Public Understanding and Perception of Harm Reduction and Prevention Messaging About Fentanyl Overdoses

Fentanyl-related opioid fatalities have risen drastically in the United States, indicating a "new wave" of the opioid crisis and highlighting the urgent need for more effective public health interventions to address its harms. Despite an increasing number of public communication campaigns focused on the general public, evidence on how people perceive fentanyl-related harm reduction strategies and prevention messaging is still nascent.

We conducted a cross-sectional survey with a national sample (N = 1,044). Fentanyl-related information seeking, risk perception, and message perception were measured. Specifically, message perception was compared between three harm reduction strategies-carrying naloxone, using fentanyl test strips, and never using drugs alone and between two prevention message taglines-One Pill Kills and One Pill Can Kill.

Respondents preferred healthcare providers and the Internet as sources if they would seek information about fentanyl. Risk perception of fentanyl was high; however, there is room to improve public awareness of naloxone as an opioid antagonist. Respondents' perception was most favorable for the message about carrying naloxone, followed by the message about using fentanyl test strips, and finally, the message about never using drugs alone. Also, One Pill Can Kill was associated with a higher level of perceived effectiveness than One Pill Kills.

Findings indicate that harm reduction and prevention messages hold the potential to be effective in reducing the harmful consequences of fentanyl overdoses. Future research should examine whether favorable message perceptions can translate into actual effectiveness and behavioral changes, which could have implications for the development of public health interventions.