone uptake. While research on other overdose responses such as safe injecting facilities emphasises the need for gender sensitive approaches and other research suggests that women often feel obliged to take on caring roles during overdose events even when they felt unsafe, how gender may shape take-home naloxone uptake and use has only been fleetingly acknowledged. A notable exception examines how disproportionate expectations and burdens upon women to care for others in their social lives shapes their experiences with naloxone and overdose response. Similarly, research has documented women who inject drugs having to take on caretaker roles given men in their company are less concerned about the potential for overdose. Women in Hanson et al.’s (2020) study, for example, exercise greater caution about overdose than men, many of which relied on naloxone to reverse overdoses rather than aiming to prevent the overdose itself from occurring.

In order to bolster take-home naloxone uptake in ways that support the safety of women who consume opioids, this research examined the potential concerns about naloxone and overdose response that shape their engagement with the initiative. This broadsheet is based on research conducted as part of the project titled ‘Investigating how gender shapes uptake and use of take-home naloxone: A qualitative pilot study’. Led by researchers at La Trobe University’s school of Psychology and Public Health and the Australian Research Centre in Sex, Health and Society, this research aims to better understand barriers to take-home naloxone initiatives and how we can develop gender-sensitive overdose prevention.