Evaluation of a novel intervention to prevent polysubstance overdoses involving illicit stimulants

评估预防涉及非法兴奋剂的多物质过量服用的新型干预措施

• 批准号: 10762925
• 负责人: Nichole L Michaels
• 金额: $ 72.5万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2024-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10762925
• 关键词: Evaluation; novel; intervention; prevent; polysubstance

Project Summary Overdoses involving illicit stimulants are increasing in the United States (US). Many of these overdoses involve fentanyl, which may be added to illicit stimulants with or without the user’s knowledge. Given the potency of fentanyl and its pervasiveness in the illicit drug supply, any meaningful efforts to reduce overdose deaths involving illicit stimulants must also address fentanyl. Rapid fentanyl test strips, designed to test for the presence of fentanyl and some fentanyl analogs in urine samples, are increasingly being used off-label by people who use drugs to test illicit drugs for fentanyl before consumption. This alerts the user that they may wish to perform overdose risk reduction behaviors (e.g., using less of the drug). However, due to the emergent nature of this harm reduction strategy, peer-reviewed published research on this topic is very limited. The proposed study addresses Objective #1 of the NOFO and will test an intervention to prevent overdoses among a high-risk population of drug court clients with a history of illicit stimulant use. The intervention consists of 1) fentanyl test strip education and distribution (FTSED) and 2) opioid overdose education and naloxone distribution (OEND) through drug courts in Ohio. The long-term goal of this research is the reduction of overdose-related morbidity and mortality in Ohio and nationally. The research objectives of this study are: 1) Determine the acceptability and feasibility of providing FTSED and OEND on-site through drug courts (process evaluation – Specific Aim #1); and 2) Evaluate the impact of providing FTSED in combination with OEND to drug court clients who use illicit stimulants or polysubstances including illicit stimulants, compared with providing OEND alone (outcome evaluation – Specific Aims #2 & #3). Using a two-arm group randomized trial design, we will answer the research objectives by testing the following specific aims: 1) Determine the perceived acceptability, barriers, and facilitating factors associated with providing FTSED and OEND on-site in drug courts to clients who use illicit stimulants or polysubstances including illicit stimulants; 2) Test the hypothesis that individuals with a history of illicit stimulant use who receive FTSED and OEND on-site in drug courts will have improved knowledge and self-efficacy regarding how to test drugs for fentanyl and strategies for reducing their risk of an overdose compared to those who receive OEND only; 3) Test the hypothesis that individuals with a history of illicit stimulant use who receive FTSED and OEND on-site in drug courts will have lower non-fatal and fatal overdose rates associated with illicit stimulants or polysubstance use involving illicit stimulants than those who receive OEND only. Given the pervasiveness of fentanyl in the illicit drug supply, even individuals whose preferred drugs are illicit stimulants are likely to encounter fentanyl and/or fentanyl analogues. We will evaluate the feasibility, acceptability, and associated benefits and harms of integrating FTSED into drug court programs in a state with high rates of overdoses involving stimulants.

项目摘要 在美国，涉及非法兴奋剂的药物过量正在增加。许多这些药物过量涉及 芬太尼，可能在使用者知情或不知情的情况下添加到非法兴奋剂中。考虑到 芬太尼及其在非法药物供应中的普遍性，任何减少过量死亡的有意义的努力 涉及非法兴奋剂的毒品问题也必须处理芬太尼问题。快速芬太尼测试条，旨在测试 芬太尼和一些芬太尼类似物在尿样中的存在，越来越多地被用于标签外， 使用毒品的人在消费前测试非法药物中的芬太尼。这提醒用户，他们可能 希望进行过量风险降低行为（例如，使用较少的药物）。然而，由于紧急 鉴于这一减少危害战略的性质，关于这一主题的经同行审查的已发表研究非常有限。的 拟议的研究涉及NOFO的目标#1，并将测试一种干预措施，以防止 有非法使用兴奋剂历史的毒品法庭客户的高风险人群。干预措施包括：（1） 芬太尼试纸教育和分发（FTSED）和2）阿片类药物过量教育和纳洛酮 分销（OEND）通过毒品法庭在俄亥俄州。这项研究的长期目标是减少 过量相关的发病率和死亡率在俄亥俄州和全国。本研究的研究目标是：1） 确定通过毒品法庭现场提供FTSED和OEND的可接受性和可行性（流程 评价-具体目标#1）;以及2）评价提供FTSED与OEND相结合的影响， 使用非法兴奋剂或包括非法兴奋剂在内的多种物质的毒品法庭客户， 单独提供OEND（结果评估-具体目标#2和#3）。使用两组随机试验 设计，我们将回答的研究目标，通过测试以下具体目标：1）确定 与现场提供FTSED和OEND相关的感知可接受性、障碍和促进因素 毒品法庭向使用非法兴奋剂或包括非法兴奋剂在内的多种物质的客户提供服务; 假设有非法兴奋剂使用史的个人在药物治疗现场接受FTSED和OEND， 法院将有关于如何测试芬太尼药物和策略的知识和自我效能的提高 与那些只接受OEND的人相比，降低了他们过量服用的风险; 3）检验假设， 在毒品法庭现场接受FTSED和OEND的有非法兴奋剂使用史的个人将有 与涉及非法药物的非法兴奋剂或多种物质使用有关的非致命性和致命性过量使用率降低 比那些只接受OEND的人更刺激。鉴于芬太尼在非法药物供应中的普遍性， 即使个人的首选药物是非法兴奋剂也可能遇到芬太尼和/或芬太尼 类似物我们将评估整合的可行性、可接受性以及相关的益处和危害 在一个兴奋剂过量率很高的州，FTSED参与了毒品法庭项目。