权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Markets and Drug Tourism

与毒品市场和毒品旅游相关的丙型肝炎病毒、艾滋病毒和药物过量的民族流行病学

基本信息

批准号：
10833944
负责人：
STEFFANIE A. STRATHDEE
金额：
$ 14.74万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-01 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10833944
关键词：
Address Adult Affect Anxiety Border Community Buprenorphine California Cause of Death Cessation of life Cities Client Communities Country Dose Dose Limiting Drug Contamination Drug Metabolic Detoxication Drug usage Drug user Enrollment Epidemiology Federal Government Feeling suicidal Fentanyl Funding HIV HIV Seronegativity HIV Seropositivity Hepatitis C virus Heroin Infiltration Infrastructure Injecting drug user International Agencies Interruption Intervention Interview Medicine Mental Depression Mental Health Methadone Mexican Mexico Modeling Municipalities National Institute of Drug Abuse Opiate Addiction Opioid Outcome Overdose Parents Participant Pattern Persons Pharmaceutical Preparations Pharmacotherapy Pharmacy facility Plants Policy Maker Prevalence Quality Control Relapse Reporting Running Sampling Time Travel Visit World Health Organization anxiety symptoms cohort depressive symptoms drug market drug relapse experience high risk manufacture manufacturing facility methadone clinic/center methadone treatment mortality opioid mortality opioid use opioid use disorder overdose death overdose risk prospective recruit substance use suicidal suicidal morbidity suicide mortality suicide rate

项目摘要

In April 2023, Mexico’s federal government closed the country’s only methadone manufacturing plant following concerns about quality control. In Mexican-U.S. border cities, such as Tijuana, where the prevalence of opioid use disorder (OUD) is among the country’s highest, the city’s four methadone clinics are turning new clients away, and for existing clients are limiting doses or not dosing altogether. Although there are no accurate estimates of the number of persons with OUD in Mexico, there were ~1000 adults receiving methadone in Tijuana alone at the time of the plant closure. Few empirical studies have been conducted on the impact of methadone dispensing interruptions but these have focused almost entirely on methadone prescribers, rather than people with OUD and have only examined short-term effects. We propose to leverage our existing cohort infrastructure in Tijuana to meet these Aims: 1) To qualitatively explore the experiences of adults in Tijuana receiving methadone for the treatment of OUD following the closure of Mexico’s only methadone manufacturing plant. 2) To prospectively characterize the impact of the closure of Mexico’s only methadone manufacturing plant on rates of drug use relapse, overdose (OD), suicidality, anxiety, depression and mortality among adults with OUD in Tijuana. Specifically, we will compare PWUD who have had their methadone treatment interrupted vs. those who have not and those who have never or not recently received methadone treatment. 3) To estimate the number of ODs and deaths caused by the closure of Mexico’s only methadone manufacturing plant among PWUD in Tijuana over the first month and first year after the closure using dynamic modeling. We hypothesize that PWUD with methadone treatment interruptions will have higher rates of drug relapse, OD, depression, anxiety, suicidality and death. We will re-open recruitment in the parent study to enroll 200 PWUD in Tijuana who were recently receiving methadone treatment, and compare outcomes to the existing cohort (N=250 for a total of N=450). Participants will undergo quantitative interviews every 6 months over 18 months. A subset will be purposively sampled for prospective qualitative interviews. Dynamic modeling will be used to estimate the impact of treatment interruptions on rates of overdose and mortality, and micro- and macro-level interventions that may be undertaken to ameliorate the crisis. Findings will be used to inform policymakers at the municipal, state and federal level in Mexico, as well the US and international agencies.

2023年4月，墨西哥联邦政府关闭了该国唯一的美沙酮生产厂