Preventing Overdoses Involving Stimulants (POINTS)Study

项目总结 近年来，涉及非法可卡因、甲基苯丙胺和其他兴奋剂的过量使用有所增加 在全国范围内以及在马萨诸塞州(MA)和罗德岛州(RI)这两个过量用药热点州。多物质使用 长期以来一直是已知的过量用药的风险因素。然而，缉获毒品的数据表明，可卡因， 甲基苯丙胺和假药可能掺入芬太尼。无意中消耗了 含有非法芬太尼的兴奋剂是阿片类药物驱动过量的主要风险因素，而 在MA和RI中，高效力可卡因和甲基苯丙胺的可获得性和使用率增加，对 仅限兴奋剂过量。了解吸毒者使用药物的模式和策略 预防兴奋剂过量是必要的，以确定涉及兴奋剂的危险和保护因素 吸毒过量。对参与药品分销的个人进行的混合方法研究也可以提供关键的 关于芬太尼和其他兴奋剂进入兴奋剂供应的机制的信息。 对药物样本的测试可以进一步三角测量消费者和经销商关于效力的观点 以及在药品供应中掺假。傅里叶变换红外(FTIR)光谱技术在药物检测中的应用 能够检测样品中的所有活性掺假物，包括芬太尼及其类似物。与之配对时 验证性测试、药物检查可以提供对不断变化的药物供应、暴露于 高效力或掺杂芬太尼的兴奋剂和高危社区的过量服用风险。最后，协作性 需要与社区利益攸关方共同努力，确定最佳、可行和可接受的战略，以防止 在高风险社区，致命和非致命的过量使用。我们的总体目标是减少兴奋剂的使用 在受过量药物流行影响不成比例的地区使用过量药物。我们的方法来满足这么长的时间- 学期目标是利用多管齐下的方法来确定兴奋剂相关的风险和保护因素。 过量用药，并利用这些发现开始制定一套针对当地情况的干预方案 可以在未来的研究中迅速实施的战略，以防止兴奋剂过量。一致 根据RFA-CE-21-002的目标2，我们的目标是[1]与使用或 分发非法兴奋剂，以确定兴奋剂过量的风险和保护因素；[2]实施药物 检查兴奋剂的效力以及芬太尼和其他药物的存在和相对数量 兴奋剂供应中的掺假；以及[3]召集一系列工作组，由参与兴奋剂供应的个人组成。 MA和RI的一级和二级过量预防，以使我们的混合方法研究结果和 确定多层次干预策略，以防止兴奋剂过量。这项研究的完成将 对两个州兴奋剂过量的社会流行病学有丰富的理解 不成比例地受到吸毒过量危机的影响。研究结果将产生社区衍生的干预策略 这可以很容易地实施和扩展，以防止在MA、RI和其他地方涉及兴奋剂的过量使用。

PROJECT SUMMARY In recent years, overdoses involving illicit cocaine, methamphetamine, and other stimulants, have increased nationally and in the overdose hotspot states of Massachusetts (MA) and Rhode Island (RI). Polysubstance use has long been a known risk factor for overdose. However, drug seizure data suggest that cocaine, methamphetamine, and counterfeit pills may be adulterated with fentanyl. The unintentional consumption of stimulants containing illicit fentanyl represents a major risk factor for opioid-driven overdoses, whereas the increasing availability and use of highly potent cocaine and methamphetamine in MA and RI pose a risk for stimulant-only overdoses. Understanding the drug use patterns and strategies used by people who use stimulants to prevent overdose is necessary to identify risk and protective factors for stimulant-involved overdoses. Mixed-methods research with individuals involved in drug distribution can also provide critical information into the mechanisms through which fentanyl and other adulterants may enter the stimulant supply. The testing of drug samples can further triangulate consumer and distributor perspectives regarding the potency and adulteration of the drug supply. Drug checking using Fourier-Transform Infrared (FTIR) spectroscopy enables the detection of all active adulterants in a sample, including fentanyl and its analogs. When paired with confirmatory testing, drug checking can provide insights into the changing drug supply, the risk of exposure to highly potent or fentanyl-adulterated stimulants and overdose risk for high-risk communities. Finally, collaborative efforts with community stakeholders are needed to identify optimal, feasible, and acceptable strategies to prevent fatal and non-fatal overdoses in high-risk communities. Our overall objective is to reduce stimulant-involved overdoses in regions disproportionately affected by the overdose epidemic. Our approach to meeting this long- term objective is to utilize a multi-pronged approach to identify risk and protective factors for stimulant-involved overdose and use these findings to begin the process of developing a package of locally-tailored intervention strategies that can be swiftly implemented in future research to prevent stimulant-involved overdoses. Consistent with Objective 2 of RFA-CE-21-002, we aim to [1] Carry out mixed-methods research with people who use or distribute illicit stimulants to identify risk and protective factors for stimulant-involved overdoses; [2] Conduct drug checking to examine the potency of stimulants and the presence and relative quantity of fentanyl and other adulterants in the stimulant supply; and [3] Convene a series of working groups with individuals involved in primary and secondary overdose prevention in MA and RI to contextualize our mixed-methods findings and identify multilevel intervention strategies to prevent stimulant-involved overdoses. Completion of this study will yield a rich understanding of the social epidemiology of stimulant-involved overdoses in two states disproportionately affected by the overdose crisis. Findings will yield community-derived intervention strategies that can be readily implemented and scaled to prevent stimulant-involved overdoses in MA, RI, and beyond.