Understanding Polydrug Use Risk and Protective Factors, Patterns, and Trajectories to Prevent Drug Overdose - 2022

了解多种药物使用风险和预防药物过量的保护因素、模式和轨迹 - 2022

• 批准号: 10579709
• 负责人: Julia Elizabeth Hood
• 金额: $ 34.8万
• 依托单位: SEATTLE-KING COUNTY PUBLIC HEALTH DEPT
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2025-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10579709
• 关键词: Understanding; Polydrug; Use; Risk; Protective

Drug consumption trends in the United States have substantially changed in recent years, triggering a surge in overdose deaths. Efforts to address the crisis at the local level are oftentimes focused on meeting the needs of persons in the most advanced stages of substance use disorder (SUD), in part because this group is most visible at acute care, public health, and social service sites and corresponding data systems. Intervening at an earlier stage of use represents an opportunity to prevent drug use from progressing to polysubstance use, injection drug use (IDU), SUD, overdose, and other severe health outcomes. However, the precursors to drug use initiation and the patterns of consumption that follow are poorly characterized and the factors associated with progression to severe outcomes are largely unknown. Illicitly manufactured fentanyl (IMF) and concurrent use of opioids and stimulants are now at the core of America’s overdose crisis, responsible for much of the recent increase in overdose deaths. Specific consumption behaviors and corresponding rationale associated with IMF and co- occurring use of methamphetamine and opioids are not well-characterized and may directly correlate with overdose risk. We propose to conduct an exploratory sequential mixed methods evaluation of drug use behaviors, patterns, trajectories, and risk factors in a sample of King County, WA residents who initiated use within the past three years of a high-risk drug class (includes illicitly manufactured fentanyl, heroin, methamphetamine, cocaine, crack, and prescription opioids or benzodiazepines used for a non-prescribed or euphoric purpose). Our study will: (1) evaluate how and why polysubstance patterns emerge and evolve through one- on-one semi-structured in-depth interviews, (2) describe polydrug use trajectories following initiation of a high-risk drug class; and (3) quantitatively assess factors associated with consumption of IMF and the concurrent use of opioids and methamphetamine through a case- control study. The quantitative and qualitative results from our study will inform development of novel early intervention strategies and development of methods to reach a currently hidden population with overdose prevention programs and related evaluations.

近年来，美国的毒品消费趋势发生了重大变化， 导致过量死亡人数激增在地方一级解决危机的努力是 通常侧重于满足处于物质最高级阶段的人的需要 使用障碍（SUD），部分原因是这个群体在急性护理，公共卫生和 社会服务网站和相应的数据系统。在使用的早期阶段进行干预 是防止吸毒发展为使用多种物质、注射 药物使用（IDU），SUD，过量和其他严重的健康后果。然而， 吸毒的开始和随后的消费模式的特点很差， 与进展为严重结局相关的因素在很大程度上是未知的。非法 制造芬太尼（货币基金组织）和同时使用阿片类药物和兴奋剂现在是核心 美国的过量用药危机，负责最近过量死亡人数增加的大部分。 具体的消费行为和相应的理论基础与货币基金组织和合作， 使用甲基苯丙胺和阿片类药物的情况没有得到很好的描述， 与用药过量的风险有关我们建议进行探索性的序贯混合方法 评价药物使用行为，模式，轨迹和风险因素在国王的样本 在过去三年内开始使用高风险药物类的西澳县居民 （包括非法制造的芬太尼，海洛因，甲基苯丙胺，可卡因，快克， 用于非处方或欣快目的的处方阿片类药物或苯二氮卓类药物）。我们 研究将：（1）评估多物质模式是如何以及为什么通过一个- 对一个半结构化的深入访谈，（2）描述多种药物使用轨迹， 启动高风险药物类别;（3）定量评估与 消费IMF和同时使用类阿片和甲基苯丙胺， 对照研究我们研究的定量和定性结果将为发展提供信息， 新的早期干预策略和方法的发展，以达到目前隐藏的 接受过量预防计划和相关评估的人群。