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

7.项目概要/摘要 该提案的目标是（1）检查甲基苯丙胺（MA）使用模式和相关危害 （包括MA使用障碍和MA过量）在根深蒂固和持续使用阿片类药物的背景下 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 不成比例地受到与毒品有关的伤害。我们的团队建立了合作和研究 基础设施，并进行了初步研究，通知当前的应用程序。使用 结合结构化流行病学访谈、生物学测试和定性时间轴随访 通过访谈，本提案旨在了解MA和多种药物使用模式如何影响健康 结果，重点是在药物使用研究中代表性不足的群体，特别是现在研究和 该方案的努力几乎完全限于有问题的阿片类药物使用。这项建议的目的是： 1.估计当前MA使用的患病率，并确定与当前MA使用相关的风险和保护因素，以及 在使用药物的人中与MA相关的危害。 a.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使用模式。MA使用将是 通过自我报告和尿液毒理学筛查确定。 B.确定MA使用与（i）风险因素，（ii）保护因素，（iii）健康和社会 后果（例如，自我报告的HIV、HCV状态、软组织感染、OD、物质使用障碍）。 C.研究社会经济地位（SES），种族和耻辱的调节作用。 2.定性描述MA使用、多种药物使用和进展至 滥用和依赖使用终身药物使用历史访谈。 a.描述启动模式，MA与其他药物之间的过渡，社会和结构因素， 影响MA使用（包括Rx阿片类药物和兴奋剂可用性）、社交网络和经济力量 毒品使用和相关危害的结构。 3.检查有希望的预防、治疗和减少危害的可行性和可接受性 使用MA的人的策略。 a.评估潜在生物医学干预措施的可行性和可接受性，例如 药物疗法治疗MA使用障碍，目前在临床管道。 B.评估使用MA的人的危害减少策略的可行性和可接受性。 本提案直接响应RFA-CD-21-002目标2。它包含了详细的翻译， 传播计划，这将有助于迅速实施可采取行动的调查结果，并利用一个成功的 调查人员和社区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.