Macmadu Alexandria, Carroll Jennifer J, Hadland Scott E, Green Traci C, Marshall Brandon D L
The Center for Prisoner Health and Human Rights, The Miriam Hospital, 8 Third Street, Providence, RI 02906, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 South Main Street, Box G-S-121-7, Providence, RI 02912, USA.
The Division of Infectious Diseases, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA; Department of Medicine, The Warren Alpert School of Medicine of Brown University, 222 Richmond Street, Providence, RI 02903, USA.
Addict Behav. 2017 May;68:35-38. doi: 10.1016/j.addbeh.2017.01.014. Epub 2017 Jan 6.
The rate of overdose deaths caused by fentanyl-contaminated heroin (FCH) use is increasing rapidly in the United States. We examined risk factors for exposure to FCH and experiences with FCH use among young adult non-medical prescription opioids (NMPO) users.
We analyzed data from the Rhode Island Young Adult Prescription Drug Study (RAPiDS), which enrolled young adults aged 18 to 29 reporting prior 30day NMPO use between January 2015 and February 2016. Participants completed questionnaires ascertaining drug use patterns and risk behaviors, including FCH exposure. Logistic regression was used to assess factors associated with known or suspected FCH exposure.
Of 199 participants, the median age was 25 (IQR: 22, 27), 130 (65.3%) were male, and 122 (61.3%) were of White, non-Hispanic race/ethnicity. In total, 22 (11%) reported known or suspected FCH exposure in the prior six months. Several drug use patterns and risk behaviors were associated with FCH exposure, including: regular heroin and cocaine use; diverted pharmaceutical fentanyl use in the prior six months; NMPO use to avoid withdrawal symptoms; longer duration of NMPO use; regular injection drug use; and prior overdose (all p<0.001). Among participants who reported FCH exposure, 59% were unaware that their heroin was contaminated with fentanyl prior to last use, 59% reported that FCH provides a better high, and all recognized that fentanyl increases overdose risk.
Exposure to fentanyl-contaminated heroin is an emerging trend among young adult NMPO users in Rhode Island. Overdose prevention programs addressing FCH use are urgently needed.
在美国，因使用受芬太尼污染的海洛因（FCH）导致的过量用药死亡发生率正在迅速上升。我们调查了年轻成年非医疗处方阿片类药物（NMPO）使用者接触FCH的风险因素以及使用FCH的经历。
我们分析了罗德岛年轻成年处方药研究（RAPiDS）的数据，该研究纳入了年龄在18至29岁之间、报告在2015年1月至2016年2月期间有过30天NMPO使用史的年轻成年人。参与者完成了问卷调查，以确定药物使用模式和风险行为，包括FCH接触情况。采用逻辑回归分析与已知或疑似FCH接触相关的因素。
199名参与者的中位年龄为25岁（四分位间距：22，27），130名（65.3%）为男性，122名（61.3%）为非西班牙裔白人种族/族裔。总共有22名（11%）报告在过去六个月中有已知或疑似FCH接触。几种药物使用模式和风险行为与FCH接触相关，包括：经常使用海洛因和可卡因；在过去六个月中使用转用的药用芬太尼；使用NMPO来避免戒断症状；NMPO使用时间更长；经常注射吸毒；以及既往有过过量用药经历（所有p<0.001）。在报告有FCH接触的参与者中，59%在最后一次使用前不知道他们的海洛因被芬太尼污染，59%报告FCH带来的快感更好，并且所有人都认识到芬太尼会增加过量用药风险。
接触受芬太尼污染的海洛因是罗德岛年轻成年NMPO使用者中的一个新趋势。迫切需要针对FCH使用的过量用药预防项目。
