Risk and Protective Factors Associated With Posttraumatic Stress Disorder Among Layperson Responders to Opioid Overdose Incidents

Objective: Fatal and nonfatal overdoses involving opioids have increased to crisis levels in recent years. Laypersons have been increasingly tasked with responding to these events by administering naloxone, performing rescue breaths/cardiopulmonary resuscitation, and calling for medical assistance. However, little is known about the development of posttraumatic stress disorder (PTSD) related to opioid overdose responding among laypersons. To this end, we sought to determine the factors associated with PTSD stemming from responding to an opioid overdose event. Method: From April 2021 to October 2021, structured interviews were conducted with layperson responders who had responded to an opioid overdose. Participants were administered structured diagnostic interviews, Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and completed validated self-report measures. Results: In total, 101 layperson adults who responded to an opioid overdose were recruited for the present study (Mage: 34, 65% identified as women, 79% as White, and 11% as Hispanic/Latino). Of the 80 participants who completed the Clinician-Administered PTSD Scale for DSM-5, 100% met Criteria A for PTSD related to overdose responding, and over one quarter (27.5%) met current PTSD diagnosis criteria related to overdose responding. Current PTSD related to overdose responding was associated with depression symptoms, generalized anxiety symptoms, and presence of law enforcement or professional first responders during the most distressing overdose responding event. Conclusions: Responding to opioid overdoses is traumatizing for many and results in a considerable burden of PTSD among layperson responders. As such, we call for trauma-informed interventions that cater to the unique experiences of layperson opioid overdose responders.