Evaluation of Drug Checking as a Novel Intervention to Address the Opioid Overdose Crisis Attributable to Fentanyl and its Analogues

药物检查作为解决芬太尼及其类似物导致的阿片类药物过量危机的新型干预措施的评估

• 批准号: 10491661
• 负责人: Evan Wood
• 金额: $ 49.42万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10491661
• 关键词: Address; Adopted; American; Back; Behavior; Behavior Therapy; Behavioral; British Columbia; Canada; Caring; Cause of Death; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chemicals; Cocaine; Dancing; Data; Decision Making; Drug Compounding; Drug Evaluation; Drug usage; Drug user; Emergency response; Environment; Environmental Exposure; Epidemic; European; Evaluation Research; Event; Fentanyl; Funding; Generations; Goals; Government; Hallucinogens; Health; Healthcare Systems; Hospitals; Illicit Drugs; Immunoassay; Income; Individual; Intervention; Intervention Studies; Laboratories; Legal; Life; Light; Link; Medical; Methods; Music; Naloxone; Narcotic Analgesics; National Institute of Drug Abuse; North America; Opioid; Outcome; Overdose; Overdose reversal; Pattern; Pharmaceutical Preparations; Policies; Program Evaluation; Province; Psychotropic Drugs; Public Health; Questionnaires; Recording of previous events; Recreational Drugs; Reference Standards; Registries; Request for Applications; Research; Research Personnel; Rhode Island; Risk; Risk Behaviors; Risk Reduction; Sampling; Savings; Scientific Advances and Accomplishments; Scientific Evaluation; Services; Shapes; Site; Source; Spectroscopy, Fourier Transform Infrared; Statutes and Laws; Stimulant; Street Drugs; Techniques; Technology; Testing; Time; United States National Institutes of Health; Visit; Washington; Weight; Work; addiction; analog; base; behavior change; cost; demographics; drug market; drug testing; drug use behavior; ecstasy; equipment acquisition; health data; implementation measures; improved; innovation; laboratory equipment; mortality; non-opioid analgesic; novel; opioid agonist therapy; opioid epidemic; opioid mortality; opioid overdose; opioid use; opioid user; overdose risk; point of care; prevent; programs; public health intervention; rapid testing; recruit; scale up; service utilization; social structure; sociodemographics; stimulant user; substance use; synthetic opioid; test strip; treatment optimization; uptake

PROJECT SUMMARY This application requests funding for the rigorous scientific evaluation of a provincial drug checking program in a Canadian setting where drug checking is legal. Drug checking—the analysis of illicit drug samples and provision of drug composition information back to people who use drugs (PWUD)—is a highly innovative public health intervention that can equip PWUD with crucial information and potentially contribute to life-saving behavior change. This is particularly relevant in light of the most serious drug overdose crisis in North American history. Evidence indicates that fentanyl and fentanyl analogues are increasingly found as adulterants in the street opioid supply across much of the continent, and may also be found in the stimulant and psychedelic street drug supply. While various drug checking technologies have been used in some European jurisdictions to reduce the risks of using illicit recreational drugs (e.g., MDMA, ecstasy) in the electronic dance music scene, drug checking of other street drugs is still nascent in North America and remains largely illegal in the U.S. In the Canadian province of British Columbia, governments at all levels have supported drug checking programs as part of their opioid overdose emergency response and have invested in technology and operational funding for drug checking services, including both rapid point-of-care and laboratory-based confirmatory testing. This represents a significant opportunity to study this intervention and its impacts on opioid overdose risk. Accordingly, this application seeks to fund a rigorous scientific evaluation that aims to evaluate and describe the rate and patterns of uptake of point-of-care drug checking technologies by various drug market actors (e.g., opioid users, stimulant users, drug dealers). It further aims to behavioral impacts and overdose risk reduction practices (e.g., using less) associated with receipt of quantitative and qualitative drug checking results among different drug market actors. Lastly, it aims to examine the impact of drug checking service utilization on non-fatal and fatal overdose events. This highly innovative and significant program of research involves the use of three complementary sources of data: 1) baseline questionnaire data, which captures information on demographics, drug use patterns and behaviors, and social-structural and environmental exposures; 2) longitudinal data on street drug contents using point-of-care and established laboratory techniques as well as data on intended behaviors following receipt of drug checking results; and 3) detailed longitudinal administrative public health data available on overdose outcomes through Canada’s universal health care system. Collectively, these data will be confidentially linked and used to evaluate how such information can be integrated into addiction treatment and substance use focused public health programming. Investigating innovative solutions to the opioid crisis is perfectly aligned with NIDA’s plans to highlight research on synthetic psychoactive drugs, as well as with the broad behavioral intervention goals identified by NIH’s HEAL and Opioid Initiatives, which include research dedicated to preventing and reversing overdoses.

项目概要 本申请请求资助对省级药品检查项目进行严格的科学评估 药品检查在加拿大是合法的。药物检查——非法药物样本的分析和 向吸毒者 (PWUD) 提供药物成分信息——是一个高度创新的公众 健康干预措施可以为残疾人士提供重要信息并可能有助于挽救生命的行为 改变。鉴于北美历史上最严重的药物过量危机，这一点尤其重要。 有证据表明，芬太尼和芬太尼类似物越来越多地被发现作为街头阿片类药物的掺假物 供应遍及非洲大陆大部分地区，也可能出现在兴奋剂和致幻剂街头毒品供应中。 虽然欧洲一些司法管辖区已使用各种药物检查技术来降低风险 在电子舞曲领域使用非法娱乐性药物（例如 MDMA、摇头丸）、对其他人进行药物检查 街头毒品在北美仍处于萌芽状态，在美国基本上仍然是非法的。 不列颠哥伦比亚省各级政府都支持药物检查计划作为其阿片类药物的一部分 药物过量应急响应，并投资了药物检查的技术和运营资金 服务，包括快速现场护理和基于实验室的验证性检测。这代表了一个 研究这种干预措施及其对阿片类药物过量风险影响的重要机会。据此，这 申请旨在资助严格的科学评估，旨在评估和描述比率和模式 不同毒品市场参与者（例如阿片类药物使用者、兴奋剂使用者）采用床旁药物检查技术的情况 用户、毒贩）。它还旨在减少行为影响和过量风险的实践（例如，减少使用） 与收到不同毒品市场参与者之间的定量和定性药物检查结果相关。 最后，其目的是研究药物检查服务的利用对非致命和致命用药过量事件的影响。 这项高度创新且意义重大的研究计划涉及使用三种互补来源 数据：1) 基线问卷数据，捕获有关人口统计、吸毒模式和 行为、社会结构和环境暴露； 2) 使用街头毒品含量的纵向数据 护理点和已建立的实验室技术以及收到后预期行为的数据 药品检查结果； 3) 关于用药过量的详细纵向行政公共卫生数据 通过加拿大全民医疗保健系统取得的成果。总的来说，这些数据将被保密地链接起来 并用于评估如何将这些信息整合到成瘾治疗和药物滥用中 公共卫生规划。研究阿片类药物危机的创新解决方案与 NIDA 的目标完全一致 计划重点研究合成精神活性药物以及广泛的行为干预 NIH 的 HEAL 和阿片类药物倡议确定的目标，其中包括致力于预防和阿片类药物的研究 逆转药物过量。