Table 2:

Responses to naloxone observed by people who use opioids and labelled as ‘not rage, not withdrawal’

Type of Response	Not rage, not withdrawal	Illustration of Response and Outcome (emphases added)
Physiological	Breathing difficulties and perspiration	Respondent: He like, like when you come out of the water and then you want to … breathing again like that. Interviewer: Yeah, kind of a big deep breath. Was he able to speak, did he say anything. Respondent: No, no, not for a while. He was sweating and he was … it was nervous it was so we call 911. We called 911. (Participant 43)
	Breathing difficulties	Interviewer: And then but he already woke up after the first (dose), right? Respondent: Yeah had started going—like he was like gasping but he started coming around. (Participant 32)
	Confusion, disbelief and perspiration	Respondent: (After the dose) … he’s like ‘what’s going on?’ He didn’t even realize what’s going on. It was like he just was sleeping; and he just woke up. ‘What’s going on? What happened?’ ‘Calm down first of all; calm down man. You just OD’d’. ‘What? Oh my god; no; don’t tell me that.’…. I went and got a towel you know he started sweating. (Participant 41)
	Flatulence and burning sensation in chest	Respondent: (After the dose) and he said like, he got to burp, he feel like he got to burp you know, his chest was burning. He had to burp. So we walked to the bathroom, he sat there at the toilet for about five minutes, and he burped. (Participant 49):
	Fatigue	Interviewer: Like he didn’t seem dope sick (after the naloxone)? Respondent: No. I can’t say he was dope sick because I don’t know if he had a habit or not, you see what I’m saying? But the effect of it, it was like you can tell everything just was out of him. He was out of it, and… Interviewer: Out of it like he seemed tired? Respondent: Yeah like fatigued. (Participant 23)
	Fatigue and confusion	Interviewer: Did he go back into it after that first (dose)? Respondent: No, but it seemed like … it took a lot out of him I guess or whatever. Interviewer: What do you mean when you say he came out of it? Did his eyes perk up, did he sit up, did he speak? Describe that a little bit more for me. Respondent: He spoke. Interviewer: What did he say? Respondent: Basically, uh, ‘what happened’ really. (Participant 15)
Emotional	Shock	Interviewer: How did he seem to you? Respondent: He was in shock. Interviewer: Shock? Respondent: Kinda upset. Like “What happened?” I said, “Yo boy you OD’d bro.” He goes, “Oh shit, oh shit, for real?” I said, “Yeah boy you almost called the ambulance.” (Participant 16)
	Shock and disbelief	Interviewer: Was he complaining of any other symptoms afterwards? Respondent: Nothing; he was just sitting there like he couldn’t believe …. Interviewer: He’s in shock? Respondent: Yes, shock. He couldn’t believe what just happened. (Participant 41)
	Confusion, amnesia and hilarity	Respondent: So, I hit him. I gave him a shot. And I think it took about a minute; and he just came out of it. And came out of it confused. Interviewer: What did he say; do you remember? Respondent: Like what we doing here? He didn’t remember nothing. He was like confused. Then he remembered and basically like started laughing. (Participant 10)
	Gratitude and remorse	Interviewer: What did that look like? What was she doing after she responded? Respondent: Started crying. She said, thank you for saving my life. I don’t want to die. (Participant 40)
	Paranoia and confusion	Respondent: And then I hit her, half in one nostril and nothing and then nothing. And then I hit her with the other and then she started… you know? Like I was telling xxx, when she came to, she was not scared but like paranoid. Like didn’t know what the hell was going on. (Participant 02)
Poor Communication	Inability to talk and nasal problems	Respondent: And then I was smacking him around and I said ‘c’mon, what’s going on?’ You know? He goes ‘ehmhm’, he’s babbling on something. So later on, minutes later, after he had come around to it, I don’t know if the naloxone helped or didn’t help but somehow it affected his nasal, whatever it was, maybe he had some type of annoyance with his nasal and he was going (inaudible) and so I gave him some tissue and stuff. I says, ‘if you don’t talk to me I’m going to hit you again. I’m going to blast you again’. And then he goes, ‘No, no, I don’t wanna’ and then he started getting a little more responsive. (Participant 26)
	Incoherence	Interviewer: But he had no other reaction? Did he talk? Respondent: I don’t know, mumbled, that’s it. Interviewer: Okay, so he was definitely awake. Respondent: Yeah of course. Interviewer: Did he have any signs of withdrawal, any reactions that you observed? Respondent: No. Interviewer: Could you understand what he said? Respondent: No. (Participant 34)
	Dazed	Respondent: After the second dose yeah, she responded right away. Interviewer: How did it seem? Respondent: She’s looking at me, you know, because I’m in the back seat with the doors open. I’m like dude, ‘you just overdosed. So, don’t freak out, you know?’ I was like ‘yeah obviously this shit was good and you did too much’. (Participant 01)
Amnesia	Confusion, amnesia and hilarity (from above)	Respondent: So, I hit him. I gave him a shot. And I think it took about a minute; and he just came out of it. And came out of it confused. Interviewer: What did he say; do you remember? Respondent: Like what we doing here? He didn’t remember nothing. He was like confused. Then he remembered and basically like started laughing. (Participant 10)
	Unable to remember events	Interviewer: … so he woke up and didn’t know what was going on. Anything else? Respondent: No. He asked me what happened. I told him ‘you OD. You passed out.’ (Participant 50)
	Unable to remember events	Respondent: … that’s all I recall; they said since I was acting funny; they shot me with it and I say you shot…? And I couldn’t remember that. I could not remember that. And that’s all I said. And the reason I know they shot me with it, because you know, I have the bottle to prove that the needle is out; and then, I had caught some pain like the next day. (Participant 09 describing his own overdose reversal)
Gratitude	Expressing thanks	Interviewer: Was she concerned? How did she seem? Respondent: Yeah, she’s thanking me, and he’s crying, because my husband’s saving her husband right next to her, you know? (Participant 01)
	Expressing thanks and remorse (from above)	Interviewer: What did that look like? What was she doing after she responded? Respondent: Started crying. She said, thank you for saving my life. I don’t want to die. (Participant 40)
Deliberate cognisance	Amnesia with definitive decision-making	Respondent: And after he came back through, I was like uh, and I told him what happened. And he was like ‘no, don’t call the ambulance. Don’t call the ambulance’. I was like ‘but you need to go to the hospital.’ And he was like ‘no I’m okay, I’m okay, I won’t go with the ambulance.’ (Participant 37)