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

项目摘要在过去的20年里，药物过量危机已经在美国夺走了100多万人的生命。为了应对这场危机，纽约市实施了全国第一个公认的过量服药预防中心(OPC)，这些设施允许客户在接受过培训以在服药过量时进行干预的人员的监督下消费预先获得的受控物质。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，并提供转介到其他治疗、健康和康复服务。2021年7月，罗德岛州成为第一个授权服药过量预防中心(OPC)的州，计划于2022年3月开业。虽然其他国家的研究表明，OPC具有个人和社区利益，但美国没有对受制裁的OPC进行评估。这项拟议的研究具有很高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的潜在好处和意想不到的后果。作为第一步，我们将评估[1]OPC实施后对与毒品有关的公共秩序的衡量标准(例如，在公共场所吸毒、与毒品有关的垃圾)的立即变化，并将这些变化与不包含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潜在客户队列的可行性，这些客户使用纽约市和罗德岛的OPC来检查一系列行为、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、多组成部分的长期研究奠定基础，以评估与在这两个司法管辖区实施OPC有关的个人和社区一级成果的广度。

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.