Communicating Risk in the Context of Methadone Formulation Changes: A Qualitative Study of Overdose Warning Posters in Vancouver, Canada

Highlights

• Posters used to alert people to methadone formulation change in Vancouver, Canada.
• Study explores people who use drugs’ (PWUD) views of two warning posters.
• Warnings of “stronger” methadone were perceived to increase drug-related risks.
• Descriptive language and universal hazard symbols more effectively conveyed risk.
• Posters and other PWUD were key sources of information about formulation change.

Abstract

Background

British Columbia, Canada's provincial methadone program recently replaced their existing methadone formulation with a formulation ten times more concentrated. The transition raised concerns about heightened risk of accidental overdose, leading two organizations to disseminate methadone overdose warning posters during the transitional period. This study explores people who use drugs’ (PWUD) perceptions of these warning posters.

Methods

Qualitative interviews were conducted with thirty-four PWUD enrolled in methadone maintenance treatment in Vancouver. Participants were recruited from on-going cohort studies of drug-using individuals. Interview transcripts were analyzed thematically, focusing on participants’ perceptions of the warning posters and potential impacts on drug-related risks.

Results

Overdose warning posters constituted a key source of information about the methadone formulation change, but did not provide adequate information for all participants. Participants articulated a preference for descriptive language, focusing on changes in concentration rather than “strength”, and universal hazard symbols to effectively communicate overdose risks.

Conclusion

Participants indicated that warnings employing descriptive language more effectively communicated risk of methadone overdose. Future overdose warnings for drug-using populations must provide adequate information for the intended audience, and be communicated to PWUD through multiple channels.

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By:  Nicole Markwick,  Ryan McNeil, Solanna Anderson, Will Small, Thomas Kerr

Affiliations

British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608–1081 Burrard Street, Vancouver, BC, V6T 1Z1, Canada

Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada

Correspondence

Corresponding author. BC Centre for Excellence in HIV/AIDS 608 - 1081 Burrard Street Vancouver, BC V6T 1Z1.

 

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