People Preferring Fentanyl (PPF): Characteristics, Outcomes, and Perspectives

人们偏好芬太尼 (PPF)：特征、结果和前景

• 批准号: 9973245
• 负责人: Jan Gryczynski
• 金额: $ 20万
• 依托单位: FRIENDS RESEARCH INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9973245
• 关键词: AIDS/HIV problem; Accident and Emergency department; Accounting; Adult; Automobile Driving; Baltimore; Cessation of life; Characteristics; Clinical Trials; Communities; Data; Data Collection; Data Linkages; Databases; Development; Dose; Epidemic; Ethnography; Euphoria; Event; Fentanyl; Firearms; Floods; Health; Health Care Costs; Healthcare; Hearing; Heroin; Hospital Departments; Illicit Drugs; Individual; Injections; Intervention; Interview; Laboratories; Lead; Learning; Maryland; Medical Examiners; Methods; Morphine; Naloxone; Naloxone Training; Names; New England; Opioid; Outcome; Overdose; Participant; Patients; Penetration; Pharmaceutical Preparations; Pharmacologic Substance; Pharmacology; Policies; Population; Preparation; Public Health; Records; Reporting; Research Design; Risk; Risk-Taking; Sampling; Scientific Inquiry; Severities; Side; Structure; System; Testing; Time; Treatment outcome; Ventilatory Depression; Withdrawal; Work; analog; attributable mortality; carfentanil; drug market; health care service utilization; high risk population; illicit opioid; improved; innovation; mortality; novel; opioid injection; opioid mortality; opioid overdose; opioid use; opioid use disorder; overdose death; overdose prevention; overdose risk; preference; prescription opioid; prevent; public health emergency; public health intervention; recruit; response; synthetic opioid; therapy design; therapy development; trafficking; treatment comparison; treatment program; vehicular accident

Project Summary/Abstract The opioid overdose epidemic is a public health emergency, claiming more lives each year than HIV/AIDS, motor vehicle accidents, or firearms at their peak. A significant development in illicit drug markets has been the emergence of illicit fentanyl and its high-potency analogues, often manufactured in clandestine labs overseas. Within just the last few years, fentanyl has become a driver of opioid overdose deaths. The escalation in mortality has been rapid and unprecedented, and fentanyl is now implicated in more deaths than heroin or prescription opioids. Fentanyl’s extreme potency leaves very little room for error in discerning between lethal and non-lethal doses. Illicit fentanyl is often used as an adulterant in the heroin supply, and is increasingly sold on the street by name. Recent evidence suggests that demand-side responses to fentanyl have ranged from avoidance strategies to the development of distinct preferences for fentanyl. The wide availability of fentanyl has led to the emergence of a new group of individuals with opioid use disorder (OUD) for whom fentanyl has become a preferred drug of choice. Very little is known about this high-risk group of people who prefer fentanyl (PPF). It is not known how PPF differ from other individuals with OUD who prefer less potent opioids, how they fare in OUD treatment, or how they perceive overdose prevention and treatment interventions. This study seeks to learn more about intentional vs. unintentional fentanyl exposure and preferences among people entering OUD treatment. The study will: (1) Characterize fentanyl preferences among patients starting OUD treatment, (2) Compare 6-month OUD treatment outcomes for PPF and non-PPF, and (3) examine PPF perspectives on public health interventions to prevent overdose and improve OUD treatment engagement. The study will recruit 250 fentanyl-exposed adults newly admitted to a large community OUD treatment program. Participants will complete a structured assessment, and 6-month outcomes will be tracked via innovate data linkage across OUD treatment, healthcare, and judiciary record systems. A subset of 40 participants will complete semi-structured, qualitative interviews focused on fentanyl preferences and perspectives on interventions. This study will yield timely data on the public health emergency of fentanyl, and will inform intervention design for a high-risk group of patients who have developed distinct preferences for fentanyl.

项目摘要/摘要 阿片类药物过量流行是一种公共卫生紧急情况，每年夺走的生命超过艾滋病毒/艾滋病， 机动车事故，或枪械的高峰期。非法毒品市场的一个重大发展是 非法芬太尼及其高效类似物的出现，通常是在海外的秘密实验室制造的。 就在过去的几年里，芬太尼已经成为阿片类药物过量死亡的驱动因素。中美关系升级 死亡是迅速和史无前例的，芬太尼现在涉及的死亡人数比海洛因或 处方类阿片。芬太尼的极端效力在区分致命和致命之间的错误方面几乎没有留下什么空间 和非致命性剂量。非法芬太尼经常被用作海洛因供应中的掺杂物，而且越来越多地被出售 在街上叫着名字。 最近的证据表明，需求侧对芬太尼的反应从回避策略到 对芬太尼的不同偏好的发展。芬太尼的广泛使用导致了这种情况的出现 一组新的阿片类药物使用障碍(OUD)患者，芬太尼已成为他们的首选药物 选择。对于这群喜欢芬太尼(PPF)的高危人群，我们知之甚少。目前尚不清楚 PPF与其他更喜欢效力较低的阿片类药物的OUD患者有何不同，他们在OUD中的表现如何 或者他们如何看待过量用药的预防和治疗干预。 这项研究旨在了解更多关于有意和无意芬太尼暴露和偏好的情况 人们进入了我们的治疗。这项研究将：(1)描述患者对芬太尼的偏好。 OUD治疗，(2)比较PPF和非PPF的6个月治疗结果，以及(3)检查PPF 预防过量用药和提高治疗参与度的公共卫生干预的观点。 这项研究将招募250名新近进入大型社区接受治疗的芬太尼暴露的成年人。 程序。参与者将完成结构化评估，并通过以下方式跟踪6个月的结果 创新OUD治疗、医疗保健和司法记录系统的数据链接。40个人的子集 参与者将完成半结构化的定性访谈，重点是芬太尼的偏好和 对干预措施的看法。 本研究将提供有关芬太尼突发公共卫生事件的及时数据，并将为干预设计提供参考 适用于对芬太尼有明显偏好的高危患者。