Evaluating the impact of fentanyl test strip use among rural and urban populations

项目摘要 高致命性芬太尼和芬太尼类似物在非洲非法药物供应中的日益普遍性 包括俄亥俄州在内的美国对公共卫生官员提出了一个重大挑战， 采取干预措施，以减少无意过量。快速芬太尼测试条，旨在测试是否存在 芬太尼和一些芬太尼类似物在尿液样本中，越来越多地被使用者使用标签外使用 在消费前测试非法药物芬太尼的药物。最近的研究表明，当人们使用 药物收到积极的芬太尼测试结果，他们更有可能执行过量的风险降低行为 (e.g.,使用较少的药物）。然而，由于这种减少伤害战略的紧急性质，同行- 关于这一主题的已发表研究非常有限。我们建议测试一种干预措施， 试纸教育和分发给使用阿片类药物过量教育子集中药物的人， 俄亥俄州农村和城市县的纳洛酮分布点。这项研究的长期目标是 降低俄亥俄州和全国的过量相关发病率和死亡率。本研究的目的 研究是：1）确定提供芬太尼测试条教育和测试的可行性和可接受性 现有阿片类药物过量教育和纳洛酮分配方案中的材料分配;以及2） 确定是否将芬太尼试纸教育和分发添加到阿片类药物过量教育和纳洛酮中 分发计划降低了使用毒品的人中阿片类药物过量的比率。使用双臂群集- 随机试验设计，我们将通过测试以下3个具体目标来回答研究目标：1） 确定与加入芬太尼试纸相关的感知障碍和促进因素 农村现有阿片类药物过量教育和纳洛酮分配计划中的教育和分配 和城市县; 2）测试的假设，谁使用药物谁接受芬太尼试纸教育的人 作为阿片类药物过量教育和纳洛酮分发计划的一部分， 关于如何测试芬太尼药物的知识和自我效能以及降低其 阿片类药物过量的风险;以及3）测试接受芬太尼试纸教育的个人的假设 作为阿片类药物过量教育和纳洛酮分发计划的一部分， 阿片类药物过量率低于接受阿片类药物过量教育和纳洛酮分配的个人 （“惯例”）。芬太尼试纸的使用越来越普遍，但研究支持这种做法 是有限的。我们将调查整合的可行性、可接受性以及相关的利益和危害 芬太尼测试条教育和分发到现有的阿片类药物过量教育和纳洛酮分发 农村和城市社区的方案。

Project Summary The increasing pervasiveness of highly lethal fentanyl and fentanyl analogs in the illicit drug supply in the United States, including Ohio, has posed a substantial challenge for public health officials seeking interventions to reduce unintentional overdoses. 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. Recent research indicates that when people who use drugs receive a positive fentanyl test result, they are more likely 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. We propose to test an intervention to provide fentanyl test strip education and distribution to people who use drugs in a subset of opioid overdose education and naloxone distribution sites in rural and urban counties 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 feasibility and acceptability of providing fentanyl test strip education and testing materials distribution in existing opioid overdose education and naloxone distribution programs; and 2) Determine if adding fentanyl test strip education and distribution to opioid overdose education and naloxone distribution programs decreases opioid overdose rates among people who use drugs. Using a two-arm cluster- randomized trial design, we will answer the research objectives by testing the following 3 specific aims: 1) Determine the perceived barriers and facilitating factors associated with incorporating fentanyl test strip education and distribution in existing opioid overdose education and naloxone distribution programs in rural and urban counties; 2) Test the hypothesis that people who use drugs who receive fentanyl test strip education and testing materials as part of an opioid overdose education and naloxone distribution program will have improved knowledge and self-efficacy regarding how to test drugs for fentanyl and strategies for lowering their risk of an opioid overdose; and 3) Test the hypothesis that individuals who receive fentanyl test strip education and testing materials as part of an opioid overdose education and naloxone distribution program will have a lower opioid overdose rate than individuals who receive opioid overdose education and naloxone distribution only (“usual practice”). Fentanyl test strip use is becoming more common, but research supporting the practice is limited. We will investigate the feasibility, acceptability, and associated benefits and harms of integrating fentanyl test strip education and distribution into existing opioid overdose education and naloxone distribution programs in rural and urban communities.