Staying Alive in Little Five: Perceptions of Service Industry Workers Who Encounter and Respond to Opioid Overdose in Little Five Points, Atlanta Open Access

Febres-Cordero, Sarah (Summer 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/w0892c092?locale=en
Published

Abstract

Background: In Little Five Points (L5P), Atlanta, opioid overdose occurs, and service industry workers are often first responders by default. Little Five Points is an eclectic, primarily independent, commercial district comprised of service industry workers. Community members are implementing harm reduction strategies, including access to sterile syringes and free distribution of naloxone (opioid antidote) to those who are likely to encounter and respond to an opioid-induced overdose. These attributes make L5P an ideal location to identify strategies that can be implemented by laypeople, improve education regarding naloxone administration, and overdose management.

Purpose: The purpose of this study is to describe the perceptions of service industry workers who encounter and respond to opioid overdose in a community setting.

 Methods: I conducted a qualitative descriptive study with elements of ethnography and phenomenology in an Atlanta commercial district that has been encountering and responding to opioid overdose in the community and practicing harm reduction since the 1990s. To explore potential strategies for layperson response to overdose, this qualitative descriptive study utilized participant observation, criterion, and snowball sampling, and led to an enrollment of 15 participants. One-on-one interviews employed a 13-question interview guide with semi-structured open-ended questions. Iterative analysis with constant comparison was employed with inductive reasoning. Internal validity was ensured by member checks, reflexivity, peer review, triangulation of methods, and archival research.

Findings: One-on-one interviews with 15 service industry workers yielded 13 hours of rich, descriptive data, and participant observations over seven months produced 44 hours of field data. Our inquiry uncovered the perceived invisible and hidden nature of opioid use and overdose, revealing three themes: hidden places of consumption, hidden by blending in, and hidden dangers.

Table of Contents

Introduction

Purpose of Study

Summary of Papers

Context of Inquiry

Service Industry Workers as First Responders

Naloxone, an Opioid Antagonist

Chapter 1: Blending Qualitative Methods: An Immersive Approach to Community Research

Abstract

Introduction

Risk for Human Subjects

Data Collection

Reflexivity and Ethics

Making Community Connections

Community Advisory Board

Member Checks

Sampling Strategy

Interdisciplinarity and Cross-Collaboration

Analysis

Analytic Strategy

Coding

Conclusion

Chapter 2: Service Industry Workers Perceptions of the hidden and invisible nature of opioid and heroin use in Little Five Points, Atlanta

Study Context

Harm Reduction

Stigma

Social Geography and Stigma

Method

Ethics

Results

Sample

Data collection

Analysis

Results

Theme 1: Places of Consumption

Theme 2: Hidden by Blending In

Intoxication and alcohol use

Counterculture and subculture appearance

Homelessness and untreated mental health problems

There is no Normal

Theme 3: Hidden Dangers

Disease transmission

Unintentional overdose: Fentanyl and Carfentanil and found drugs

Fear of perceived violence

Discussion

Concealability

Disruptiveness

Aesthetic Qualities

Peril

Limitations

Conclusion

Appendix, Tables and Figures

Appendix A

Table 1 Demographics

Figure 1 Theoretical Framework

Figure 2 Train kid in L5P. Photo by SFC

Chapter 3: Designing a Graphic Novel: Engaging Community, Arts, and Culture into Public Health Initiatives

Abstract

Background

Naloxone and Layperson Response to Opioid Overdose

Parent Study Methods

Emerging Study Findings

Why We Chose the Graphic Novel Format for Dissemination

Disseminating with Art in Little Five Points

Working with a Community Artist

Implications for Research and Cross-Collaboration

Figures and Images

Image 1

Image 2

Image 3

Figure 2

Figure 3

Figure 4

Figure 5

Conclusion

It takes a village

Why L5P?

Preliminary Work

Approach

Theoretical framework

Reflexivity and ethics

Stigma

Next Steps

References

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