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

项目总结 本申请申请资金，用于对#年省级药品检查项目进行严格的科学评估。 在加拿大，毒品检查是合法的。毒品检查--分析非法药物样本和 向吸毒者提供药物成分信息(PWUD)-是一个高度创新的公众 健康干预，可以为PWUD提供关键信息，并可能有助于拯救生命的行为 变化。鉴于北美历史上最严重的药物过量危机，这一点尤其相关。 有证据表明，芬太尼和芬太尼类似物越来越多地被发现为街头阿片类药物的掺杂物。 在非洲大陆的大部分地区都有毒品供应，在兴奋剂和迷幻剂的街头毒品供应中也可能发现这种情况。 虽然各种药物检查技术已在一些欧洲司法管辖区使用，以降低 在电子舞曲现场使用非法娱乐药物(如摇头丸、摇头丸)，检查其他 街头毒品在北美仍处于萌芽状态，在美国仍然是非法的。 不列颠哥伦比亚省，各级政府支持药物检查计划，将其作为阿片类药物的一部分 过量应急，并投资于药物检查的技术和业务资金 服务，包括快速护理点检测和基于实验室的确证检测。这表示一个 这是研究这一干预措施及其对阿片类药物过量风险影响的重要机会。因此，这 应用程序寻求资助一项严格的科学评估，旨在评估和描述比率和模式 不同药品市场行为者(如阿片类药物使用者、兴奋剂)对护理点药物检查技术的接受情况 吸毒者、毒贩)。它还着眼于行为影响和减少过量用药的风险做法(例如，减少使用) 与收到不同药品市场行为者之间的定量和定性药品检查结果有关。 最后，它的目的是研究药物检查服务的利用对非致命和致命的过量用药事件的影响。 这一极具创新性和重大意义的研究计划涉及使用三个互补的来源 数据：1)基线问卷数据，其中包括人口统计、药物使用模式和 行为、社会结构和环境暴露；2)街头毒品使用情况的纵向数据 护理点和已建立的实验室技术以及在收到以下信息后预期行为的数据 药物检查结果；以及3)关于过量用药的详细的纵向公共卫生管理数据 通过加拿大的全民医疗保健系统取得的成果。总而言之，这些数据将以保密方式链接 并用于评估如何将这些信息整合到成瘾治疗和重点药物使用中 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 计划强调合成精神活性药物的研究，以及广泛的行为干预 NIH的治疗和阿片类药物倡议确定的目标，其中包括致力于预防和 逆转过量用药。

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.