New psychoactive substance exposure among NYC nightclub and festival attendees

新的精神活性物质（NAPs），如芬太尼类似物，合成大麻素和合成 卡西酮（“浴盐”）继续以惊人的速度出现。我们对艾滋病的流行程度知之甚少 暴露或对这些药物的影响，因为他们出现，主要是因为大多数人接触不知道 他们使用（因为这些是添加到摇头丸和海洛因等药物中的常见掺杂物）。更先进 需要毒理学方法来检测暴露，大多数毒理学研究依赖于来自 那些已经住院的人。包括毒理学方法在内的流行病学调查框架可以提供帮助 克服依赖中毒的偏见，并迅速提供有关接触和影响的信息， 科学家和公众都能看到因此，我们提出了这一R 01，其中审查的趋势， 报告的高风险人群中的药物使用-电子舞曲（EDM）党的与会者。的人 参加EDM活动（在夜总会和节日）是使用毒品的高风险，特别是可卡因， 摇头丸（MDMA，Molly），LSD，甲基苯丙胺和阿片类药物-以及相关的不良后果，包括 死亡鉴于这种高风险的场景可能会成为扩散到一般趋势的风向标 人口，结果将有助于防止使用，过量，和死亡，不仅在EDM党的观众，而且在 一般人口。通过该调查小组在2016年至2018年期间开展的项目， 到2021年，我们发现毒品使用和无意接触毒品的人数急剧增加。在R 01中，我们 我将继续使用我们目前的R 01的招募方法和有效的快速药物调查（查询 使用>100种药物）来估计药物使用趋势，但我们将更多地关注我们的新的和创新的 毒理学方法我们的毒理学方法现在将使用唾液测试来测试暴露于> 1，000种药物 （包括超过120种芬太尼类似物）。所有参与者将被要求提供唾液样本 并采取后续调查，以评估潜在的药物相关的不良影响，在他们的夜晚了。我们将 招募4,160名成年人连续四年参加EDM派对，使用时空抽样。本研究 将使我们能够确定谁最近接触过甲孕酮（大多数其他实验室还不能检测到）， 确定调查中的诚实和关注等因素是否能预测测试结果为阳性， 报告使用（基于我们修改的印象管理理论模型）。我们已经确认 我们的方法的可行性，并提出了四个目标。首先，我们将估计唾液测试增加 与报告的吸毒流行率之间的关系。第二，我们将确定暴露于新药物的影响概况，因为它们 出现。第三，我们将确定事件，如DEA调度的预测趋势的变化， exposure.第四，我们将确定药物使用和不良反应的变化是否是药物相关疾病的风向标。 结果。我们将迅速传播我们的研究结果，关于在这个高风险， 人口，以防止使用和相关的伤害之间的EDM党的观众以及一般公众。

New psychoactive substances (NPS) such as fentanyl analogs, synthetic cannabinoids, and synthetic cathinones (“bath salts”) continue to emerge at an alarming rate. We know very little about prevalence of exposure or about effects of these drugs as they emerge—largely because most people exposed are unaware that they used (as these are common adulterants added to drugs like ecstasy and heroin). More advanced toxicology methods are needed to detect exposures and most toxicology studies rely on biospecimens from those who have been hospitalized. Epidemiological survey framework including toxicology methods can help overcome the biases of relying on poisonings and quickly provide information on exposure and effects to those recently exposed, and to scientists and the public. As such, we propose this R01 which examines trends in reported drug use among a high-risk population—electronic dance music (EDM) party attendees. People who attend EDM events (at nightclubs and festivals) are at high risk for use of drugs—particularly NPS, cocaine, ecstasy (MDMA, Molly), LSD, methamphetamine, and opioids—and related adverse outcomes, including death. Given that this high-risk scene may serve as a bellwether for trends that diffuse to the general population, results will help prevent use, overdose, and death not only among EDM partygoers, but also in the general population. Through projects conducted by this team of investigators conducted between 2016 and 2021, we have identified dramatic increases in drug use and unintentional exposure to NPS. In this R01, we will continue to utilize our current R01’s recruitment methods and validated rapid drug survey (which queries use of >100 drugs) to estimate trends in drug use, but we will focus more on our new and innovative toxicological methods. Our toxicology methods will now use saliva testing to test for exposure to >1,000 drugs (including over 120 fentanyl analogs). All participants will be asked their willingness to provide a saliva sample and to take a follow-up survey to assess potential drug-related adverse effects during their night out. We will recruit 4,160 adults entering EDM parties continuously over four years using time-space sampling. This study will allow us to determine who was recently exposed to NPS (which most other labs cannot yet detect) and determine whether factors such as honesty and attention on the survey predict testing positive after not reporting use (based on our modified Impression Management theoretical model). We have confirmed the feasibility of our methods and propose four aims. First, we will estimate the extent to which saliva testing adds to prevalence of reported drug use. Second, we will determine effect profiles of exposure to new NPS as they emerge. Third, we will determine if events such as DEA scheduling of NPS predict changes in trends of NPS exposure. Fourth, we will determine if shifts in use and adverse effects are a bellwether for drug-related outcomes. We will rapidly disseminate our findings regarding NPS exposure and NPS effects in this high-risk population to prevent use and associated harms among EDM partygoers as well as the general public.