A Multi-Site Mixed Methods Study of Methamphetamine Use in the Mountain West

7. 项目总结/摘要 该提案的目标是 (1) 检查甲基苯丙胺 (MA) 的使用模式和相关危害 （包括 MA 使用障碍和 MA 过量）在根深蒂固且持续使用阿片类药物的情况下 流行病，以及 (2) 为社区确定有希望的预防、治疗和减少危害的方法 受毒品相关危害的影响尤为严重。我们的团队已经建立了合作和研究 基础设施，并进行了为当前应用提供信息的初步研究。使用 结构化流行病学访谈、生物检测和定性时间表跟踪的结合 访谈，该提案旨在了解 MA 和多种药物的使用模式如何影响健康 结果，重点关注在药物使用研究中代表性不足的群体，特别是现在当研究和 计划工作几乎完全局限于有问题的阿片类药物使用。该提案的目的是： 1. 估计 MA 的流行率并确定与当前 MA 使用相关的风险和保护因素，以及 吸毒者中与 MA 相关的危害。 一个。描述 MA 使用的频率和数量，以及 MA 使用与其他药物之间的关联， 包括处方 (Rx) 兴奋剂、阿片类药物和其他多种药物的使用模式。 MA 的用途将是 通过自我报告和尿液毒理学筛查来识别。 b.确定 MA 使用与 (i) 风险因素、(ii) 保护因素、(iii) 健康和社会因素之间的关联 后果（例如，自我报告的 HIV、HCV 状况、软组织感染、OD、物质使用障碍）。 c.检查社会经济地位 (SES)、种族和耻辱的调节影响。 2. 定性描述 MA 使用、多种药物使用以及进展的经验和理由 通过终生药物使用史访谈来了解滥用和依赖性。 一个。描述 MA 与其他药物之间的起始模式、过渡模式、社会和结构因素 影响 MA 的使用（包括 Rx 阿片类药物和兴奋剂的可用性）、社交网络和经济力量 构成药物使用和相关危害。 3. 检验有希望的预防、治疗和减少危害的可行性和可接受性 使用 MA 的人的策略。 一个。评估潜在生物医学干预措施的可行性和可接受性，例如 目前正在临床研发中的治疗 MA 使用障碍的药物疗法。 b.评估 MA 使用者减少伤害策略的可行性和可接受性。 该提案直接响应 RFA-CD-21-002 目标 2。它包含详细的翻译和 传播计划将促进快速实施可操作的调查结果，并利用成功的 研究人员和社区合作伙伴之间现有的多学科合作。

7. Project Summary/Abstract The goal of this proposal is to (1) examine patterns of methamphetamine (MA) use and related harms (including MA use disorder and MA overdose) in the context of an entrenched and ongoing opioid use epidemic, and (2) identify promising prevention, treatment, and harm reduction approaches for communities disproportionately affected by drug-related harms. Our team has an established collaboration and research infrastructure, and has conducted preliminary research that informs the current application. Using a combination of structured epidemiological interviews, biological testing, and qualitative timeline follow-back interviews, this proposal is designed to understand how MA and polydrug use patterns influence health outcomes, with a focus on groups underrepresented in drug use research, especially now when research and program efforts are almost exclusively confined to problematic opioid use. The aims of this proposal are: 1. To estimate prevalence of and identify risk and protective factors associated with current MA use, and MA-related harms among people who use drugs. a. Describe the frequency and quantity of MA use, and associations between MA use and other drugs, including prescription (Rx) stimulants, opioids, and other polydrug use patterns. MA use will be identified by self-report and by urine-toxicology screening. b. Identify associations between MA use and (i) risk factors, (ii) protective factors, (iii) health and social consequences (e.g.,self-reported HIV, HCV status, soft-tissue infections, OD, substance use disorder). c. Examine moderating impact of socioeconomic status (SES), ethnicity, and stigma. 2. To qualitatively describe the experiences of and rationale for MA use, polydrug use, and progression to misuse and dependence using lifetime drug use history interviews. a. Describe patterns of initiation, transition between MA and other drugs, social and structural factors that influence MA use (including Rx opioid and stimulant availability), social networks, and economic forces that structure drug use and related harms. 3. To examine the feasibility and acceptability of promising prevention, treatment, and harm reduction strategies for people who use MA. a. Assess the feasibility and acceptability of potential biomedical interventions, such as pharmacotherapies to treat MA use disorder that are currently in the clinical pipeline. b. Assess feasibility and acceptability of harm reduction strategies for people who use MA. This proposal responds directly to RFA-CD-21-002 Objective 2. It contains a detailed translation and dissemination plan that will facilitate rapid implementation of actionable findings, and leverages a successful existing multidisciplinary collaboration among investigators and community partners.