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的极大影响，许多 社区被阿片类药物使用和阿片类药物过量淹没。在所有种族/民族中 在美国，美洲印第安人和阿拉斯加原住民的发病率位居第二 所有阿片类药物的过量死亡率和第二和第三高的阿片类药物过量死亡率 海洛因和合成阿片类药物。与该国其他地区一样，阿片类药物是导致 加州发生吸毒过量死亡事件。在南加州，监控数据表明 包括美洲印第安人保留地在内的地区经历了一些最古老的时代- 阿片类药物过量相关死亡、住院和急诊科的调整比率 来访。虽然一直在努力减少阿片类药物危机，但这项工作的大部分重点是 人口层面的战略没有充分重视社区动态和地方层面 阿片类药物使用的背景。这项研究的首要目标是描述变化的特征 南加州美国印第安人(AI)阿片类药物滥用和过量风险的病因学 通过实施研究方法来促进社区参与并向 及时应对阿片类药物流行的公共卫生。在4年内，我们将在当地收集 来自不同来源的相关数据(80次访谈、200次调查和关于 阿片类药物过量死亡)，以捕捉新出现的风险模式并对该信息进行三角测量 告知规划和分配针对AI成人的预防和治疗服务。我们的 研究将以以下具体目标为指导：1.确定个人的流行概况 面临阿片滥用和阿片过量的风险；2.检查社区资产和能力 解决预防和治疗阿片类药物使用/滥用及其造成的过量用药的问题；以及3.制定 以社区为基础的监测工具，为社区减少阿片类药物提供信息 服药过量致死。通过组合多个信息源，更全面地分析 并且可以生成阿片类药物危机的准确图景。这对公共卫生的意义 研究将持续评估导致阿片类药物滥用和过量的环境 人工智能部落之间不同的社会和地理环境的风险。我们预计我们的 研究结果将为预防和治疗服务的短期和长期规划提供参考 以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.