Assessing fentanyl test strip use accuracy and fentanyl presence in the non-heroin drug supply

项目摘要 芬太尼对海洛因和其他毒品的污染越来越普遍，导致显著的 非故意的芬太尼相关过量用药。芬太尼试纸(FTS)是一种低阈值的缓解方法 吸毒者中与芬太尼相关的过量风险(PWUD)。使用FTS，PWUD可以溶解少量 为测试芬太尼的存在而将药物放入水中的量。PWUD报告称，FTS易于使用 与使用相关的后勤和环境障碍很少。此外，新出现的证据表明，FTS 使用会对后续行动产生积极影响。在我们团队之前进行的工作中，PWUD在费城 报告的非海洛因药物FTS阳性结果的比率非常高，远远高于 其他地点。这些不一致的结果可能的解释包括费城非法交易的饱和 芬太尼的药物市场，FTS的错误使用，FTS的错误解释，或三者的组合。 尽管FTS的分布越来越多，但到目前为止还没有研究探索PWUD使用FTS的准确性。在……里面 此外，虽然芬太尼在海洛因供应中的流行率已被广泛记录在案，但目前 目前尚不清楚芬太尼在非海洛因毒品市场中的存在程度。根据最近在 费城报告称，非海洛因药物FTS阳性率高得令人震惊，目前 了解FTS的使用和非海洛因药物供应的污染，迫切需要 为了评估PWUD中FTS使用的准确性以及芬太尼在费城非 海洛因毒品供应。这项工作的长期目标是利用FTS推进过量用药预防措施 和其他药品检查技术在美国各地的药品市场。这项提案的总体目标是 利用费城建立的市政和社区合作伙伴关系以及先进药物的使用- 检查技术，以解释先前检测到的药物中芬太尼水平之间的差距 在费城PWUD中使用FTS的供应和自我报告结果。我们的目标一定会实现 有两个具体目标：(1)确定用户使用和解释FTS的过程和(2)估计真实的 宾夕法尼亚州费城非海洛因药物供应中存在芬太尼。这项研究将产生重大影响 通过解决关于将FTS作为一种减少危害战略的效用的知识差距，并提供可操作的 关于非海洛因药物中芬太尼存在程度的证据。我们预计以下三个方面的结果 目标：(1)找出在正确使用FTS方面的教育差距，并解释其结果 在PWUD中，(2)费城非海洛因非法药物芬太尼污染的时间点数据，以及 (3)向正在进行的国家运动提供信息，教育PWUD有关FTS和过量用药预防战略。 研究结果将加强针对供应方芬太尼的循证过量预防努力 PWUD的污染和真实世界FTS使用做法。

PROJECT ABSTRACT Fentanyl contamination of heroin and other drugs is increasingly common, leading to significant rates of unintentional fentanyl-related overdoses. Fentanyl test strips (FTS) are a low-threshold approach to mitigating fentanyl-related overdose risk among people who use drugs (PWUD). Using FTS, PWUD can dissolve a small quantity of a drug into water to test for the presence of fentanyl. PWUD report that FTS are easy to use with few logistical and environmental barriers associated with use. Moreover, emerging evidence indicates that FTS use positively impacts subsequent actions. In prior work conducted by our team, PWUD in Philadelphia reported exceptionally high rates of positive FTS results on non-heroin drugs, far higher than rates seen in other locations. Possible explanations for these discordant results include saturation of the Philadelphia illicit drug market with fentanyl, incorrect use of FTS, incorrect interpretation of FTS, or a combination of the three. Despite increasing distribution of FTS, no studies to date have explored the accuracy of FTS use by PWUD. In addition, while the prevalence of fentanyl in the heroin supply has been widely documented, it is currently unknown to what extent fentanyl is present in non-heroin drug markets. Based upon the recent findings in Philadelphia reporting alarmingly high rates of FTS positivity with non-heroin drugs and these gaps in current knowledge regarding both FTS use and contamination of the non-heroin drug supply, there is an urgent need to assess the accuracy of FTS use among PWUD and the extent fentanyl is present in the Philadelphia non- heroin drug supply. The long-term goal of this work is to advance overdose prevention measures using FTS and other drug-checking technology in drug markets around the U.S. The overall objective of this proposal is to leverage established municipal and community partnerships in Philadelphia and the use of advanced drug- checking technology to explicate gaps identified between previously detected levels of fentanyl in the drug supply and self-reported results from FTS use among PWUD in Philadelphia. Our objective will be achieved with two specific aims: (1) Determine user process of use and interpretation of FTS and (2) Estimate the true presence of fentanyl in the non-heroin drug supply in Philadelphia, PA. This study will have significant impact by addressing knowledge gaps regarding utility of FTS as a harm reduction strategy and providing actionable evidence regarding the extent of fentanyl presence in non-heroin drugs. We anticipate three outcomes from aims: (1) the identification of educational gaps in the proper use of FTS and interpretation of their results among PWUD, (2) point-in-time data for fentanyl contamination of non-heroin illicit drugs in Philadelphia, and (3) informing ongoing national campaigns to educate PWUD about FTS and overdose prevention strategies. Study findings will enhance evidence-based overdose prevention efforts targeted at supply-side fentanyl contamination and real-world FTS use practices by PWUD.