Suburban Opioid Study (SOS)

流行病学数据显示，阿片类药物和海洛因的使用急剧增加，这主要是由于非医疗用途的 阿片类处方药。全国范围内减少处方阿片类药物转移的努力似乎 显示阿片类药物过量死亡率持平，但同时海洛因过量急剧增加 2012年至2013年的死亡率。不幸的是，尽管越来越重视阻止阿片类药物的传播 流行，最新数据显示阿片类药物和海洛因的使用和过量死亡率再次上升 越来越多。阿片类药物滥用跨越了社会、经济和地理边界。目前的阿片类药物和 海洛因危机是近代史上从未有过的。目前大多数海洛因吸毒者都是从身体上开始的 对处方类阿片上瘾。与以前的海洛因吸毒者不同，大多数新吸毒者是 白人，中产阶级，生活在非城市地区。在中国缺乏对吸毒者群体的研究 郊区社区。修订后的R15应用程序的主要目标是填补我们对 在阿片类药物使用普遍的郊区社区，阿片类药物和海洛因的使用模式。这项研究包括两项 具体目标：(目标1)审查阿片类药物和海洛因的使用开始、轨迹、环境、情况和风险 (目标2)按种族、族裔和性别比较阿片类药物和海洛因的使用模式。我们的质量 研究三角测量人种学田野研究和在三个郊区田野地点进行的深度访谈 在大小、位置和人口统计上有所不同。样本将包括180名阿片类药物和/或海洛因使用者 在马萨诸塞州波士顿(N=60)、康涅狄格州纽黑文(N=60)和 佐治亚州亚特兰大(N=60)。我们将使用定向抽样、滚雪球抽样和理论抽样等方法。我们的新奇用法 用贝叶斯分析和数据可视化的定性方法来说明阿片类药物和 在郊区人群中使用海洛因是本研究设计的一个创新。我们的协作性和技能 研究团队由多名PI领导，其中包括一起工作过的经验丰富的调查人员 在药物研究项目上取得成功。我们的目标是建立在之前考察新趋势的郊区研究的基础上 这是我们早期研究的合乎逻辑的延伸。这项研究是对一个紧急情况的回应 需要知道为什么阿片类药物和海洛因滥用持续增加，以及哪些预防和干预措施 需要制定方案来解决阿片类药物的流行问题。我们的发现将为医疗保健工作提供有针对性的信息 阿片类药物和海洛因使用者的郊区人口。更全面地了解郊区的毒品使用情况， 风险环境和社会背景也可以为更大规模的阿片类药物转化、路线等流行病学研究提供信息 阿片类药物和海洛因使用的不同郊区的管理做法和其他危险行为 都在增加。

Epidemiological data show a dramatic increase in opioid and heroin use, largely due to nonmedical use of opioid prescription medications. Nationwide efforts to reduce diversion of prescription opioids appeared to show a leveling of opioid overdose mortality rates but accompanied by a sharp increase in heroin overdose mortality rates from 2012 to 2013. Unfortunately, despite increased focus on stopping the spread of the opioid epidemic, the most recent data show both opioid and heroin use and overdose mortality rates are again increasing. Opioid abuse has traversed social, economic, and geographic boundaries. The current opioid and heroin crisis is like no other experienced in recent history. Most current heroin users started with physical addiction to prescription opioids. Unlike previous cohorts of heroin users, the majority of new heroin users are White, middle class, and live in nonurban areas. There is a lack of research on drug user populations in suburban communities. The broad goal of this revised R15 application is to fill the gap in our understanding of opioid and heroin use patterns in suburban communities where opioid use is epidemic. The study includes two specific aims: (Aim 1) To examine opioid and heroin use initiation, trajectories, settings, situations, and risk practices; (Aim 2) To compare opioid and heroin use patterns by race, ethnicity, and gender. Our qualitative study triangulates ethnographic field research and in-depth interviews conducted in three suburban field sites that differ by size, location, and demographics. The sample will consist of 180 opioid and/or heroin users living in suburban communities around Boston, Massachusetts (N=60), New Haven, Connecticut (N=60), and Atlanta, Georgia (N=60). We will use targeted, snowball, and theoretical sampling methods. Our novel use of qualitative methods with Bayesian analysis and data visualizations to illustrate transition patterns in opioid and heroin use among suburban populations is an innovation of this study design. Our collaborative and skilled research team is led by multiple PIs and includes experienced investigators who have worked together successfully on drug research projects. Our aims build on our previous suburban studies examining new trends in suburban drug use and are a logical extension of our earlier research. This study responds to an urgent need to know why opioid and heroin abuse continue to increase and what prevention and intervention programs are needed to address the opioid epidemic. Our findings will inform health care efforts targeted to suburban populations of opioid and heroin users. A more comprehensive understanding of suburban drug use, risk environments, and social context can also inform larger epidemiological studies on opioid transitions, route of administration practices, and other risk behaviors in diverse suburban areas where opioid and heroin use are increasing.