Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States
Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States
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DOI：
10.1016/j.drugpo.2018.08.007
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发表时间：
2019-01-01
影响因子：
4.4
通讯作者：
Zibbell, Jon E.
中科院分区：
文献类型：
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作者：
Peiper, Nicholas C.;Clarke, Sarah Duhart;Zibbell, Jon E.
背景资料：2016年，涉及非法制造的芬太尼（IMF）的过量死亡人数首次超过海洛因和处方阿片类药物死亡人数，从2013年到2016年，10个州涉及IMF的过量死亡人数增加了500%以上。IMF是一种非常有效的合成阿片类药物，经常与海洛因混合，并经常出售给不知情的消费者。社区组织已开始分发芬太尼试纸，作为在街头购买的产品中识别货币基金组织的一项战略。我们调查了FTS的使用和药物使用行为的变化之间的关联，并认为过量的安全性之间的社区为基础的样本的人谁注射毒品（PWID）in the United States.Methods：在2017年9月至10月，共有125 PWID完成了一项在线调查，他们最近的FTS使用在格林斯伯勒，北卡罗来纳州。我们感兴趣的第一个结果包括PWID在使用FTS后是否发生以下药物使用行为变化：使用量低于平时，给予测试注射，推动注射器柱塞比平时慢，以及用鼻喷而不是注射。我们感兴趣的第二个结果是PWID是否认为FTS的使用使他们感觉能够更好地保护自己免受过量。我们进行了双变量和多变量分析，以确定FTS的使用和这两个outcome.Results之间的关联：总体而言，63%的样本报告阳性FTS测试结果和81%的报告使用FTS之前消耗他们的药物。对于结果，43%的人报告了药物使用行为的变化，77%的人表示通过使用FTS增加了过量用药的安全性。在调整人口统计学和FTS相关性的多变量模型中，与阴性结果相比，具有阳性FTS测试结果的PWID报告药物使用行为变化的几率是阴性结果的5倍。在吸毒后使用FTS的PWID与吸毒前使用FTS的人相比，在随后的吸毒中报告行为变化的可能性降低了70%。PWID谁不是现有的注射器服务程序的客户有四倍的几率比现有的客户报告增加过量使用FTS.Conclusions安全性：我们发现，使用FTS，并收到一个积极的测试结果与药物使用行为的变化和过量安全的看法。当与其他以证据为基础的预防阿片类药物过量和相关伤害的策略一起使用时，FTS可能是对当前过量预防工作的有效补充。
Background: In 2016, the number of overdose deaths involving illicitly-manufactured fentanyl (IMF) surpassed heroin and prescription opioid deaths in the United States for the first time, with IMF-involved overdose deaths increasing more than 500% across 10 states from 2013 to 2016. IMF is an extremely potent synthetic opioid that is regularly mixed with heroin and often sold to unwitting consumers. Community-based organizations have started to distribute fentanyl test strips (FTS) as a strategy to identify IMF in street purchased products. We investigated the association between FTS use and changes in drug use behavior and perceived overdose safety among a community-based sample of people who inject drugs (PWID) in the United States.Methods: Between September-October 2017, a total of 125 PWID completed an online survey about their most recent FTS use in Greensboro, North Carolina. Our first outcome of interest included whether PWID engaged in any of the following changes in drug use behavior after using FTS: used less than usual, administered tester shot, pushed syringe plunger slower than usual, and snorted instead of injected. Our second outcome of interest was whether PWID felt that FTS use made them feel better able to protect themselves from overdose. We conducted bivariate and multivariate analyses to determine the association between FTS use and these two outcomes.Results: Overall, 63% of the sample reported a positive FTS test result and 81% reported using FTS prior to consuming their drugs. For the outcomes, 43% reported a change in drug use behavior and 77% indicated increased perceived overdose safety by using FTS. In multivariable models adjusting for demographic and FTS correlates, PWID with a positive FTS test result had five times the odds of reporting changes in drug use behavior compared to those with a negative result. PWID who used the FTS after drug consumption were 70% less likely to report behavioral changes at subsequent drug consumption compared to those who used it before consumption. PWID who were not existing clients of the syringe services program had four times higher odds than existing clients to report increased overdose safety from using FTS.Conclusions: We found that using FTS and receiving a positive test result was associated with changes in drug use behavior and perceptions of overdose safety. FTS may represent an effective addition to current overdose prevention efforts when included with other evidence-based strategies to prevent opioid overdose and related harm.