Instruments

This study utilized the Opioid Overdose Knowledge Scale (OOKS) developed for bystanders by Williams et al. [27]. The scale was originally designed for use alongside peer-administered intramuscular naloxone, and had a total score range of 0–45 points. However, in order to adapt it for intranasal naloxone use, items 5 and 6 were removed, resulting in the total score for this study of 0–39 points. Maximum possible scores for the scale’s four domains included risk (9), recognizing the signs of an overdose (10), actions to take when witnessing an overdose (11), and how to use naloxone (9). The questionnaire was translated into Norwegian for the purposes of this study by the first author. While translation of any kind risks altering the reliability and validity of a given research tool, the likelihood of the OOKS being compromised here is minimal because of the relative simplicity of the text translated. The questionnaire was not piloted within this setting prior to its use.