Prescription Opioids Among Street Drug Users: Medical Use, Misuse & Diversion

描述(由申请人提供)：从历史上看，纽约市是美国吸食海洛因人数最多的城市(约25万人)。需要对街头吸毒者中处方阿片类药物(PO)的医疗使用、误用和转移有更清晰的科学理解。通过处方获得的阿片类药物的数量有所增加，有关其滥用的报告也有所增加。街头吸毒者滥用和非法转移POS的风险很高，尽管这些人口也可能出于适当的医疗原因使用POS。对于这一庞大的吸毒者群体，还没有广泛的纵向研究来确定随着时间的推移PO的使用、误用和转移的程度。一项截至2006年对700多名纽约街头吸毒者进行的最新试点研究发现，近90%的吸毒者在一生中使用吸毒者，60%的吸毒者在过去一个月使用吸毒者。奥施康定、维柯丁和街头美沙酮是最常被使用、误用和出售/转移的药物；研究发现，使用原因、使用方式和pos的来源有相当大的差异。拟议的研究旨在澄清使用PO的各种动机(例如，止痛、避免戒断、兴奋)、摄入途径(例如，如所示的口服、嗅闻/鼻塞、注射)、供应来源(例如，医生/药剂师、街头小贩、家庭)以及转移/转售(例如，被他人使用、转售、海洛因替代品)。该研究还将记录各种监管政策的影响，以防止POS的滥用和转用。社会网络理论提供了概念框架；这项研究将包括基本的网络分析，将海洛因和可卡因使用者/卖家的网络与主要使用POS的网络进行比较。人种学数据将补充转售活动的定量报告。目的A(医疗使用和非医疗滥用)：记录和分析纽约市街头吸毒者的PO消费模式。目的B：分析纽约市街头吸毒者POS的分流途径和市场。500名街头吸毒者将接受关于他们使用、滥用和转移POS的面谈，并在6个月后进行跟踪。100名街头吸毒者报告有系统地将POS改道，将就改道事件接受详细访谈。统计分析将记录其他药物使用、POS的医疗使用和各种形式的PO滥用之间的联系。这项研究将提供系统的、纵向的证据，说明该人群中POS的医疗使用、误用和转移的程度，以帮助为药物滥用控制工作提供信息。

DESCRIPTION (provided by applicant): Historically, New York City has had the largest number of heroin users in the U.S. (approximately 250,000). There is a need for a much clearer scientific understanding of prescription opioid (PO) medical use, misuse, and diversion among street drug users. The number of opioids available via prescription has increased, as have reports of their misuse. Street drug users are at high risk for misusing and illegally diverting POs, though this population may also use POs for appropriate medical reasons. There has been no broad-based longitudinal research with this significant population of drug users to determine the extent of PO use, misuse and diversion over time. An updated pilot study of over 700 NYC street drug users through 2006 found that nearly 90% used POs in their lifetimes and 60% used POs in the past month. OxyContin, Vicodin, and street methadone were the most often used, misused, and sold/diverted; the study found considerable variation in reasons for use, modes of use, and sources of POs. The proposed research aims to clarify the various motivations for PO use (e.g. pain relief, withdrawal avoidance, euphoria), routes of ingestion (e.g. oral as indicated, sniff/snort, injection), sources of supply (e.g. physicians/pharmacists, street dealers, family), and diversion/resale (e.g. use by someone else, resold, heroin substitute). The study will also document the impact of various regulatory policies to prevent misuse and diversion of POs. Social network theory provides the conceptual framework; this study will include a basic network analysis, comparing heroin and cocaine users'/sellers' networks with those predominantly using POs. Ethnographic data will complement the quantitative reports of resale activity. AIM A (Medical Use and Non-medical Misuse): Document and analyze patterns of PO consumption among street drug users in NYC. AIM B: Analyze the routes of diversion and markets for POs among street drug users in NYC. 500 street drug users will be interviewed regarding their use, misuse, and diversion of POs and followed-up after 6 months. 100 street drug users who report systematic diversion of POs will be interviewed in detail regarding episodes of diversion. Statistical analyses will document associations among other drug use, medical use of POs, and various forms of PO misuse. The research will provide systematic, longitudinal evidence about the extent of medical use, misuse, and diversion of POs within this population to help inform drug abuse control efforts.