Examination of evolving opioid misuse and overdose risk among American Indians

项目摘要 美国印第安人社区受到阿片类药物流行病的极大影响， 社区被阿片类药物使用和阿片类药物过量所淹没。在所有种族/族裔中 在美国，美洲印第安人和阿拉斯加原住民的死亡率是第二高的。 所有阿片类药物的过量死亡率以及第二和第三高的过量死亡率， 海洛因和合成鸦片与该国其他地区一样，阿片类药物是 加州吸毒过量死亡人数在南加州，监测数据表明， 包括美洲印第安人保留地在内的地区经历了一些最高的年龄， 调整后的阿片类药物相关过量死亡率、住院率和急诊率 探访虽然一直在努力减少阿片类药物危机，但大部分工作都集中在 人口一级的战略，而没有充分重视社区动态和地方一级 阿片类药物使用的背景。本研究的总体目标是描述变化的 南加州美洲印第安人阿片类药物滥用和过量风险的病因学（AI） 成人通过实施研究方法，以促进社区参与，并告知 及时对阿片类药物流行病作出公共卫生反应。在4年的时间里，我们将在当地收集 来自不同来源的相关数据（80次访谈，200次调查，以及人口水平的数据， 阿片类药物过量死亡），以捕捉新出现的风险模式并对这些信息进行三角测量 为成人禽流感预防和治疗服务的规划和分配提供信息。我们 研究将遵循以下具体目标：1.确定个人的流行情况 存在阿片类药物滥用和阿片类药物过量的风险; 2.检查社区资产和能力， 处理预防和治疗类阿片使用/滥用以及由此造成的过量;以及3.发展 以社区为基础的监测工具，为减少类阿片的社区行动提供信息 吸毒过量致死通过结合多个信息源，进行更全面的分析 并准确地描绘出阿片类药物危机的图景。这对公众健康的重要性 研究将持续评估导致阿片类药物滥用和过量的环境 AI部落之间不同社会和地理环境的风险。我们预计， 调查结果将为预防和治疗服务的短期和长期规划提供信息 满足加州部落的需求。

Project Summary American Indian communities have been greatly affected by the opioid epidemic with many communities being overwhelmed by opioid use and opioid overdose. Among all racial/ethnic groups in the U.S, American Indians and Alaska Natives have the second highest rate of overdose fatalities from all opioids and second and third highest overdose fatality rates from heroin and synthetic opioids. As with other parts of the country, opioids are the main driver of drug overdose deaths in California. Within Southern California, surveillance data indicates that areas encompassing American Indian reservations have experienced some of the highest age- adjusted rates of opioid-related overdose deaths, hospitalization, and emergency department visits. While there have been efforts to curtail the opioid crisis, much of this work has focused on population-level strategies without enough focus on the community dynamics and local-level context of opioid use. The overarching goal of this study is to characterize the changing etiology of opioid misuse and overdose risk among Southern California American Indian (AI) adults by implementing research methods to promote community engagement and inform a timely public health response to the opioid epidemic. Over a 4-year period, we will collect locally relevant data from diverse sources (80 interviews, 200 surveys, and population-level data on opioid overdose fatalities) to capture emerging patterns of risks and triangulate that information to inform the planning and allocation of prevention and treatment services for AI adults. Our study will be guided by the following Specific Aims: 1. Identify the epidemic profile of individuals at risk for opioid misuse and opioid overdose; 2. Examine community assets and capacity to address prevention and treatment of opioid use/misuse and resulting overdose; and 3. Develop community-based surveillance tool to inform community action towards reducing opioid overdose fatalities. By combining multiple information sources, a more comprehensive analysis and accurate picture of the opioid crisis can be generated. The public health significance of this study will be to continuously assess the environment contributing to opioid misuse and overdose risk across different social and geographical settings among AI Tribes. We anticipate that our findings will inform the short-term and long-term planning of prevention and treatment services that are responsive to the needs of California Tribes.