Ohio Public Libraries Study

Is Narcan the New CPR? The Capacity of Ohio Public Libraries as Opioid Responders

Public libraries in the US are trusted institutions that connect people to information and resources, They welcome all, including the most vulnerable, and respond to changing community needs with information, programming, and services. Libraries are also vital healthcare facilitators and educators, providing access to health services and developing health literacy to Americans.

As opioid-related fatalities have soared in the US over the last five years, libraries have been thrust into the unexpected role of frontline responders. In response to opioid overdoses on their premises, some public libraries now stock the opioid antagonist naloxone (Narcan) and train staff to reverse overdose. Other measures include modifying restrooms to discourage injection, moving desks and shelving to establish clear sightlines for staff, installing sharps collection kits, and providing substance use education and treatment referrals.

Ohio has the second-highest age-adjusted opioid-related overdose mortality rate in the US. Yet we have no data about the extent of opioid activity at the 251 Ohio library systems or measures that libraries have adopted, the considerations that shape their responses, or whether libraries have the capacity to respond in ways that are effective and acceptable to their communities.

We are conducting a a multi-phase community-engagement study to understand the capacity of Ohio public libraries to respond to opioid activity on their premises, the ethical considerations that shape library responses, and the perspectives of library directories on the role and work that public libraries are performing in managing the US opioid crisis.

The study has three specific aims. Aim 1: To collect baseline data about Ohio public libraries that have observed opioid activity on their premises and identify their opioid response measures, selection criteria, and evaluation activities. Aim 2: To identify considerations that shape libraries’ decisions to implement opioid response measures. Aim 3: To solicit perspectives from Ohio library directors about the role that libraries are playing and their obligations and capacity to respond.

The study team will conduct a mixed-methods survey of 251 Ohio library system directors followed by one-on-one interviews with a convenience sample of survey respondents. A project advisory board comprised of community partners and library directors will guide study design and execution.

The significance of the study lies in addressing both the social transformation of public libraries in response to a national opioid crisis and the ethical dilemmas that this crisis generates for libraries. Do library staff have an obligation to use naloxone to rescue patrons who appear to be overdosing? Are libraries moving into the space of safe consumption sites in a nation where none are legally sanctioned to operate? What kinds of public spaces are libraries becoming, and whose work are they performing when they respond to the opioid crisis?