Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency
Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency
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DOI：
10.1186/s12954-018-0232-z
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发表时间：
2018-05-16
影响因子：
4.4
通讯作者：
Ciccarone, Daniel
中科院分区：
文献类型：
--
作者：
Mars, Sarah G.;Ondocsin, Jeff;Ciccarone, Daniel
背景：在国际上，过量是注射毒品者死亡的主要原因。然而，自2001年以来，美国与海洛因有关的过量死亡人数增加了六倍，其中合成阿片类药物，特别是芬太尼的死亡率上升。本文认为，一些美国海洛因注射者正在作出调整，以保护自己免受这些risks.Methods：2015年和2016年之间，一组民族志学家收集的数据，通过半结构化的采访和观察捕获的现场笔记和视频记录的海洛因准备/消费。访谈了91名当前的海洛因注射者（巴尔的摩，n = 22;芝加哥，n = 24;马萨诸塞州和新罕布什尔州，n = 36;旧金山弗朗西斯科，n = 9）。注射海洛因的经验从不到1年到47年不等。八名参与者，谁是纯粹的海洛因吸食者，也接受了采访。数据进行了分析thematics.Results：在整个研究地点，多种方法的采样“海洛因”被确定，有时结合使用，范围从非注射途径（鼻吸，吸烟或品尝少量注射前）注射部分剂量和等待。部分注射有不同的形式：“慢射”，即用户将一部分溶液注入注射器，将针头保持在注射部位，然后继续或撤回注射器，或“测试器射”，即溶液被分成单独的注射。其他技术包括从使用同一批次海洛因的其他人那里获得反馈，或者观察那些对注射同一批次海洛因具有较高耐受性的人，然后再判断自己注射多少。虽然少数受访者描述使用这些药物采样技术，有明显的接受性，一些用户保护自己，通过使用各种methods.Conclusions：使用药物采样作为一种手段，防止过量注射药物使用减少了吸收的数量在任何一个时间允许用户监测药物强度和滴定相应的剂量。鉴于目前在美国作为海洛因出售的毒品的效力高度不可预测，应该更广泛地采取普遍预防措施。需要进一步研究采用这些药物取样方法的促进因素和障碍。
Background: Internationally, overdose is the primary cause of death among people injecting drugs. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks.Methods: Between 2015 and 2016, a team of ethnographers collected data through semi structured interviews and observation captured in field notes and video recording of heroin preparation/consumption. Ninety-one current heroin injectors were interviewed (Baltimore, n = 22; Chicago, n = 24; Massachusetts and New Hampshire, n = 36; San Francisco, n = 9). Experience injecting heroin ranged from < 1-47 years. Eight participants, who were exclusively heroin snorters, were also interviewed. Data were analyzed thematically.Results: Across the study sites, multiple methods of sampling "heroin" were identified, sometimes used in combination, ranging from non injecting routes (snorting, smoking or tasting a small amount prior to injection) to injecting a partial dose and waiting. Partial injection took different forms: a "slow shot" where the user injected a portion of the solution in the syringe, keeping the needle in the injection site, and continuing or withdrawing the syringe or a "tester shot" where the solution was divided into separate injections. Other techniques included getting feedback from others using heroin of the same batch or observing those with higher tolerance injecting heroin from the same batch before judging how much to inject themselves. Although a minority of those interviewed described using these drug sampling techniques, there is clearly receptivity among some users to protecting themselves by using a variety of methods.Conclusions: The use of drug sampling as a means of preventing an overdose from injection drug use reduces the quantity absorbed at any one time allowing users to monitor drug strength and titrate their dose accordingly. Given the highly unpredictable potency of the drugs currently being sold as heroin in the US, universal precautions should be adopted more widely. Further research is needed into facilitators and barriers to the uptake of these drug sampling methods.