Background
Methods
Study Design
Overall Data Collection
Study Participants
Quantitative Methods
Data Collection
Study Variables
GSDOA Awareness | P-valuea | |||
---|---|---|---|---|
Aware (N = 239) n (row %) | Unaware (N = 214) n (row %) | Total (N = 453) n (column %) | ||
Age (years) | 0.162 | |||
16 – 24 years | 47 (44.3) | 59 (55.7) | 106 (23.4) | |
25 – 34 years | 54 (61.4) | 34 (38.6) | 88 (19.4) | |
35 – 44 years | 55 (56.7) | 42 (43.3) | 97 (21.4) | |
45 – 54 years | 47 (50.0) | 47 (50.0) | 94 (20.8) | |
55 years and over | 30 (51.7) | 28 (48.3) | 58 (12.8) | |
Unknownb | 6 (60.0) | 4 (40.0) | 10 (2.2) | |
Gender Identity | 0.271 | |||
Cis man | 135 (52.9) | 120 (47.1) | 255 (56.3) | |
Cis woman | 95 (54.6) | 79 (45.4) | 174 (38.4) | |
Trans and gender expansive | 8 (36.4) | 14 (63.6) | 22 (4.9) | |
Unknownb | 1 (50.0) | 1 (50.0) | 2 (0.4) | |
Indigenous Self-Identification | 0.097 | |||
Indigenous | 81 (47.1) | 91 (52.9) | 172 (38.0) | |
Non-Indigenous | 133 (55.9) | 105 (44.1) | 238 (52.5) | |
Unknownb | 25 (58.1) | 18 (41.9) | 43 (9.5) | |
Health Region | 0.392 | |||
Fraser | 49 (51.6) | 46 (48.4) | 95 (21.0) | |
Interior | 72 (59.0) | 50 (41.0) | 122 (26.9) | |
Island | 43 (46.2) | 50 (53.8) | 93 (20.5) | |
Northern | 19 (47.5) | 21 (52.5) | 40 (8.8) | |
Vancouver Coastal | 56 (54.4) | 47 (45.6) | 103 (22.7) | |
Housing Status | 0.852 | |||
Private | 89 (52.7) | 80 (47.3) | 169 (37.3) | |
Supportive or Unstable Housing | 112 (54.9) | 92 (45.1) | 204 (45.0) | |
Homeless | 35 (51.5) | 33 (48.5) | 68 (15.0) | |
Unknownb | 3 (25.0) | 9 (75.0) | 12 (2.6) | |
Employment | 0.999 | |||
Yes | 77 (52.7) | 69 (47.3) | 146 (32.2) | |
No | 153 (52.8) | 137 (47.2) | 290 (64.0) | |
Unknownb | 9 (52.9) | 8 (47.1) | 17 (3.8) | |
Cellphone Possession | 0.023 | |||
Yes | 167 (56.4) | 129 (43.6) | 296 (65.3) | |
No | 60 (44.1) | 76 (55.9) | 136 (30.0) | |
Unknownb | 12 (57.1) | 9 (42.9) | 21 (4.6) | |
Perceived Risk of Experiencing an Overdose (last 6 months)c | < 0.01 | |||
Never | 95 (45.0) | 116 (55.0) | 211 (46.6) | |
Ever | 138 (59.7) | 93 (40.3) | 231 (51.0) | |
Unknownb | 6 (54.5) | 5 (45.5) | 11 (2.4) | |
Perceived Risk of Witnessing an Overdose (last 6 months)c | < 0.01 | |||
Never | 11 (22.0) | 39 (78.0) | 50 (11.0) | |
Ever | 222 (56.8) | 169 (43.2) | 391 (86.3) | |
Unknownb | 6 (50.0) | 6 (50.0) | 12 (2.6) | |
Opioid Use (last 6 months) | < 0.01 | |||
Yes | 157 (57.7) | 115 (42.3) | 272 (60.0) | |
No | 66 (42.6) | 89 (57.4) | 155 (34.2) | |
Unknownb | 16 (61.5) | 10 (38.5) | 26 (5.7) | |
Opioid Overdose (last 6 months)d | 0.224 | |||
Yes | 53 (63.9) | 30 (36.1) | 83 (18.3) | |
No | 99 (55.0) | 81 (45.0) | 180 (39.7) | |
Didn’t use opioids | 66 (42.6) | 89 (57.4) | 155 (34.2) | |
Unknownb | 21 (60.0) | 14 (40.0) | 35 (7.7) | |
Stimulant Overdose (last 6 months) | 0.286 | |||
Yes | 43 (59.7) | 29 (40.3) | 72 (15.9) | |
No | 182 (52.0) | 168 (48.0) | 350 (77.3) | |
Unknownb | 14 (45.2) | 17 (54.8) | 31 (6.8) | |
Opioid Overdose Witnessed (last 6 months) | < 0.01 | |||
Yes | 158 (61.5) | 99 (38.5) | 257 (56.7) | |
No | 58 (39.7) | 88 (60.3) | 146 (32.2) | |
Unknownb | 23 (46.0) | 27 (54.0) | 50 (11.0) | |
Stimulant Overdose Witnessed (last 6 months) | 0.026 | |||
Yes | 103 (59.5) | 70 (40.5) | 173 (38.2) | |
No | 111 (47.8) | 121 (52.2) | 232 (51.2) | |
Unknownb | 25 (52.1) | 23 (47.9) | 48 (10.6) |
Data Analysis
Missing data
Qualitative Methods
Data Collection
Data Analysis
Results
Quantitative Results
Participant Characteristics and GSDOA Awareness
Factors associated with GSDOA awareness
GSDOA Awarenessa | ||||
