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Objectives: Widespread naloxone distribution is key to mitigating opioid-related morbidity, but stigma remains a barrier. Naloxone stigma among providers, emergency responders, and the public is well-documented and associated with treatment and policy preferences, but little is known about naloxone stigma among people who use drugs (PWUD), who may be overdose first responders. This study examines naloxone stigma, its correlates, and its association with stigma toward medication for opioid use disorder (MOUD) among PWUD., Methods: We recruited 293 individuals with a history of substance misuse from facilities that provide substance use and/or health care services (retained n = 195, 54% women, 75% White). Participants completed self-report measures, including the 5-item Naloxone-Related Risk Compensation Beliefs scale., Results: One in 5 respondents agreed with beliefs that access to naloxone leads to more opioid use and less treatment seeking and is "enabling." Those with nonopioid drug misuse, without prior overdose, and with fewer recovery attempts endorsed more naloxone stigma. Opioid misuse, prior overdose, and MOUD utilization were also inversely associated with MOUD stigma. There were no demographic differences in either stigma type. Naloxone stigma was positively associated with MOUD stigma in adjusted models., Conclusions: This is the first study to quantitatively examine naloxone stigma among PWUD. Findings emphasize the potential role of overdose education and naloxone distribution among those earlier in the substance use disorder course and who use nonopioid drugs. They support integrating MOUD stigma interventions into current overdose education and naloxone distribution targeted at PWUD to increase the acceptance and uptake of both medications., Competing Interests: PC-R is a consultant to Rissana, LLC, PredictView, and Woebot. The other authors report no conflicts of interest., (Copyright © 2024 American Society of Addiction Medicine.)

This article describes a subset of interactive medical education software that is representative of currently available products. Packages are now being produced with a variety of languages and "authoring" programs and have been distributed over CD-ROMs, floppy disks, and laser videodiscs. The developers and distributors include individuals, universities, pharmaceutical companies, publishers, and software companies. The target audiences are physicians, allied health workers, patients, and students. Software development is currently being encouraged by the recognition, on the part of several professional organizations, of the need to use computers in medical education.

GC-mass spectrometry was used to measure extremely low levels of fentanyl in dog plasma. Deuterated fentanyl was synthesized for use as an internal standard. Fentanyl was hydrolyzed to despropionyl fentanyl by 20% DCl in in deuterium oxide. Mass spectrometric analysis of the product revealed that the molecular ion was three mass units higher than that of the authentic despropionyl fentanyl, indicating that the deuterium exchange reactions occurred at this stage. Deuterated despropionyl fentanyl was reesterified by propionyl chloride to fentanyl-d3. The drug was assayed in biological fluids by extraction into ethyl acetate followed by analysis with GC-chemical-ionization mass spectrometry. The lowest measurable plasma fentanyl level is 500 pg/ml. The method is highly selective and is suitable for monitoring the time course of plasma drug levels. Evaluation of pharmacokinetic data from experiments using nine dogs revealed a triphasic phenomenon. No measurable amounts of the major metabolites, depropionyl fentanyl and norfentanyl, were detected.