Why the FUSS (Fentanyl Urine Screen Study)? A cross-sectional survey to characterize an emerging threat to people who use drugs in British Columbia, Canada.
Why the FUSS (Fentanyl Urine Screen Study)? A cross-sectional survey to characterize an emerging threat to people who use drugs in British Columbia, Canada.
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DOI：
10.1186/s12954-015-0088-4
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发表时间：
2015-11-14
影响因子：
4.4
通讯作者：
Buxton JA
中科院分区：
文献类型：
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作者：
Amlani A;McKee G;Khamis N;Raghukumar G;Tsang E;Buxton JA
在不列颠哥伦比亚省（BC），芬太尼检测到的非法药物过量死亡人数最近从2012年的13人急剧增加到2014年的90人，这标志着一个新的公共卫生问题。非法芬太尼以药丸或粉末形式出售，通常与海洛因或羟考酮等其他物质混合;验尸官的报告表明，芬太尼经常被吸毒者在不知不觉中服用。本研究旨在评估在不列颠哥伦比亚省访问减少伤害（HR）服务的客户中使用芬太尼的流行率和特征。在不列颠哥伦比亚省17个地点参加人力资源服务的参与者被邀请完成一份匿名问卷，描述他们在过去3天内使用的药物，并提供尿液样本以检测芬太尼。使用描述性、双变量和多变量统计方法分析合格参与者的数据。收到了来自17个人力资源站点的调查，对242名合格参与者的回复进行了分析。大多数参与者使用多种物质（中位数= 3），其中冰毒（59%）和海洛因（52%）使用最频繁。70名参与者（29%）芬太尼检测呈阳性，其中73%没有报告使用芬太尼。控制年龄，性别和卫生当局，报告使用芬太尼（比值比（OR）= 6.13，95%置信区间（CI）= [2.52，15.78]，p < 0.001）（OR = 3.82，95%CI = [1.79，8.63]，p < 0.001）使用与芬太尼检测显著相关。检测呈阳性的人中没有报告故意使用芬太尼的比例是一个相当大的公共卫生问题。这一脆弱人群中过量用药的风险突出了有针对性的人力资源策略的必要性，例如增加纳洛酮的可获得性，过量教育和尿液筛查。
Fentanyl-detected illicit drug overdose deaths in British Columbia (BC) recently increased dramatically from 13 deaths in 2012 to 90 deaths in 2014, signaling an emerging public health concern. Illicit fentanyl is sold as pills or powders, often mixed with other substances like heroin or oxycodone; reports from coroners suggested that fentanyl was frequently taken unknowingly by people who use drugs. This study aimed to assess the prevalence and characteristics of fentanyl use among clients accessing harm reduction (HR) services in BC. Participants attending HR services at 17 sites across BC were invited to complete an anonymous questionnaire describing drugs they have used within the last 3 days and provide a urine sample to test for fentanyl. Data from eligible participants were analyzed using descriptive, bivariate, and multivariate statistical methods. Surveys from 17 HR sites were received, resulting in analysis of responses from 242 eligible participants. Most participants used multiple substances (median = 3), with crystal meth (59 %) and heroin (52 %) use most frequently reported. Seventy participants (29 %) tested positive for fentanyl, 73 % of whom did not report using fentanyl. Controlling for age, gender, and health authority, reported use of fentanyl (odds ratio (OR) = 6.13, 95 % confidence interval (CI) = [2.52, 15.78], p < 0.001) and crystal methamphetamine (OR = 3.82, 95 % CI = [1.79, 8.63], p < 0.001) use were significantly associated with fentanyl detection. The proportion of those testing positive who did not report knowingly using fentanyl represents a considerable public health concern. The risk of overdose among this vulnerable population highlights the need for targeted HR strategies, such as increased accessibility to naloxone, overdose education, and urine screens.