Rapid Research for Xylazine Response

赛拉嗪反应的快速研究

• 批准号: 10836135
• 负责人: DANIELLE GERMAN
• 金额: $ 32.75万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10836135
• 关键词: Abscess; Affect; Animals; Awareness; Baltimore; Behavioral; Belief; Cessation of life; Characteristics; Collaborations; Communities; Country; Data; Dedications; Development; Discrimination; Drug usage; Drug user; Enrollment; Ensure; Epidemiology; Fentanyl; Geographic Locations; Geography; Goals; Government Agencies; HIV; HIV Infections; Harm Reduction; Health; Health Services Accessibility; Healthcare; Healthcare Systems; Heroin; Illicit Drugs; Injecting drug user; Injections; Intervention; Interview; Knowledge; Location; Maryland; Medical Examiners; Methods; Mid-Atlantic Region; Naloxone; Necrosis; Opioid; Outcome; Overdose; Persons; Pharmaceutical Preparations; Prevalence; Prevention strategy; Provider; Public Health; Puerto Rico; Qualitative Methods; Recording of previous events; Reporting; Research; Respondent; Risk; Risk Factors; Sampling; Services; Site; Skin Tissue; Soft Tissue Infections; Surveys; Time; Translating; Wound Infection; Xylazine; cohort; drug testing; epidemiology study; experience; improved; medical attention; mortality; non-opioid analgesic; opioid overdose; overdose death; overdose risk; peer; prevent; recruit; response; sedative; service providers; social stigma; stem; surveillance study; treatment program; wound; wound care

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.

项目摘要 甲苯噻嗪是一种新出现的严重威胁注射毒品的人（PWID）。甲苯噻嗪和芬太尼药物混合物 增加风险过量，因为甲苯噻嗪不是阿片类药物，纳洛酮不会逆转其作用。尽管 在美国，甲苯噻嗪在过量死亡中的存在越来越多，流行病学研究有限 侧重于描述在死亡率数据表明 已知的高风险。虽然在这些人中，严重创伤和坏死的人数明显增加， 使用含有甲苯噻嗪的药物，具体的药物使用实践或与药物相关的其他特征 伤口的发展是未知的。这项研究的目的是产生迫切需要的证据， 了解与甲苯噻嗪使用相关的患病率、风险因素、知识和危害减少实践 以及PWID中伤口的发展，以便有效地告知实践并提高认识 在受影响的社区，医疗保健和减少伤害服务提供者和公众中， 与甲苯噻嗪相关的健康风险。我们提出了一种混合方法的方法，使用响应驱动 在巴尔的摩抽样识别和调查约n = 300名PWID，n = 40名定性访谈， 使用甲苯噻嗪的人，医疗保健和减少伤害的提供者。我们将估计患病率， 与故意和疑似赛拉嗪使用的相关性，并检查赛拉嗪特异性过量知识， 信仰和实践。我们将确定与甲苯噻嗪使用相关的伤口的患病率， 艾滋病毒感染、吸毒行为和伤口之间的联系。我们还将描述 使用定性方法获得伤口护理。这项关于突然出现的非法药物的研究将产生 具有时间敏感性的知识，将直接有助于防止与下列方面有关的有害后果： 甲苯噻嗪出现。我们将翻译我们的调查结果并进行广泛传播， 利益相关者，合作伙伴组织和政府机构，以告知过量和治疗方案。