Bath Salts & the Illicit Drug Market: Use, Violence & Health Consequences

描述（由申请人提供）：使用“浴盐”——一种与甲基苯丙胺和可卡因效果相似的合成卡西酮——与该国各地青少年和成年人的暴力行为、紧急住院和一些死亡事件有关。作为回应，几个州和地方管理机构以及联邦政府最近立法禁止浴盐中的活性化学成分。这些措施造成了一个新的非法药物市场，可能会严重影响使用者的体验。迄今为止，人们对浴盐的了解大多来自急诊室的报告和大众媒体对极端用户体验的报道。然而，同样重要的是要了解使用者的经历，他们可能最终不会进入急诊室，但可能会招致与药物有关的其他未知健康风险。迄今为止，科学研究主要集中在毒理学上，这一点至关重要，因为浴盐制造商经常调整成分化学成分，以逃避执法。然而，人们对正在发展的非法市场、亚文化和其他影响用户体验的社会背景知之甚少。这里提出的为期5年的混合方法调查将开始填补这一知识空白，实现以下目标：A.（毒品市场一体化）科学地记录浴盐融入非法毒品市场的情况，确定和记录正在销售的常见浴盐品种、销售方式、销售数量、价格变化、获得产品的途径、街头/品牌名称和名称变更以及经销商如何管理使用者；B.（暴力的作用）描述暴力的作用，并记录这种暴力如何以及在什么情况下与浴盐的使用/销售同时发生，以及非法市场如何管理这种行为；将审查与快客和甲基苯丙胺的比较，以记录市场如何调整以整合这些行为；C.（使用惯例）记录浴盐使用者的使用惯例（制定和设定）和行为规范，并查明与使用有关的长期健康问题。招聘和数据收集将平均分配给4个城市：新奥尔良、休斯顿、加尔维斯顿（德克萨斯州）和纽约。研究小组以前曾在所有这些城市进行市场研究，并在非法药物使用者和销售者之间建立了良好的联系。方法将包括民族志（n=80）、焦点小组（n=200）和调查（n= 1000）。这项研究将补充正在进行的关于浴盐的毒理学研究，这与NIDA以跨学科的方式将科学应用于药物滥用和成瘾问题的使命是一致的。了解浴盐使用的亚文化和社会背景，包括使用者的看法和期望，将有助于制定和实施高度针对性的预防信息和治疗战略的长期目标。

DESCRIPTION (provided by applicant): The use of "bath salts" - synthetic cathinones with effects similar to methamphetamine and cocaine - has been associated with violent behavior, emergency hospitalizations and some fatalities among youth and adults in various parts of the country. In response, several state and local governing bodies and the federal government recently legislated bans on the active chemical ingredients in bath salts. These measures have created a new illicit drug market, which may significantly affect user experiences. Most of what is known about bath salts to date comes from emergency room reports and mass media coverage of extreme user experiences. However, it is also important to understand the experiences of users who may not end up in emergency rooms but who may be incurring other, as yet unknown, health risks related to the drugs. Scientific research to date is focused on toxicology, which is vitally important, given that bath salts makers frequently adjust the ingredient chemicals in order to evade law enforcement. Little is known, however, about the developing illicit market, or about subcultural and other social contexts that affect user experiences. The mixed-methods, 5-year investigation proposed here will start to fill that knowledge gap, by meeting the following aims: A. (Drug Market Integration) To scientifically document the integration of bath salts into the illicit drug markets, identify and document commonplace varieties of bath salts that are being sold, how they are sold, quantities being sold, variation in prices, access to products, street/brand names and name changes and how dealers manage users; B. (Role of Violence) To delineate the role of violence and document how and under what circumstances such violence co-occurs with bath salts use/sales, and how the illicit market manages such behaviors; a comparison with crack and methamphetamine will be examined to document how the market adjusts to integrate such behaviors; C. (Use Practices) To document use practices (set and setting) and conduct norms among bath salts users and to identify health problems occurring over time associated with use. Recruitment and data collection will be evenly divided among 4 cities: New Orleans, Houston, Galveston (TX) and New York. The research team has previously conducted market studies in all of these cities and has well established contacts among illicit drug users and sellers. Methods will include ethnography (n=80), focus groups (n=200) and survey (n=1,000). This study will complement ongoing toxicology research into bath salts, consistent with NIDA's mission to apply science to questions of drug abuse and addiction, and to do so in a cross-disciplinary way. Understanding subcultural and social contexts of bath salts use, including user perceptions and expectations, will serve the long-term goal of developing and implementing highly targeted prevention messages and treatment strategies.