First responder encounters
Question	Probes
Can you tell me about your most recent interaction with a first responder (fire fighter, police or paramedic)?	• What led to that situation with the first responder? • What have your interactions been like with first responders during an overdose, either for yourself or when you’ve been a bystander? • How satisfied did you feel with the outcome of that interaction? • Did you receive any referrals to other supports or services from the first responder you interacted with? • [If they don’t already mention it] How long ago was that interaction?
What would a good interaction look like between a first responder and someone experiencing an overdose?	• How should a first responder approach the people at an overdose response call? • What would be most helpful for you when you are met by someone who is responding to an overdose or another drug-related emergency? • Would there be any other supports or services that would be helpful to receive when a first responder responds to an overdose or other drug-related call?
Have you ever had interactions with mobile integrated health team or a co-responder team consisting of a first responder paired with a mental health professional like a nurse or social worker? What was that interaction like?	• What do you think about receiving services from teams like these, as opposed to traditional first responders? • Are there services for substance use that you think should definitely be available through mobile clinic or co-responder programs rather than first responders? Why?
Experiences with opioid-related services
Question	Probes
Have you ever gotten naloxone, also known as Narcan, to take home with you or carry on you?	[If never received], • Can you tell me why you haven’t accessed naloxone? • Did you have any issues or challenges with getting naloxone when you’ve wanted to get some? What kinds of issues? • Is take-home naloxone easy to access, in your opinion? What makes it easy/hard to access? • If naloxone was offered to you for free by a first responder, to take home or carry with you, would you take it? Why or why not? [If received], • Do you have it right now? If so, where did you get the naloxone from? • Is take-home naloxone easy to access, in your opinion? What makes it easy/hard to access? • If naloxone was offered to you for free by a first responder, to take home or carry with you, would you take it? Why or why not?
How do you feel about first responders handing out naloxone to patients or bystanders when they respond to an overdose? Is this something you or people you know would want?	• How should first responders offer these kits to people? What about their approach would make you more or less likely to want to take a naloxone kit? • What should be included in these kits? • Do you think these services should be offered by first responders? What might be some problems with first responders offering this service? • Do you have a preference for what kinds of first responders or mobile clinic staff you’d get naloxone from? Why? • How does (or would) having naloxone with you affect your likelihood of calling 9–1-1 in an overdose event?
Experiences with opioid-related services
Question	Probes
Buprenorphine, also known as Suboxone, is a medication used to treat opioid use disorder. Can you tell me about any experiences you may have had receiving buprenorphine?	[If never accessed]: • Can you tell me why you haven’t received this medication before? • How easy is buprenorphine easy to access, in your opinion? • How do other people you know (who use drugs) feel about buprenorphine? • If the option to start buprenorphine treatment was available and free alongside first responder services, would you have wanted to start it that way? Why or why not? [If have accessed]: • Do you currently have buprenorphine? • Where did you get the buprenorphine/Suboxone from? • Did you have any issues or challenges with obtaining buprenorphine or Suboxone? What kinds of issues? • How easy is buprenorphine easy to access, in your opinion? • How do other people you know (who use drugs) feel about buprenorphine? • If the option to start buprenorphine treatment was available and free alongside first responder services, would you have wanted to start it that way? Why or why not?
Between different kinds of first responders and mobile clinic staff, who would you prefer to receive buprenorphine from?	• What do you think would be good about receiving buprenorphine from first responders like firefighters or paramedics? • What about from mobile clinics? • What sorts of challenges would you expect to encounter receiving a medication this way? • What would you think about participating in a telemedicine visit with a provider who could prescribe buprenorphine, facilitated by a first responder or mobile clinic staff member?
Experiences with other medical services
Question	Probes
Can you tell me what you know about testing for HIV and hepatitis C?	• Have you ever wanted to be tested for HIV or Hep C but haven’t been able to? If so, what stopped you from getting tested? • What do you think some of the barriers are to accessing testing for HIV or Hep C? • Can you tell me anything else about why you think people who use drugs may not want to get tested?
If HIV or Hep C testing was available and free in first responder services would you use it? Why or why not?	• Do you think other people would use these testing services from first responders? • Between different kinds of first responders and mobile clinic staff, who would you prefer to receive testing from? • If first responders or mobile clinic staff are engaging with people out in the community, what do you think they can do that would help people feel more comfortable and willing to get tested?
If you needed treatment for Hep C and linkage to Hep C treatment were free and available alongside first responder services, would you use it? Why or why not?	• Have you ever accessed treatment for HCV? If yes, how did you start that treatment process? If not, why not? • What sorts of challenges would you expect people would encounter receiving treatment this way?
Do you think it would be helpful for first responders to provide access to safer use supplies, like syringes, pipes, or fentanyl testing strips? Why or why not?	• What sorts of challenges would you expect to encounter receiving safer use supplies like this? • Is there anything I didn’t mention that you think should be included with safer use supplies?
Other needs and preferences
Question	Probes
First responder services have gone through some changes recently. Have you noticed any ways that your experience interacting with first responders has changed over time?	• What kinds of differences have you noticed (if any)? • When did you start to notice these changes?
Are there any other services (other than the ones we asked you about) that you think would be important to have offered by first responder to better serve people who use drugs?	• Are there different things that are more important to you than the services we mentioned today? • Are there other services that you have trouble accessing?