Consuming illicit opioids during a drug overdose epidemic: Illicit fentanyls, drug discernment, and the radical transformation of the illicit opioid market.
Consuming illicit opioids during a drug overdose epidemic: Illicit fentanyls, drug discernment, and the radical transformation of the illicit opioid market.
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DOI：
10.1016/j.drugpo.2021.103467
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Zibbell JE
中科院分区：
文献类型：
--
作者：
Duhart Clarke SE;Kral AH;Zibbell JE
北美继续面临阿片类药物过量的流行，这是由于非法芬太尼的持续增加和效力的波动导致消费者的不确定性。进行这项定性研究是为了更好地了解注射毒品（PWID）的人如何认识到芬太尼是海洛因的一种日益增长的掺杂物，以及他们随后采用的继续注射的感官识别策略。我们的主要目标是研究如何将观察和知识结合起来，作为检测芬太尼和最大限度地降低风险的本土技术。次要目的是研究芬太尼掺假对个人药物使用行为的影响。2019年4月至5月期间，从北卡罗来纳州格林斯伯勒的针头服务项目中特意招募了28名PWID（18名男性，10名女性;平均年龄= 38.43岁，SD = 9.26）。研究参与者进行了访谈，在人使用定性，半结构化的工具。使用NVivo12的一般归纳法分析了访谈。与会者描述了检测非法阿片类药物中芬太尼的方法。突然增加的效力的"冲"和急剧减少的长度的"高"是主要指标沿着变化的药物颜色和质地。重度镇静与芬太尼的使用有关，组胺释放效应的特征是“针和针”被归因于注射芬太尼作为匆忙的一部分。芬太尼短暂的高帮助解释了较高的注射频率，而重度镇静是芬太尼与可卡因/快克或甲基苯丙胺共同使用的主要原因。PWID有能力识别非法阿片类药物供应的变化。研究参与者通过采用本土识别技术，改变药物使用行为和共同使用非阿片类药物，在非法阿片类药物市场中导航不可预测的波动。研究人员和政策制定者应该让PWID作为主题专家参与进来，帮助芬太尼时代的现代化减害，并采取切实可行的策略来提高弹性和拯救生命。
North America continues to face an opioid overdose epidemic, driven by persistent increases in illicit fentanyls and fluctuations in potency leading to uncertainty for consumers. This qualitative study was conducted to better understand how people who inject drugs (PWID) came to recognize fentanyl as a growing adulterant of heroin and the subsequent sensory discernment strategies they employed to continue injecting. Our main objective was to investigate how observations and knowledge are combined as homegrown techniques for detecting fentanyl and minimizing risk. Secondary objectives were to examine the impact of growing fentanyl adulteration on individual drug use behavior. Between April and May 2019, 28 PWID (18 men, 10 women; average age = 38.43 years, SD = 9.26) were purposely recruited from a needle services program in Greensboro, North Carolina. Study participants were interviewed in-person using a qualitative, semi-structured instrument. Interviews were analyzed with a general inductive approach using NVivo12. Participants described methods for detecting fentanyl in illicit opioids. Sudden increases in the potency of the ‘rush’ and sharp decreases in the length of the ‘high’ were chief indicators along with changes in drug color and texture. Heavy sedation was associated with fentanyl use and histamine-releasing effects characterized as ‘pins and needles’ were ascribed to injecting fentanyl as a component of the rush. Fentanyl’s short high helped explain higher injection frequency and heavy sedation was the leading reason for co-using fentanyl with cocaine/crack or methamphetamine. PWID have the capacity to recognize changes to the illicit opioid supply. Study participants navigated unpredictable fluctuations in the illicit opioid market by employing homegrown discernment techniques, modifying drug use behavior, and co-using non-opioid drugs. Researchers and policymakers should involve PWID as subject matter experts to help modernize harm reduction for the fentanyl age with practical strategies to boost resiliency and save lives.
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影响因子：
4.2
作者：
Bardwell, Geoff;Boyd, Jade;Kerr, Thomas
通讯作者：
Kerr, Thomas
影响因子：
4.4
作者：
Kolla, Gillian;Strike, Carol
通讯作者：
Strike, Carol
影响因子：
12.7
作者：
Cicero, Theodore J.;Ellis, Matthew S.;Kasper, Zachary A.
通讯作者：
Kasper, Zachary A.
DOI：
10.4103/0259-1162.128921
发表时间：
2014-01
期刊：
Anesthesia, essays and researches
影响因子：
--
作者：
Gupta B;Ramchandani S;Balakrishnan I;Kumar A
通讯作者：
Kumar A
DOI：
10.1007/s11524-010-9486-9
发表时间：
2010-09-01
影响因子：
6.6
作者：
Kral, Alex H.;Malekinejad, Mohsen;Raymond, H. Fisher
通讯作者：
Raymond, H. Fisher