---|---|---|---|---|
Simple Bivariate OR (95% CI) | Block 1 (Demographics) AOR (95% CI) | Block 2 (Overdose Response) AOR (95% CI) | Block 3 (Overdose Characteristics) AOR (95% CI) | |
Demographic Characteristics | ||||
Age (years) | ||||
16 – 24 | — | — | — | — |
25 – 34 | 2.31 (1.24, 4.31) ** | 2.15 (1.14, 4.07) * | 2.77 (1.42, 5.41) ** | 2.18 (1.09, 4.35) * |
35 – 44 | 1.89 (1.02, 3.51) * | 1.74 (0.92, 3.28) | 2.06 (1.07, 3.96) * | 1.59 (0.81, 3.14) |
45 – 54 | 1.35 (0.74, 2.47) | 1.24 (0.66, 2.32) | 1.42 (0.75, 2.69) | 1.21 (0.62, 2.34) |
55 + | 1.43 (0.71, 2.90) | 1.31 (0.63, 2.71) | 1.47 (0.70, 3.10) | 1.36 (0.63, 2.95) |
Gender | ||||
Cis man | — | — | — | — |
Cis woman | 0.96 (0.63, 1.47) | 1.02 (0.66, 1.58) | 0.91 (0.58, 1.42) | 1.01 (0.63, 1.60) |
Trans and gender expansive | 0.37 (0.12, 1.11) | 0.47 (0.15, 1.47) | 0.46 (0.15, 1.45) | 0.54 (0.17, 1.72) |
Overdose Response Resources | ||||
Cellphone possession | ||||
Yes | 1.71 (1.10, 2.66) * | 2.15 (1.34, 3.47) ** | 2.36 (1.44, 3.86) *** | |
No | — | — | — | |
Overdose Characteristics | ||||
Perceived risk of overdoseb | ||||
Ever | 1.82 (1.21, 2.75) ** | 1.47 (0.93, 2.31) | ||
Never | — | — | ||
Opioid overdose witnessed | ||||
Yes | 2.62 (1.70, 4.05) *** | 2.29 (1.42, 3.70) *** | ||
No | — | — | ||
LR Pseudo–R2 | 0.019 | 0.040 | 0.080 | |
Pseudo–R2 change | 0.019 | 0.021** | 0.040 *** |
Complete understanding of the GSDOA
Responsea | |||
---|---|---|---|
No/Don’t known (%) | Yesn (%) | Prefer not to say/Missingn (%) | |
Do you believe the GSDOA protects the following people from being arrested for simple possession of substances (small amount of drugs for own use) at the scene of an overdose?b | |||
(A) The person who calls 9–1-1 | 80 (33.5) | 144 (60.3) | 15 (6.3) |
(B) The person who overdoses | 87 (36.4) | 129 (54.0) | 23 (9.6) |
(C) Anyone at the scene of an overdose | 89 (37.2) | 132 (55.2) | 18 (7.5) |
Imagine there is an overdose in a public space; 9–1-1 is called and the police come to the scene. Do you think the police can legally arrest a person if they:b | |||
(A) Have a larger amount of drugs on them or items (eg. A scale) that may look like they are involved in drug dealing? | 105 (43.9) | 120 (50.2) | 14 (5.9) |
(B) Are in a red/no-go zone they received for a previous charge that was not simple drug possession (eg. theft)? | 134 (56.1) | 92 (38.5) | 13 (5.4) |
(C) Have an outstanding warrant for something other than simple drug possession (eg. theft)? | 107 (44.8) | 121 (50.6) | 11 (4.6) |
Qualitative Results
Participant Characteristics
Adults N = 28 n (%) | Youth N = 14 n (%) | Total N = 42 n (%) | |
---|---|---|---|
Gender | |||
Cis Man | 10 (35.7%) | 4 (28.6%) | 14 (33.3%) |
Cis Woman | 15 (53.6%) | 6 (42.9%) | 21 (50%) |
Trans and Gender Expansive | 0 (0%) | 3 (21.4%) | 3 (7.1%) |
Unknown | 3 (10.7%) | 1 (7.1%) | 4 (9.5%) |
Age (years) | |||
18 or under | 0 (0%) | 3 (21.4%) | 3 (7.1%) |
19–24 | 0 (0%) | 10 (71.4%) | 10 (23.8%) |
25–35 | 9 (32.1%) | 0 (0%) | 9 (21.4%) |
36–45 | 8 (28.6%) | 0 (0%) | 8 (19%) |
46–55 | 5 (17.9%) | 0 (0%) | 5 (11.9%) |
56–65 | 3 (10.7%) | 0 (0%) | 3 (7.1%) |
Unknown | 3 (10.7%) | 1 (7.1%) | 4 (9.5%) |
Indigenous Self-Identification | |||
Indigenousa | 8 (28.6%) | 8 (57.1%) | 16 (38.1%) |
Non-Indigenous | 17 (60.7%) | 5 (35.7%) | 22 (52.4%) |
Unknown | 3 (10.7%) | 1 (7.1%) | 4 (9.5%) |
Urbanicity | |||
Metropolitan | 9 (32.1%) | 8 (57.1%) | 17 (40.5%) |
Large Urban | 15 (53.6%) | 3 (21.4%) | 18 (42.9%) |
Medium Urban | 0 (0%) | 1 (7.1%) | 1 (2.4%) |
Small Urban | 4 (14.3%) | 0 (0%) | 4 (9.5%) |
