85. The Rigmarole: Getting Care After an Overdose85. The Rigmarole: Getting Care After an Overdose
Addiction Medicine Journal Club
Drs. Sonya Del Tredici and John Keenan discuss a qualitative study on why overdose survivors often avoid or disengage from medical care, highlighting mistrust, stigma and structural barriers. They also touch on emerging opioids, flavoured vapes and the wider system pressures affecting addiction treatment.
36:59•19 Oct 2026
Why Overdose Survivors Avoid Care: A Look at Mistrust, Stigma and Broken Systems
Episode Overview
- Many overdose survivors avoid or leave medical care due to mistrust of first responders and prior negative experiences in emergency settings.
- Fear of arrest, child protection involvement, eviction, job loss and large medical bills strongly influences decisions about calling 911 or going to hospital.
- Participants often manage overdoses themselves with naloxone and do not see a need for formal medical services.
- Evidence-based treatments such as medications for opioid use disorder are rarely offered consistently in emergency care, contributing to poor engagement.
- Hosts highlight the need for more respectful, trauma-informed, flexible care models and better support for burnt-out frontline staff.
“You have a potentially fatal disease with a seminal event, a sentinel event like an overdose. It almost killed you. And treatments exist that are readily available. Why would you not get those treatments?”
What drives someone to seek a life without alcohol or drugs, and what stops them even after a near-death experience? This episode of Addiction Medicine Journal Club takes a hard look at that question by unpacking a qualitative study on why overdose survivors often skip medical care after a nonfatal opioid overdose. Aimed squarely at clinicians and addiction professionals, the conversation between Dr. Sonya Del Tredici and Dr.
John Keenan mixes solid research talk with dry humour and real-world frustration about the US healthcare system. You’ll hear them walk through how qualitative research works, why it matters for understanding patient experience, and what it can realistically change in everyday practice. The featured study looks at 23 overdose survivors from seven US states and asks why so many avoid or abandon care even after being revived with naloxone.
Themes include deep mistrust of first responders and emergency departments, fear of arrest, child protection involvement and job loss, past experiences of stigma and even abuse, and the simple fact that many people feel they can handle overdoses themselves at home. As one line sums it up: “You have a potentially fatal disease with a seminal event, a sentinel event like an overdose. It almost killed you. And treatments exist that are readily available.
Why would you not get those treatments?” Alongside this, the hosts chat about a new ultra-potent opioid, cychlorphine, tobacco companies pushing unauthorised flavoured vapes, and even fake podcasts used to sell illegal drugs, all framed with a clinician’s eye for what matters in practice. If you’re working with people who use opioids, or supporting someone after an overdose, this conversation offers practical reflection on how care systems might become less hostile and more humane.
How could your own practice feel safer and more respectful to someone who’s already on their last bit of trust?
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