Rapid Research for Xylazine Response

项目摘要 赛拉津是一种新出现的对注射吸毒者(PWID)的严重威胁。赛拉津和芬太尼药物混合物 由于赛拉津不是阿片类药物，纳洛酮不能逆转其作用。尽管 在美国，赛拉津在过量死亡中的存在越来越多，但流行病学研究有限 重点是在死亡率数据表明 已知的高风险。尽管严重的伤口和坏死率明显上升 使用含有赛拉津的药物、特定的药物使用方法或其他与 伤口的发展情况尚不清楚。这项研究的目标是产生急需的证据，以 了解与赛拉津使用有关的流行率、风险因素、知识和减少伤害的做法 以及PWID中伤口的发展，以便有效地向实践提供信息并提高认识 在受影响的社区中，保健和减少伤害服务提供者和公众 与赛拉津相关的健康风险。我们提出了一种使用回应者驱动的混合方法 在巴尔的摩进行抽样调查，以确定和调查大约300名PWID，并对40人进行定性访谈 那些使用赛拉津的人，医疗保健和减少伤害的提供者。我们将估计流行率和 有意使用和怀疑使用赛拉津与检查赛拉津特定过量知识的相关性， 信仰和实践。我们将确定与赛拉津使用有关的伤口的流行率和 艾滋病毒感染、吸毒行为和伤口之间的关系。我们还将描述障碍的特征 使用定性方法获取伤口护理。这项对一种突如其来的非法药物的研究将产生 对时间敏感的知识，这将直接有助于防止与 赛拉津出现了。我们将翻译我们的发现并进行广泛传播，与当地 利益攸关方、合作伙伴组织和政府机构，向过量用药和治疗方案提供信息。

Project Summary Xylazine is an emerging serious threat to people who inject drugs (PWID). Xylazine and fentanyl drug mixtures elevate risk overdose and because xylazine is not an opioid, naloxone does not reverse its effects. Despite the increasing presence of xylazine in overdose deaths across the US, there is limited epidemiologic research focused on characterizing the prevalence and risk factors of its use in settings where mortality data indicates a known elevated risk. Although there has been a marked uptick of severe wounds and necrosis among those using drugs that contain xylazine, the specific drug use practices or other characteristics related to the development of wounds are not known. The goal of this research is to generate urgently needed evidence to understand the prevalence, risk factors, knowledge, and harm reduction practices associated with xylazine use and the development of wounds among PWID, in order to effectively inform practice and raise awareness among the affected communities, health care and harm reduction service providers and the public regarding the health risks associated with xylazine. We propose a mixed methods approach using respondent-driven sampling to identify and survey approximately n=300 PWID in Baltimore and n=40 qualitative interviews with those who use xylazine, health care and harm reduction providers. We will estimate the prevalence and correlates of both intentional and suspected xylazine use and examine xylazine-specific overdose knowledge, beliefs and practices. We will determine the prevalence of wounds associated with xylazine use and the association between HIV infection, drug use practices and wounds. We will also characterize barriers to accessing wound care using qualitative methods. This research on a sudden emerging illicit drug will generate time-sensitive knowledge that will directly contribute to preventing the harmful consequences associated with xylazine emergence. We will translate our findings and conduct broad dissemination, working with local stakeholders, partner organizations, and governmental agencies to inform overdose and treatment programs.