Rural Hub | 0 (0%) | 1 (7.1%) | 1 (2.4%) |
Unknown | 0 (0%) | 1 (7.1%) | 1 (2.4%) |
Currently use illicit drugs | |||
Yes, opioids only | 3 (10.7%) | 2 (14.3%) | 5 (11.9%) |
Yes, stimulants only | 8 (28.6%) | 2 (14.3%) | 10 (23.8%) |
Yes, opioids and stimulants | 10 (35.7%) | 3 (21.4%) | 13 (31%) |
Nob | 4 (14.3%) | 6 (42.9%) | 10 (23.8%) |
Unknown | 3 (10.7%) | 1 (7.1%) | 4 (9.5%) |
Peer Worker | |||
Yes | 11 (39.3%) | 11 (26.2%) | |
No | 17 (60.7%) | 17 (40.5%) | |
Unknown | 0 (0.0%) | 0 (0.0%) |
Theme | Sub-theme |
---|---|
Awareness of the GSDOA | Inconsistent awareness |
Sources of awareness | |
Understanding of the GSDOA | General understanding |
Misconceptions about the GSDOA | |
Recommendations to increase awareness and understanding | School curriculum |
Social media | |
Word of mouth and the importance of peers |
Varied awareness of the GSDOA
Inconsistent awareness
“The majority of people that I’m around they all know about it…the big majority.” (Connor, Adult, Currently uses illicit drugs)“A lot of people probably don’t know about it. I’ve been involved with drugs for years and I’ve never heard of it.” (Lynda, Adult, Currently uses illicit drugs)
“I think everybody knows that [GSDOA] now, yeah.” (Sam, Youth, Currently uses illicit drugs)“I don’t think youth know about it. I also, like, I haven’t heard parents talk about it either. I don’t think teachers might know about it because we haven’t had that brought up to us in presentations. So I would say, like, the majority of people, especially, I mean, that are in my circle or, you know, slightly outside, I don’t think they know too much about it.” (Sophia, Youth, Does not currently use illicit drugs)
Sources of awareness
“The recent time of the two-hour naloxone training, they mentioned it there and that’s also something that in our training we bring it up to the high schoolers and everything about the Good Samaritan Act. But they didn’t really go in too much detail.” (Emily, Youth, Does not currently use illicit drugs)
“The most recent training I received, no, I don’t think I did [learn about the GSDOA].” (Kate, Youth, Does not currently use illicit drugs)
Varied understanding of the GSDOA
General understanding
“So my understanding of the Good Samaritan Act is that it’s not supposed to be a punitive approach or not supposed to be any repercussions to a medical emergency like I had stated before. So addressing these as public health issues rather than criminality behind them.” (Megan, Adult, Currently uses illicit drugs)
“It’s like people who are present during an emergency response… they’re not able to receive drug charges for possession and things like that if they have to call 9-1-1 for someone who’s overdosed. It’s to prevent people from not calling on very serious situations based on the fear of getting a charge for the drugs that they’re using or the drugs that they have on their person”. (Sam, Youth, Currently uses illicit drugs)
“I never knew that if you had warrants, they would pick up, whatever, whatever other stuff, it was just-- like I never had ever had somebody say that fine line. Oh, it was just to protect from possession.” (Anna, Adult, Does not currently use illicit drugs)
Misconceptions about the GSDOA
“You’re given basically a get out of jail free card. Because they’re currently in the state of overdosing and you’re trying to save their life while they’re still alive.” (Daniel, Adult, Currently uses illicit drugs)“So the Good Samaritan Drug Act is you don’t have to worry about when you phone and there’s an overdose. They won’t ever check you for your drugs. They’ll never charge you for anything if you’re trying to save a life and-- yeah. So you won’t be searched. You won’t be charged. You won’t be taken away.” (Jack, Adult, Currently uses illicit drugs)
