Reducing Drug-Related Mortality Using Predictive Analytics: A Randomized, Statewide, Community Intervention Trial

在过去的二十年里，药物过量危机在美国夺去了100多万人的生命。为了应对这一危机，纽约市已经建立了全国第一个公开认可的过量预防中心（OPC），这些中心是允许客户在经过培训的人员的监督下消费预先获得的受控物质的设施，这些人员接受过过量事件的干预。OPC的工作人员还提供更安全的药物消费教育，获得无菌药物使用用品，提供其他健康和辅助服务，并提供其他治疗，健康和康复服务的转介。2021年7月，罗得岛成为第一个授权过量预防中心（OPC）的州，计划于2022年3月开放。虽然其他国家的研究表明，OPCs具有个人和社区的好处，但在美国没有对受制裁的OPCs进行评估。拟议的研究具有高度的公共卫生和政策意义，因为该项目将首次确定美国受制裁的OPC的潜在益处和意外后果。作为第一步，我们将评估OPC实施后立即在与毒品有关的公共秩序措施方面的变化（例如，公共场所的药物使用，与药物有关的垃圾），并将这些变化与不含OPC的对照社区的趋势进行比较（目标1）。我们还将确定招募和保留一批在纽约市和罗得岛使用OPC的潜在客户的可行性，以检查一系列行为、健康和与护理结果的联系（目标2）。如果成功，这项初步研究将为一项强有力的、多组成部分的、长期的研究奠定基础，以评估这两个司法管辖区实施OPC所带来的个人和社区层面成果的广度。

PROJECT SUMMARY The drug overdose crisis has claimed more than one million lives in the United States over the past two decades. In response to this crisis, New York City has implemented the nation’s first publicly recognized overdose prevention centers (OPCs), which are facilities that permit clients to consume pre-obtained controlled substances under the supervision of personnel who are trained to intervene in the event of an overdose. Staff at OPCs also provide safer drug consumption education, access to sterile drug use supplies, offer other health and ancillary services, and provide referrals to other treatment, health, and recovery services. In July 2021, Rhode Island became the first state to authorize overdose prevention centers (OPCs), with plans to open in March 2022. While studies from other countries have demonstrated that OPCs have individual and community benefits, there exist no evaluations of sanctioned OPCs in the United States. The proposed research is of high public health and policy significance, since this project will, for the first time, determine the potential benefits and unintended consequences of sanctioned OPCs in the US. As a first step, we will evaluate immediate, post[1]OPC implementation changes in measures of drug-related public disorder (e.g., drug use in public, drug-related litter) and compare these changes to trends in control neighborhoods that do not contain OPCs (Aim 1). We will also establish the feasibility of recruiting and retaining a prospective cohort of clients who use an OPC in New York City and Rhode Island to examine a range of behavioral, health, and linkage to care outcomes (Aim 2). If successful, this preliminary research will lay the foundation for a robust, multi-component, longer-term study to evaluate the breadth of individual and community-level outcomes associated with OPC implementation in these two jurisdictions.