• Kyle Patch, Caroline Huang, Saskia Hendriks, David Wasserman, Matthew Parrish, and Christine Grady.
• Department of Bioethics, National Institutes of Health Clinical Center, Bethesda, Maryland.
• Prehosp Emerg Care. 2023 Jul 18: 181-8.

BackgroundFirst responders play a vital role in the United States opioid drug overdose crisis, a public health emergency that has claimed many lives.ObjectiveWe sought to investigate first responders' experiences and attitudes toward opioid overdose emergencies and the ongoing crisis, as well as emotional effects, coping strategies, and support systems.MethodsA convenience sample of first responders (n = 18) at the Columbus Fire Division, with experience responding to opioid emergencies, participated in semi-structured telephone interviews between September 2018 and February 2019. Interviews were recorded, transcribed verbatim, and analyzed using content analysis for themes.ResultsWhile almost all participants described overdose emergencies as routine, they recalled some as memorable and emotionally impactful. Almost all respondents were frustrated by the high rates of overdose among their patients and the lack of sustainable improvements in outcomes, yet expressed a strong moral commitment to caring for patients and saving lives. Themes of burnout, compassion fatigue, and hopelessness emerged, as did themes of increased compassion and empathy. Support for personnel experiencing emotional difficulty was either lacking or underutilized. Further, many felt public policies should prioritize more permanent resources and improve access to care, and believed that people who use drugs should face greater accountability.ConclusionFirst responders perceive a moral and professional duty to treat patients who overdose, despite their frustrations. They may benefit from additional occupational support to cope with the resultant emotional effects of their role in the crisis. Addressing macro-level factors contributing to the overdose crisis and improving patient outcomes could also positively affect first responder wellbeing.

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