“The warrant part was where I was confused because people were, like-- they can’t get you even if you have a warrant. And I’m, like, no, I’m pretty sure if you have a warrant they can.” (Rebecca, Adult, Currently uses illicit drugs)
“Then over the time it kind of like-- this novelty kind of wore off because people were still like getting problems because of it. Even though they stopped to help somebody, like I said, they still got rolled, you know.” (Anna, Adult, Does not currently use illicit drugs)
“They thought, well, if I stop to help somebody I’m not going to get in any trouble. But they were still getting into trouble because-- yeah, it’s kind of like almost-- it kind of goes with, like, mistrust ‘cause it’s almost like a lie. It’s almost like a half lie, right, so-- yeah, it wasn’t like a half lie, but they just made it sound like everything was going to be okay.” (Anna, Adult, Does not currently use illicit drugs)
Recommendations to increase awareness and understanding
“This is stuff that I would love to take back to my community to say, like, look, this Good Samaritan Drug Overdose Act exists for people that don’t know or people that want to know.” (Mary, Adult, Does not currently use illicit drugs)
School curriculum
“I believe its grade 10 health education is a graduation requirement. So everyone who’s in the public school system in B.C. has to take that health class. So I think presenting within that health class specifically would help.” (Kate, Youth, Does not currently use illicit drugs)
“Parents are a barrier for sure. A lot of people think, like, oh, if we just don’t talk about it, like, our child will never be in that situation.” (Emily, Youth, Does not currently use illicit drugs)
“I think we leave them out a lot of the time ‘cause we have a society that feels teenagers are incompetent. Or we feel that educating them encourages drug use. Which is absolutely not the truth. Kids are going to us drugs either way.” (Kate, Youth, Does not currently use illicit drugs)
Social media
“Social media….would be, like, a big one. ‘Cause a lot-- younger kids and, like, my age and a bit younger, we love social media. We’re always on social media.” (Lisa, Youth, Does not currently use illicit drugs)
“I mean, there’s a lot of people down here that have telephones. But they might not have Internet access.” (Paul, Adult, Currently uses illicit drugs)
Word of Mouth and the Importance of Peers
“For the people on the street I think word of mouth is probably the best right now. Because not a lot of them have cell phones. Not a lot of them have, like, access to social media.” (Mary, Adult, Does not currently use illicit drugs)
“I think it’s important to be taught by peers because it seems a little less intimidating and when you’re youth you tend to think like, you know, adults are in a whole different world and whatnot.” (Emily, Youth, Does not currently use illicit drugs)“Maybe send like outreach workers to tell them. I don’t know… who they trust, you know, and who wouldn’t actually lie to them, right.” (Andrew, Youth, Does not currently use illicit drugs)
“Having an Indigenous representative connect with an Indigenous person. Because that’s how I find it’s-- being Indigenous, it’s more trusting to trust your own kind of people.” (Mary, Adult, Does not currently use illicit drugs)