Behavioral Medicine Department, Butler Hospital, Providence, RI 02906, United States of America; Boston University School of Public Health, Boston, MA 02118, United States of America.
Behavioral Medicine Department, Butler Hospital, Providence, RI 02906, United States of America; Warren Alpert Medical School of Brown University, Providence, RI 02912, United States of America.
J Subst Abuse Treat. 2019 Sep;104:144-147. doi: 10.1016/j.jsat.2019.07.006. Epub 2019 Jul 13.
Fentanyl-adulterated heroin supply chains are increasing risks for fatal overdose in the U.S.
The current study examined the use of overdose risk reduction behaviors among persons seeking treatment for heroin use and whether perceptions about the presence of fentanyl in one's heroin are associated with overdose risk reduction behaviors.
We recruited persons with opioid use disorder entering a managed withdrawal program. We used multiple linear regression to estimate the adjusted associations of participant characteristics and perception of fentanyl exposure with the frequency of engaging in each of five overdose reduction behaviors.
Participants (n = 239; 75.3% male, 81.2% White, 67% injectors) estimated that 69.2% of the heroin they use contains fentanyl, and 94.6% knew that fentanyl increases overdose risk. Approximately 30% of respondents reported usually or always making sure others are around when they use heroin, carrying naloxone, taking "tester" doses of heroin or intentionally using in reduced amounts. While a majority of the sample reported never carrying naloxone or taking tester doses, and 70.2% reported never making sure that others around them carry naloxone, 84.5% had implemented one or more behavior at least rarely. Past month injection drug use was associated with making sure others are around, but perceptions about fentanyl in one's heroin were not associated with use of harm reduction behaviors.
In this sample of people who use heroin, although overdose risk reduction behaviors were not usually used, a majority had tried at least one behavior. That perceived exposure to fentanyl-adulterated heroin was not associated with the use of such behaviors provides important implications for public health education and intervention programming.
芬太尼掺假海洛因供应链增加了美国致命过量用药的风险。
本研究考察了接受海洛因治疗的患者中减少过量用药风险行为的使用情况，以及对自身海洛因中存在芬太尼的看法是否与减少过量用药风险行为相关。
我们招募了患有阿片类药物使用障碍并进入管理戒断计划的患者。我们使用多元线性回归来估计参与者特征和对芬太尼暴露的看法与参与五种减少过量用药行为的频率之间的调整关联。
参与者（n=239；75.3%为男性，81.2%为白人，67%为注射者）估计他们使用的海洛因中有 69.2%含有芬太尼，94.6%知道芬太尼会增加过量用药风险。大约 30%的受访者表示，当他们使用海洛因时，通常或总是确保其他人在身边，携带纳洛酮，服用“测试剂量”的海洛因或故意减少用量。尽管大多数样本报告从未携带纳洛酮或服用测试剂量，并且 70.2%报告从未确保他们周围的人携带纳洛酮，但 84.5%的人至少偶尔实施了一种或多种行为。过去一个月的注射毒品使用与确保他人在身边有关，但对自身海洛因中芬太尼的看法与减少伤害行为的使用无关。
在这个使用海洛因的人群样本中，尽管减少过量用药风险的行为并不常用，但大多数人至少尝试过一种行为。对接触到芬太尼掺假海洛因的感知与这些行为的使用无关，这对公共卫生教育和干预计划具有重要意义。
