Evaluating the decriminalization of non-prescribed buprenorphine in Rhode Island

评估罗德岛州非处方丁丙诺啡的非刑事化

• 批准号: 10549069
• 负责人: JOSIAH D RICH
• 金额: $ 25.02万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10549069
• 关键词: Accounting; Affect; Agonist; Area; Attitude; Behavior; Belief; Benzodiazepines; Buprenorphine; Cessation of life; Communities; Companions; Consumption; Criminal Law; Data; Disincentive; Drug Addiction; Drug Controls; Effectiveness; Enrollment; Evaluation; Event; FDA approved; Fentanyl; Frequencies; Goals; Harm Reduction; Health; Health Benefit; Health Services Accessibility; Heroin; Illicit Drugs; Interruption; Intervention; Interview; Joints; Justice; Knowledge; Law Enforcement; Laws; Measures; Medicine; Methadone; Motivation; Municipalities; Narcotics; National Institute of Drug Abuse; New York; Opioid; Opioid agonist; Outcome; Overdose; Overdose reduction; Pattern; Perception; Personal Autonomy; Persons; Pharmaceutical Preparations; Play; Police; Policies; Population; Protocols documentation; Public Health; Publications; Recording of previous events; Records; Recreation; Relapse; Reporting; Research; Research Personnel; Research Priority; Rhode Island; Risk; Role; Safety; Science; Self Medication; Statutes and Laws; Stigmatization; Structure; Substance Use Disorder; System; Text; Time; Time Series Analysis; Toxicology; Training; Uncertain Risk; Vermont; Withdrawal; addiction; base; buprenorphine treatment; coronavirus disease; design; drug misuse; experience; hazard; illicit opioid; improved; metropolitan; mortality; non-opioid analgesic; novel; opioid epidemic; opioid injection; opioid overdose; opioid use disorder; opioid withdrawal; overdose risk; prescription opioid; prevent; public health relevance; public health research; rate of change; recidivism; reduce symptoms; response; substance misuse; treatment program

ABSTRACT TEXT In July of 2021, Rhode Island became the second state in the nation to decriminalize the possession of non-prescribed buprenorphine (NPB), the partial agonist opioid medication proven effective at treating opioid use disorder (OUD), following Vermont’s decriminalization of NPB the month prior. As the nation contends with the worst fatal overdose crisis in its history, and New York State considers decriminalizing NPB for 20 million residents, there is a time-sensitive need to understand the effects of this decriminalization on people’s consumption of buprenorphine both as part of formal treatment for OUD, and as self-treatment or a form of harm reduction. To date, however, no such evaluation has been conducted. Decriminalizing NPB is a novel response to the overdose crisis, based on evidence that most NPB consumption is for the purpose of self-treatment by people who do not have access to treatment, or do not perceive themselves as ready to succeed in formal treatment programs. It has also been associated with decreases in accidental overdose, and used as a form of protection from an adulterated illicit drug supply. At the same time, concerns among policymakers and legislators persist that consuming NPB unnecessarily delays participation in more comprehensive formal treatment, that when used in combination with non-opioid depressants it can contribute to overdose, and that it contributes to addiction when consumed recreationally, especially by opioid-naïve people. The goal of this project is to explore the effects of decriminalizing NPB on attitudes and beliefs toward buprenorphine in Rhode Island, and changes in buprenorphine’s association with fatal overdoses. It offers the opportunity to systematically examine how a change in the criminal law regulating a treatment medication affects attitudes and behaviors regarding it, allowing for a rapid and broad application of the findings. Using qualitative and quantitative measures, and closely harmonizing their efforts with researchers conducting a companion evaluation in Vermont, the research team will come to an understanding of 1) the knowledge, beliefs, and behaviors regarding decriminalized NPB of people who use illicit opioids; 2) the effects of decriminalized NPB on Rhode Island law enforcement practices, attitudes and beliefs, and 3) any post-decriminalization changes in buprenorphine’s association with fatal overdoses using data from Rhode Island’s State Unintentional Drug Overdose Reporting System. The results will yield both scientific publications and products for distribution to public administration and community stakeholder audiences. The study will produce an understanding of the effects of decriminalized NPB as New York and other states consider what role NPB decriminalization should play in their public health strategies, and will reveal the most insightful research questions and metrics for measuring the health and harm reduction outcomes of decriminalization in an ensuing R01 study.

摘要文字 2021 年 7 月，罗德岛州成为美国第二个将拥有财产合法化的州 非处方丁丙诺啡 (NPB)，部分激动剂阿片类药物，已被证明可有效治疗 佛蒙特州上个月将 NPB 合法化后，出现了阿片类药物使用障碍 (OUD)。作为国家 正在应对历史上最严重的致命过量危机，纽约州认为 为 2000 万居民实现 NPB 非刑事化，需要及时了解其影响 这种对人们消费丁丙诺啡的非刑事化，既作为正式治疗的一部分 OUD，作为自我治疗或减少伤害的一种形式。但迄今为止，还没有这样的评估 已进行。基于证据，将 NPB 非刑事化是对服药过量危机的一种新颖反应 大多数 NPB 消费是为了无法获得的人们的自我治疗目的 治疗，或认为自己尚未准备好在正式治疗计划中取得成功。它还具有 与意外用药过量的减少有关，并用作预防意外用药的一种形式 非法药物供应掺假。与此同时，政策制定者和立法者的担忧依然存在 消费 NPB 不必要地延迟参与更全面的正规治疗， 当与非阿片类抑制剂联合使用时，可能会导致药物过量，并且 娱乐性消费时会导致成瘾，尤其是对于未使用阿片类药物的人。目标是 该项目旨在探讨 NPB 非刑事化对人们的态度和信念的影响 罗德岛州的丁丙诺啡，以及丁丙诺啡与致命过量用药之间关系的变化。它 提供了系统审查刑法如何改变规范治疗的机会 药物会影响人们对其的态度和行为，从而可以快速、广泛地应用药物 发现。采用定性和定量措施，并与 研究人员在佛蒙特州进行同伴评估，研究小组将得出 1) 了解以下人士关于 NPB 去刑罪化的知识、信念和行为： 使用非法阿片类药物； 2) NPB 非刑事化对罗德岛州执法实践的影响， 态度和信仰，以及 3) 丁丙诺啡与以下疾病相关的非刑事化后的任何变化： 使用罗德岛州无意药物过量报告系统的数据来评估致命的药物过量。 研究结果将产生科学出版物和产品，分发给公共管理部门 和社区利益相关者受众。该研究将产生对影响的理解 纽约和其他州考虑 NPB 去刑事化应发挥什么作用 在他们的公共卫生战略中发挥作用，并将揭示最有洞察力的研究问题和指标 在随后的 R01 研究中衡量非刑事化对健康和减少伤害的结果。