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Exploring transitions to injecting among young adult non-medical opioid users

探索年轻成人非医疗阿片类药物使用者向注射的转变

基本信息

批准号：
8845186
负责人：
Brandon David Lewis Marshall
金额：
$ 16.62万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-05-15 至 2017-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8845186
关键词：
Address Adoption Adult Characteristics Cocaine Cohort Studies Communicable Diseases Communities Data Data Linkages Development Drug Formulations Drug Prescriptions Drug usage Drug user Effectiveness Epidemiology Exposure to Family member Goals HIV HIV Infections HIV risk Health Hepatitis C Hepatitis C virus Heroin High Prevalence Illicit Drugs Infection Injection of therapeutic agent Internet Intervention Knowledge Medical Methodology Methods Monitor Morbidity - disease rate Nature Needle-Exchange Programs Opiate Addiction Opioid Oral Overdose Oxycodone Pain management Participant Persons Pharmaceutical Preparations Physicians Pilot Projects Policies Population Prevalence Procedures Productivity Public Health Recording of previous events Recruitment Activity Reporting Research Respondent Rhode Island Risk Risk Behaviors Risk Factors Route Sampling Severities Social Network Source Technology United States Vulnerable Populations Work addiction adverse outcome age group aged base cost design disease transmission effective intervention health economics improved injection drug use member mortality novel opioid abuse outreach overdose death peer prescription opioid prescription opioid abuse prevent programs prospective risk perception social therapy development transmission process urban area web site young adult

项目摘要

DESCRIPTION: Non-medical prescription opioid (NMPO) use is a serious public health problem in the United States. Although NMPO-related health and social harms, including opioid dependence, lost productivity, and overdose are major causes of morbidity and mortality, initiation of injection drug use and infectious disease specific consequences, including HIV and hepatitis C virus (HCV) infection, are crucially understudied. The objective of this project is to examine the context and epidemiology of injection drug use as well as HIV- and HCV-related risk behaviors among young adult NMPO users. The ultimate goal of this pilot study is to use these data to inform the development of a prospective cohort study to determine the multi-level risk factors for initiation of injection drug use in this population. Specifically, the proposed stdy has the following aims: (1) to compare and evaluate the feasibility of two novel sampling methods to recruit young adult NMPO users; and (2), to explore social, macro-social, and drug-related factors associated with HIV risk behavior and transitions to injection drug use among young adult NMPO users. To achieve these aims, we will conduct a pilot study of 200 NMPO users aged 18 to 25 who reside in Rhode Island (RI), a state that is among the highest in the prevalence of NMPO use among young adults. To achieve Aim 1, we will compare the efficiency, cost, and sample composition of two novel recruitment strategies, including a combination of targeted canvassing and respondent-driven sampling, as well as mixed internet-based recruitment from drug information and social media websites. To achieve Aim 2, we will assess non-injectors' perceptions of risk for initiating injection. We will also examine the relationship between social, macro-social, and drug-related risk factors (e.g., diversion from family members, social network characteristics, denial of opioids for pain control, progression to heroin use following abuse-deterrent reformulations) and HIV risk behaviors and transitions to injection drug use. Finally, to assess receipt of opioid prescriptions from multiple physicians as risk factor for injecting initiation, we will obtain past-year opioid dispensation histories by conducting a deterministic, confidential data linkage to the RI prescription monitoring program. This study has important implications for improved prescription opioid exposure assessments as well as the development of novel sampling methodologies to access members of a population that, due to the hidden and amorphous nature of NMPO use, has been challenging to study. This research will address several questions central to the urgent public health challenges facing non-medical users of prescription opioids in the US, particularly in the context of evolving technologies and abuse-deterrent formulations to prevent injecting and opioid abuse. Taken together, the results of this work will inform the development of interventions to prevent injectin initiation and reduce HIV transmission in NMPO-using populations, and avert unintended adverse consequences of ongoing prescription opioid prescribing and policy changes.

非医疗处方阿片类药物（NMPO）的使用是美国严重的公共卫生问题。虽然NMPO相关的健康和社会危害，包括阿片类药物依赖，丧失生产力和过量是发病率和死亡率的主要原因，但注射药物使用的开始和传染病的具体后果，包括艾滋病毒和丙型肝炎病毒（HCV）感染，是至关重要的研究不足。该项目的目的是研究注射吸毒的背景和流行病学以及年轻成年NMPO使用者中HIV和HCV相关的风险行为。本初步研究的最终目标是使用这些数据为前瞻性队列研究的开发提供信息，以确定该人群中开始注射药物使用的多水平风险因素。具体而言，拟议的研究有以下目的：（1）比较和评估两种新的抽样方法招募年轻成人NMPO用户的可行性;（2），探讨社会，宏观社会和药物相关因素与艾滋病毒的危险行为和过渡到注射毒品使用的年轻成人NMPO用户。为了实现这些目标，我们将对居住在罗得岛（RI）的200名18至25岁的NMPO使用者进行试点研究，罗德岛是年轻人使用NMPO流行率最高的州之一。为了实现目标1，我们将比较两种新的招募策略的效率，成本和样本组成，包括有针对性的拉票和响应者驱动的抽样相结合，以及混合基于互联网的药物信息和社交媒体网站的招聘。为了实现目标2，我们将评估非注射者对开始注射的风险的看法。我们还将研究社会、宏观社会和药物相关风险因素之间的关系（例如，从家庭成员转移、社会网络特征、拒绝使用阿片类药物控制疼痛、在滥用威慑重新配制后发展为使用海洛因）以及艾滋病毒风险行为和过渡到注射吸毒。最后，为了评估从多名医生处接受阿片类药物处方作为开始注射的风险因素，我们将通过与RI处方监测计划进行确定性的机密数据链接，获得过去一年的阿片类药物处方史。这项研究对改善处方阿片类药物暴露评估以及开发新的采样方法以访问人群成员具有重要意义，由于NMPO使用的隐藏性和无定形性，研究一直具有挑战性。这项研究将解决美国处方阿片类药物非医疗使用者面临的紧迫公共卫生挑战的几个核心问题，特别是在不断发展的背景下，预防注射和类阿片滥用的技术和防滥用制剂。总而言之，这项工作的结果将为制定干预措施提供信息，以防止注射开始并减少NMPO使用人群中的艾滋病毒传播，并避免持续的阿片类处方药处方和政策变化带来意想不到的不良后果。

项目成果

期刊论文数量（8）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Social context and perspectives of non-medical prescription opioid use among young adults in Rhode Island: A qualitative study.

罗德岛州年轻人非医疗处方阿片类药物使用的社会背景和观点：一项定性研究。

DOI：
10.1111/ajad.12466
发表时间：
2016
期刊：
The American journal on addictions
影响因子：
0
作者：
Yedinak,JesseL;Kinnard,ElizabethN;Hadland,ScottE;Green,TraciC;Clark,MelissaA;Marshall,BrandonDL
通讯作者：
Marshall,BrandonDL

Access to substance use treatment among young adults who use prescription opioids non-medically.