Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study
Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study
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DOI：
10.1016/j.drugpo.2017.05.023
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发表时间：
2017-08-01
影响因子：
4.4
通讯作者：
Green, Traci C.
中科院分区：
文献类型：
--
作者：
Carroll, Jennifer J.;Marshall, Brandon D. L.;Green, Traci C.
背景：非法使用芬太尼在美国已经变得很普遍，导致吸毒者过量死亡的比例很高。本研究描述了罗德岛阿片类药物使用者对芬太尼暴露的模式和看法。方法：对2016年1 - 11月在罗德岛州使用非法阿片类药物或滥用处方阿片类药物的149人进行问卷调查，采用混合方法进行研究。其中，121人知道芬太尼，并报告在过去一年中已知或疑似接触过芬太尼。对前47名参与者进行了半结构化访谈。结果：研究参与者主要是男性（64%）和白人（61%）。人口统计变量在不同的样本阶层中是相似的。海洛因是报告中最常选择的毒品（72%）。自我报告在过去一年中接触非法芬太尼的情况很常见（50.4%,n = 61）。在多变量模型中，过去一年中定期（至少每周）使用海洛因与已知或疑似芬太尼暴露独立相关（调整患病率比(APR) = 4.07, 95% CI: 1.24-13.3, p = 0.020）。在采访中，使用者称芬太尼令人不快，可能致命，应该避免使用。报告芬太尼暴露的参与者经常经历或遇到非致命的过量服用。海洛因使用者报告说，他们识别毒品中芬太尼的能力有限。用于保护自己免受芬太尼暴露和过量使用伤害的减少策略包括测试击中，寻求处方阿片类药物代替海洛因，以及寻求丁丙诺啡/纳洛酮联合治疗。参与者通常无法获得结构化的治疗方案。结论：在罗德岛州的非法阿片类药物使用者中，已知或疑似芬太尼暴露是常见的，但对芬太尼的需求很低。受芬太尼污染的药物引起了用户对包括治疗在内的有效风险缓解战略的兴趣。应对芬太尼流行病的措施应借鉴当地使用者的看法和经验。丁丙诺啡/纳洛酮供应的迅速扩大可能会减缓芬太尼过量死亡的速度。(c) 2017年作者。Elsevier B.V.出版
Background: Illicit fentanyl use has become wide spread in the US, causing high rates of overdose deaths among people who use drugs. This study describes patterns and perceptions of fentanyl exposure among opioid users in Rhode Island.Methods: A mixed methods study was conducted via questionnaire with a convenience sample of 149 individuals using illicit opioids or misusing prescription opioids in Rhode Island between January and November 2016. Of these, 121 knew of fentanyl and reported known or suspected exposure to fentanyl in the past year. Semi-structured interviews were conducted with the first 47 participants.Results: Study participants were predominantly male (64%) and white (61%). Demographic variables were similar across sample strata. Heroin was the most frequently reported drug of choice (72%). Self-reported exposure to illicit fentanyl in the past year was common (50.4%, n = 61). In multivariate models, regular (at least weekly) heroin use was independently associated with known or suspected fentanyl exposure in the past year (adjusted prevalence ratio (APR) = 4.07, 95% CI: 1.24-13.3, p = 0.020). In interviews, users described fentanyl as unpleasant, potentially deadly, and to be avoided. Participants reporting fentanyl exposure routinely experienced or encountered non-fatal overdose. Heroin users reported limited ability to identify fentanyl in their drugs. Harm reduction strategies used to protect themselves from fentanyl exposure and overdose, included test hits, seeking prescription opioids in lieu of heroin, and seeking treatment with combination buprenorphine/naloxone. Participants were often unsuccessful in accessing structured treatment programs.Conclusion: Among illicit opioid users in Rhode Island, known or suspected fentanyl exposure is common, yet demand for fentanyl is low. Fentanyl-contaminated drugs are generating user interest in effective risk mitigation strategies, including treatment. Responses to the fentanyl epidemic should be informed by the perceptions and experiences of local users. The rapid scale-up of buprenorphine/naloxone provision may slow the rate of fentanyl-involved overdose deaths. (c) 2017 The Authors. Published by Elsevier B.V.