A Longitudinal Qualitative Study of Fentanyl-Stimulant Polysubstance Use Among People Experiencing Homelessness (Administrative supplement)

无家可归者使用芬太尼兴奋剂多物质的纵向定性研究（行政补充）

• 批准号: 10841820
• 负责人: Kelly Ray Knight
• 金额: $ 16.15万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-11-01 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10841820
• 关键词: Address; Administrative Supplement; Atrophic; Behavior; Cities; Cocaine; Communities; Crack Cocaine; Data; Disease; Drug usage; Enrollment; Environment; Equity; Fentanyl; Freedom; Future; Homelessness; Housing; Imprisonment; Intervention; Interview; Jail; Legal system; Methamphetamine; Movement; New York; Overdose; Parents; Participant; Pattern; Persons; Pharmaceutical Preparations; Play; Population; Prisons; Process; Recommendation; Reporting; Research; Research Activity; Risk; Role; Sampling; San Francisco; Shapes; Social Network; Stimulant; Substance Use Disorder; Supervision; Targeted Research; Time; Toxicology; Translating; Urine; experience; fentanyl use; follow-up; interest; overdose prevention; overdose risk; parent grant; parole; policy recommendation; polysubstance use; probation; programs; racial minority; recruit; response; screening; social contact; stimulant use; substance use; substance use treatment; treatment services

Project Summary We propose a one-year, Administrative Supplement to our parent grant (R01DA05672) to qualitatively examine the use homelessness relationship between experiences of community supervision (i.e., probation and parole) and polysubstance patterns, overdose vulnerability, and substance use t reatment in a sample of people experiencing with fentanyl-stimulant polysubstance use. People experiencing homelessness who use drugs are disproportionately engaged the criminal legal system and those who are racially minoritized are most impacted by the negative consequences of this engagement (e.g., arrest and incarceration). In 2020, approximately 4 million people in the US were on community supervision, which includes limitations on freedom of movement, time, and social contacts, as well as mandatory urine toxicology screening during the period of probation and parole. Formerly incarcerated people experience higher rates of homelessness, but the role that community supervision plays in shaping access to housing post-release is not well understood. Overdose vulnerability increases in the period immediately following release from jail and/or prison, due to decreased tolerance, changes to the drug supply, and atrophied social networks. However, little is known about the relationship between community supervision and overdose vulnerability, especially for people experiencing homelessness who co-use stimulants and fentanyl. In addition, the relationships between fentanyl-stimulant polysubstance use, community supervision, and access to substance use disorder treatment has yet to be studied. Extending the scope of the parent grant and building on our extensive experience studying drug use, homelessness, and community supervision, we propose the following specific aims: CLS.SA1: To characterize how community supervision shapes fentanyl-stimulant polysubstance use among people experiencing homelessness, including polysubstance use patterns and drug use practices. CLS.SA2: To explore how community supervision impacts overdose disorder vulnerability, access to housing, and substance use treatment among people experiencing homelessness with fentanyl-stimulant polysubstance use. Informed by the equity-focused Intersectional Risk Environment framework, we will conduct qualitative interviews with enrolled parent study participants who are on community supervision in San Francisco (n=25), and analytically compare those experiences to parent study participants not engaged in community supervision. Data garnered from this administrative supplement will generate emergent lines of inquiry for future R01 proposals and be used to offer recommendations for this population that are scalable and adaptable to other US cities through the parent study's extensive community stakeholder engagement processes. This study is aligned with priorities of the current Notice of Special Interest (NOT-OD-23-011) by examining the relationship between criminal legal system involvement, polysubstance use behaviors, and overdose vulnerability.

项目摘要 我们建议对我们的母公司补助金（R 01 DA 05672）进行为期一年的行政补充，以定性检查 的 使用 无家可归 社区监督经验之间的关系（即，缓刑和假释）和多种物质 模式，过量的脆弱性，和物质使用t治疗的人的样本经历 芬太尼类兴奋剂混合物吸毒的无家可归者 不成比例地卷入刑事法律的系统，而那些在种族上属于少数的人 受到这种参与的负面后果的影响（例如，逮捕和监禁）。在2020年， 美国约有400万人接受社区监督，其中包括对 行动自由，时间和社会接触，以及强制性尿液毒理学筛查期间， 缓刑和假释期以前被监禁的人无家可归的比例较高，但 社区监督在影响释放后获得住房方面发挥的作用还没有得到很好的理解。 在从监狱和/或监狱释放后的一段时间内，药物过量的脆弱性增加， 耐受性降低，药物供应改变，社交网络萎缩。然而， 关于社区监督和过量用药脆弱性之间的关系，特别是对那些 同时使用兴奋剂和芬太尼的无家可归者此外， 芬太尼兴奋剂多物质使用、社区监督和获得物质使用障碍治疗 还有待研究。扩大父母补助金的范围，并利用我们丰富的经验 通过研究吸毒、无家可归和社区监督问题，我们提出了以下具体目标： CLS.SA1：描述社区监督如何影响 无家可归的人，包括多种物质使用模式和吸毒做法。CLS.SA2: 探索社区监督如何影响过量 障碍 脆弱性、获得住房和药物使用 对使用芬太尼兴奋剂多物质的无家可归者进行治疗。 根据以股权为中心的交叉风险环境框架，我们将进行定性分析， 与在旧金山弗朗西斯科接受社区监督的登记父母研究参与者的访谈（n=25）， 并将这些经历与不参与社区活动的父母研究参与者进行分析比较， 监管从这份行政补充材料中获得的数据将产生紧急查询渠道， 未来的R 01提案，并用于为这一人群提供可扩展和适应性强的建议 通过母公司研究的广泛的社区利益相关者参与过程，向美国其他城市推广。这 研究与当前特别关注通知（NOT-OD-23-011）的优先事项保持一致， 刑事法律的系统参与、多种物质使用行为和过量之间的关系 易损性.