Preventing Overdoses Involving Stimulants (POINTS)Study

项目摘要 近年来，涉及非法可卡因，甲基苯丙胺和其他兴奋剂的过量使用有所增加 在全国范围内以及过量热点州马萨诸塞州（MA）和罗得岛（RI）。多种物质使用 长期以来都是导致吸毒过量的危险因素然而，毒品缉获数据表明，可卡因， 冰毒和假药可能掺杂了芬太尼。无意识的消费 含有非法芬太尼的兴奋剂是阿片类药物过量的一个主要风险因素， 在毒品和犯罪问题办公室和国际犯罪问题办公室，高效力可卡因和甲基苯丙胺的供应和使用日益增加， 只服用兴奋剂过量了解吸毒者的吸毒模式和策略 防止过量使用兴奋剂是必要的，以确定风险和保护因素的兴奋剂参与 吸毒过量对参与药物分配的个人进行混合方法研究也可以提供关键的 （c）提供关于芬太尼和其他掺杂物可能进入兴奋剂供应的机制的信息。 药物样品的测试可以进一步三角消费者和分销商的观点有关的效力 以及药品供应中的掺假使用傅里叶变换红外（FTIR）光谱进行药物检查 能够检测样品中的所有活性掺杂物，包括芬太尼及其类似物。当搭配 验证性测试，药物检查可以提供洞察不断变化的药物供应，暴露于 高效力或掺杂芬太尼的兴奋剂和高风险社区的过量风险。最后，合作 需要与社区利益相关者共同努力，以确定最佳、可行和可接受的战略， 高风险社区的致命和非致命过量。我们的总体目标是减少与兴奋剂有关的 在受过量流行病影响不成比例的地区，我们的方法来满足这一长期- 长期目标是利用多管齐下的方法来确定与兴奋剂有关的风险和保护因素， 并利用这些发现开始制定一套适合当地情况的干预措施的过程 在未来的研究中可以迅速实施的策略，以防止兴奋剂涉及的过量。一致 根据RFA-CE-21-002的目标2，我们的目标是[1]对使用或 分发非法兴奋剂，以确定涉及兴奋剂的过量使用的风险和保护因素; [2] 检查以检查兴奋剂的效力以及芬太尼和其他物质的存在和相对数量 兴奋剂供应中的掺假物;以及[3]召集一系列工作组， MA和RI的一级和二级过量预防，以适应我们的混合方法结果， 确定多层次的干预策略，以防止涉及兴奋剂的过量。完成本研究将 对两个州涉及兴奋剂过量的社会流行病学有了丰富的了解 过量用药危机的影响尤为严重调查结果将产生社区衍生的干预战略 这可以很容易地实施和扩展，以防止MA、RI及其他地区涉及兴奋剂的药物过量。

PROJECT SUMMARY In recent years, overdoses involving illicit cocaine, methamphetamine, and other stimulants, have increased nationally and in the overdose hotspot states of Massachusetts (MA) and Rhode Island (RI). Polysubstance use has long been a known risk factor for overdose. However, drug seizure data suggest that cocaine, methamphetamine, and counterfeit pills may be adulterated with fentanyl. The unintentional consumption of stimulants containing illicit fentanyl represents a major risk factor for opioid-driven overdoses, whereas the increasing availability and use of highly potent cocaine and methamphetamine in MA and RI pose a risk for stimulant-only overdoses. Understanding the drug use patterns and strategies used by people who use stimulants to prevent overdose is necessary to identify risk and protective factors for stimulant-involved overdoses. Mixed-methods research with individuals involved in drug distribution can also provide critical information into the mechanisms through which fentanyl and other adulterants may enter the stimulant supply. The testing of drug samples can further triangulate consumer and distributor perspectives regarding the potency and adulteration of the drug supply. Drug checking using Fourier-Transform Infrared (FTIR) spectroscopy enables the detection of all active adulterants in a sample, including fentanyl and its analogs. When paired with confirmatory testing, drug checking can provide insights into the changing drug supply, the risk of exposure to highly potent or fentanyl-adulterated stimulants and overdose risk for high-risk communities. Finally, collaborative efforts with community stakeholders are needed to identify optimal, feasible, and acceptable strategies to prevent fatal and non-fatal overdoses in high-risk communities. Our overall objective is to reduce stimulant-involved overdoses in regions disproportionately affected by the overdose epidemic. Our approach to meeting this long- term objective is to utilize a multi-pronged approach to identify risk and protective factors for stimulant-involved overdose and use these findings to begin the process of developing a package of locally-tailored intervention strategies that can be swiftly implemented in future research to prevent stimulant-involved overdoses. Consistent with Objective 2 of RFA-CE-21-002, we aim to [1] Carry out mixed-methods research with people who use or distribute illicit stimulants to identify risk and protective factors for stimulant-involved overdoses; [2] Conduct drug checking to examine the potency of stimulants and the presence and relative quantity of fentanyl and other adulterants in the stimulant supply; and [3] Convene a series of working groups with individuals involved in primary and secondary overdose prevention in MA and RI to contextualize our mixed-methods findings and identify multilevel intervention strategies to prevent stimulant-involved overdoses. Completion of this study will yield a rich understanding of the social epidemiology of stimulant-involved overdoses in two states disproportionately affected by the overdose crisis. Findings will yield community-derived intervention strategies that can be readily implemented and scaled to prevent stimulant-involved overdoses in MA, RI, and beyond.