HEALTH LITERACY AND AWARENESS OF NURSES AND NURSING STUDENTS ON FENTANYL AND DRUG ABUSE.

Abstract

Background: The rise of synthetic opioids, particularly fentanyl, has intensified the global drug abuse crisis, posing serious challenges to healthcare systems. Nurses and nursing students play a crucial role in prevention, early identification, and emergency management of opioid-related cases. Health Literacy (HL), the ability to access, understand, and use health information, has been proposed as a critical determinant of clinical competence in this context. This study aims to assess the knowledge, awareness, and health literacy of nurses and nursing students in relation to fentanyl and drug abuse, exploring potential associations between HL levels and preparedness to manage substance-related emergencies.

Subjects and methods: A national multicenter cross-sectional study was conducted from October 2024 to January 2025, involving 157 participants (nurses and nursing students) across Italy. A structured questionnaire was administered online, covering four domains: sociodemographic information, health literacy (HL), drug addiction knowledge and specific knowledge of fentanyl. Descriptive and inferential statistics were performed using SPSS.

Results: Participants demonstrated good overall knowledge about fentanyl clinical use and effects. However, misconceptions were identified - particularly regarding lethal dosages and the inability to detect fentanyl with the senses. Notably, HL scores did not consistently correlate with higher knowledge levels; in some cases, participants with lower HL scores showed better understanding of specific topics such as routes of administration and naloxone use. A significant negative correlation was found between HL and knowledge of drug availability (r = -0.35; p < 0.001). No significant differences emerged between students and professionals.

Conclusions: Findings challenge the assumption that higher HL always predicts better preparedness. Standard HL measures may fail to capture contextual and experiential knowledge essential for managing opioid-related emergencies. Nursing education should incorporate more experiential and clinically focused training on drug abuse, integrating HL as an operational - rather than merely promotional - competency. Further research with larger samples and qualitative methods is recommended.