A Multi-Site Mixed Methods Study of Methamphetamine Use in the Mountain West

7.项目摘要/摘要 这项提案的目标是(1)审查甲基苯丙胺(MA)的使用模式和相关危害 (包括MA使用障碍和MA过量)在根深蒂固和持续使用阿片类药物的背景下 流行病，以及(2)为社区确定有希望的预防、治疗和减少危害的方法 不成比例地受到毒品相关伤害的影响。我们的团队已经建立了合作和研究 基础设施，并进行了初步研究，告知当前的应用。使用 结构化流行病学访谈、生物检测和定性时间线随访相结合 采访，这项建议旨在了解吸毒者和多药使用模式如何影响健康 结果，重点关注在药物使用研究中代表性不足的群体，特别是现在的研究和 计划的努力几乎完全限于有问题的阿片类药物的使用。这项建议的目的是： 1.评估当前使用MA的流行率并确定与之相关的风险和保护因素；以及 吸毒者中与MA相关的危害。 A.描述使用MA的频率和数量，以及MA使用与其他药物之间的关系； 包括处方(Rx)兴奋剂、阿片类药物和其他多药使用模式。MA使用将是 通过自我报告和尿毒物筛查进行鉴定。 B.确定使用MA与(一)风险因素、(二)保护因素、(三)健康和社会因素之间的联系 后果(例如，自我报告的艾滋病毒、丙型肝炎病毒状态、软组织感染、吸毒过量、药物使用障碍)。 C.检查社会经济地位(SES)、种族和耻辱的缓和影响。 2.定性描述MA使用、多药使用和进展到 滥用和依赖使用终生吸毒史访谈。 A.描述启动模式、MA与其他药物之间的过渡、社会和结构性因素 影响MA的使用(包括Rx阿片类药物和兴奋剂的可用性)、社会网络和经济力量 这就是毒品使用和相关危害的结构。 3.审查承诺预防、治疗和减少危害的可行性和可接受性 为使用MA的人提供的策略。 A.评估潜在生物医学干预措施的可行性和可接受性，例如 治疗MA使用障碍的药物疗法目前正在临床流水线中。 对使用MA的人评估减少伤害策略的可行性和可接受性。 本提案直接响应RFA-CD-21-002目标2。它包含详细的译文和 传播计划，将促进可采取行动的调查结果的快速实施，并利用成功的 调查人员和社区合作伙伴之间现有的多学科合作。

7. Project Summary/Abstract The goal of this proposal is to (1) examine patterns of methamphetamine (MA) use and related harms (including MA use disorder and MA overdose) in the context of an entrenched and ongoing opioid use epidemic, and (2) identify promising prevention, treatment, and harm reduction approaches for communities disproportionately affected by drug-related harms. Our team has an established collaboration and research infrastructure, and has conducted preliminary research that informs the current application. Using a combination of structured epidemiological interviews, biological testing, and qualitative timeline follow-back interviews, this proposal is designed to understand how MA and polydrug use patterns influence health outcomes, with a focus on groups underrepresented in drug use research, especially now when research and program efforts are almost exclusively confined to problematic opioid use. The aims of this proposal are: 1. To estimate prevalence of and identify risk and protective factors associated with current MA use, and MA-related harms among people who use drugs. a. Describe the frequency and quantity of MA use, and associations between MA use and other drugs, including prescription (Rx) stimulants, opioids, and other polydrug use patterns. MA use will be identified by self-report and by urine-toxicology screening. b. Identify associations between MA use and (i) risk factors, (ii) protective factors, (iii) health and social consequences (e.g.,self-reported HIV, HCV status, soft-tissue infections, OD, substance use disorder). c. Examine moderating impact of socioeconomic status (SES), ethnicity, and stigma. 2. To qualitatively describe the experiences of and rationale for MA use, polydrug use, and progression to misuse and dependence using lifetime drug use history interviews. a. Describe patterns of initiation, transition between MA and other drugs, social and structural factors that influence MA use (including Rx opioid and stimulant availability), social networks, and economic forces that structure drug use and related harms. 3. To examine the feasibility and acceptability of promising prevention, treatment, and harm reduction strategies for people who use MA. a. Assess the feasibility and acceptability of potential biomedical interventions, such as pharmacotherapies to treat MA use disorder that are currently in the clinical pipeline. b. Assess feasibility and acceptability of harm reduction strategies for people who use MA. This proposal responds directly to RFA-CD-21-002 Objective 2. It contains a detailed translation and dissemination plan that will facilitate rapid implementation of actionable findings, and leverages a successful existing multidisciplinary collaboration among investigators and community partners.