The short and long-term dynamics of opioid/stimulant use: Mixed methods to informoverdose prevention and treatment related to polysubstance use

项目摘要 作为对NOT-DA-23-011的回应，本行政补充文件将扩大母项目的范围 （R 01 DA 057673，MPI：Genberg和German）对使用多种物质的短期和长期影响， 包括收集有关刑事法律的参与的数量和质量数据。具体来说，这 应用程序将扩大和补充我们的调查团队的技能，包括研究人员与 关于确定药物使用和刑事法律的参与的交叉点特征的专门知识，重点是 吸毒者与街头警察的互动。本行政管理的总体目标 补充是阐明多物质使用和遇到警察和其他 巴尔的摩社区招募的吸毒者群体中的刑事法律的体系要素， 马里兰州到目前为止，大多数研究只研究了多种物质使用和监禁之间的联系， 关于监禁的上游驱动因素的横截面但严格的纵向数据，例如相互作用 警察是缺乏的。克服这一知识差距很重要，因为逮捕前的分流被视为一种 这是警方将吸毒者与社区康复服务联系起来的关键机会， 在使用多种物质方面，对警察与PWUD相互作用的理解有限。因此，我们打算 收集详细的定量和定性数据的预期和实现的经验与街头一级的警察 (e.g.通过实现以下具体目标，在残疾人、残疾人和青年人中开展（制止、逮捕、骚扰）： 多种物质使用与社会决定因素（如住房）的中介作用之间的实时关联 不稳定和就业状况）; 2）描述经历， 在使用多种物质的事件中，犯罪法律的参与的观念和后果。我们将 通过在正在进行的生态数据收集中增加刑事法律的参与措施，实现目标1 在200个PWUD中进行瞬时评估。为了补充定量结果，我们将进行20- 与最近与街头警察遭遇的PWUD进行了深入访谈，以将调查结果置于 目标1.我们将利用本补充材料的发现，为R34初步有效性试验提供信息， 逮捕前转向恢复支持，MOUD和针对严重物质患者的环绕式服务 使用障碍，包括从事多种物质使用的个人。

Project summary In response to NOT-DA-23-011, this administrative supplement will expand the scope of the parent project (R01DA057673, MPI: Genberg and German) on short and long-term effects of polysubstance use to incorporate collection of quantitative and qualitative data on criminal legal involvement. Specifically, this application will broaden and complement the skills of our investigative team to include researchers with expertise on characterizing the intersection of substance use and criminal legal involvement, with a focus on people who use drugs’ interaction with street-level police officers. The overall objective of this administrative supplement is to elucidate the relationship between polysubstance use and encounters with police and other elements of the criminal legal system in a community-recruited cohort of people who use drugs in Baltimore, MD. To date, most studies have only examined the association between polysubstance use and incarceration cross-sectionally, yet rigorous longitudinal data on the upstream drivers of incarceration, such as interactions with police, are lacking. Overcoming this knowledge gap is important as pre-arrest diversion is seen as a critical opportunity for police to link people who use drugs to community-based recovery services yet our understanding on police-PWUD interactions is limited with respect to polysubstance use. Thus, we intend to collect detailed quantitative and qualitative data on anticipated and realized experiences with street-level police (e.g. stopped, arrested, harassed) among PWUD by accomplishing the following specific aims to: 1) evaluate real-time associations between polysubstance use and the mediating role of social determinants (e.g. housing instability and employment status) on negative police encounters; and 2) characterize experiences, perceptions, and consequences of criminal legal involvement during polysubstance using episodes. We will accomplish Aim 1 by adding criminal legal involvement measures to ongoing data collection of ecological momentary assessments among 200 PWUD. To complement the quantitative results, we will conduct 20 in- depth interviews with PWUD who had recent encounters with street-level police to contextualize the findings in Aim 1. We will leverage findings from this supplement to inform an R34 preliminary effectiveness trial to pilot pre-arrest deflection to recovery support, MOUD, and wrap-around services for people with severe substance use disorder, including individuals who engage in polysubstance use.