Digitally shaped ethnographic relationships during a global pandemic and beyond.

Social distancing and public safety measures enacted in response to COVID-19 created a surge in methodological "advice" for researchers facing disruption to fieldwork. Resources and publications frequently encouraged changes vis-a-vis digitally enhanced methods or employment of digital ethnography. For ethnographers, the establishment and maintenance of ethnographic relationships in pandemic contexts restricted to virtual interactions has not been thoroughly explored, leaving those trained in recruitment, rapport-building, and field engagement with fewer resources to navigate this integral topic. Here, we provide insights into how ethnographic relationships may be developed when there is limited access to the field and traditional relationship building is not possible. We argue that as ethnographic methods change and adapt, so too must perspectives on ethnographic relationship development. By closely examining ethnographic relationships confined to digital spaces in the context of the Tennessee tornado recovery amid the COVID-19 pandemic, this project sheds light on how to overcome this challenge.

Accessing Take-Home Naloxone in British Columbia and the role of community pharmacies: Results from the analysis of administrative data.

INTRODUCTION: British Columbia's (BC) Take-Home Naloxone (THN) program provides naloxone to bystanders for use in cases of suspected opioid overdose. This study seeks to provide trends and analysis from the provincial BC THN program since inception in 2012 to the end of 2018. MATERIALS AND METHODS: BC THN shipment and distribution records from 2012-2018 were retrieved. Frequency distributions were used to describe characteristics of individuals accessing the program. To evaluate correlates of distribution after the addition of hundreds of pharmacy distribution sites, an analytic sample was limited to records from 2018, and multivariate logistic regression was used to evaluate correlates of collecting naloxone at a pharmacy site. RESULTS: Since program inception to the end of 2018, there were 398,167 naloxone kits shipped to distribution sites, 149,999 kits reported distributed, and 40,903 kits reported used to reverse an overdose in BC. There was a significant increasing trend in the number of naloxone kits used to reverse an overdose over time (p<0.01), and more than 90% of kits that were reported used were distributed to persons at risk of an overdose. Individuals not personally at risk of overdose had higher odds of collecting naloxone at a pharmacy site, compared to other community sites (including harm reduction supply distribution sites, peer led organizations, drop-in centers, and supportive housing sites) (Adjusted Odds Ratio (AOR): 2.69; 95% CI: 2.50-2.90). CONCLUSIONS: This study documents thousands of opioid overdose reversals facilitated through the BC THN program. While those at highest risk of overdose may preferentially access naloxone through community sites, naloxone distribution through pharmacies has allowed the BC THN program to expand dramatically, increasing naloxone availability through longer opening hours on evenings and weekends. and in rural and remote regions. A diversity of naloxone distribution sites and strategies is crucial to prevent rising opioid overdose deaths.