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#年非法药物供应中的日益普遍 包括俄亥俄州在内的美国对公共卫生官员提出了实质性的挑战 减少意外过量的干预措施。芬太尼快速试纸，用于检测芬太尼的存在 尿样中的芬太尼和一些芬太尼类似物，越来越多地被使用标签外的人使用 在消费前对违禁药物芬太尼进行检测的药物。最近的研究表明，当人们使用 药物收到阳性芬太尼测试结果，他们更有可能进行过量的风险降低行为 (例如，减少药物的使用)。然而，由于这一减少伤害战略的紧急性质，同行- 回顾已发表的关于这一主题的研究非常有限。我们建议测试提供芬太尼的干预措施 在阿片类药物过量教育的子集中向吸毒者进行试纸教育和分发 纳洛酮在俄亥俄州农村和城市县的分布地点。这项研究的长期目标是 减少俄亥俄州和全国与服药过量有关的发病率和死亡率。本课题的研究目标是 研究内容为：1)确定提供芬太尼试纸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) 确定是否在阿片类药物过量教育和纳洛酮的基础上增加芬太尼试纸教育和分配 分配计划降低了吸毒者中的阿片类药物过量比率。使用双臂集束- 随机试验设计，我们将通过检验以下3个具体目标来回答研究目标：1) 确定与纳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方案的教育和分配 和城市县；2)检验这样一种假设，即接受芬太尼的吸毒者测试条带教育 作为阿片类药物过量教育和纳洛酮分发计划的一部分，测试材料将 提高了关于如何测试药物芬太尼的知识和自我效能，以及降低其 阿片类药物过量的风险；以及3)检验接受芬太尼试纸教育的人的假设 作为阿片类药物过量教育和纳洛酮分发计划的一部分，测试材料将有 与接受阿片类药物过量教育和纳洛酮分配的人相比，阿片类药物超标率更低 仅限(“惯例”)。芬太尼试纸的使用正变得越来越普遍，但支持这一做法的研究 是有限的。我们将调查整合的可行性、可接受性以及相关的益处和危害 芬太尼试纸教育和在现有阿片类药物过量教育和纳洛酮分配中的分配 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.