{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:50:19Z","timestamp":1787032219576,"version":"build-2736575974"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Western Journal of Emergency Medicine"],"abstract":"<p>Introduction: Recent policy changes in Washington State presented a unique opportunity to pair evidence-based interventions with \ufb01rst responder services to combat increasing opioid overdoses. However, little is known about how these interventions should be implemented. In partnership with the Research with Expert Advisors on Drug Use team, a group of academically trained and community-trained researchers with lived and living experience of substance use, we examined facilitators and barriers to adopting leave-behind naloxone, \ufb01eld-based buprenorphine initiation, and HIV and hepatitis C virus (HCV) testing for \ufb01rst responder programs. Methods: Our team completed semi-structured, qualitative interviews with 32 \ufb01rst responders, mobile integrated health staff, and emergency medical services (EMS) leaders in King County, Washington, from February\u2013May 2022. Semi-structured interviews were recorded, transcribed, and coded using an integrated deductive and inductive thematic analysis approach grounded in community-engaged research principles. We collected data until saturation was achieved. Data collection and analysis were informed by the Consolidated Framework for Implementation Research. Two investigators coded independently until 100% consensus was reached. Results: Our thematic analysis revealed several perceived facilitators (ie, tension for change, relative advantage, and compatibility) and barriers (ie, limited adaptability, lack of evidence strength and quality, and prohibitive cost) to the adoption of these evidence-based clinical interventions for \ufb01rst responder systems. There was widespread support for the distribution of leave-behind naloxone, although funding was identi\ufb01ed as a barrier. Many believed \ufb01eld-based initiation of buprenorphine treatment could provide a more effective response to overdose management, but there were signi\ufb01cant concerns that this intervention could run counter to the rapid care model. Lastly, participants worried that HIV and HCV testing was inappropriate for \ufb01rst responders to conduct but recommended that this service be provided by mobile integrated health staff. Conclusion: These results have informed local EMS strategic planning, which will inform roll out of process improvements in King County, Washington. Future work should evaluate the impact of these interventions on the health of overdose survivors.<\/p>","DOI":"10.5811\/westjem.18033","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T15:27:49Z","timestamp":1721057269000},"source":"Crossref","is-referenced-by-count":7,"title":["Harm Reduction in the Field: First Responders\u2019 Perceptions of Opioid Overdose Interventions"],"prefix":"10.5811","volume":"25","author":[{"given":"Callan Elswick","family":"Fockele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Frohe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"McBride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Perlmutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Goh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grover","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courteney","family":"Wettemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Holland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Finegood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thea","family":"Oliphant-Wells","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"van Draanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29705","published-online":{"date-parts":[[2024,6,27]]},"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T15:27:54Z","timestamp":1721057274000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/4rq0g3d0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,27]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,7,9]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.18033","relation":{},"ISSN":["1936-9018"],"issn-type":[{"value":"1936-9018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,27]]}}}