RTI-International, San Francisco, CA, United States; University of California San Francisco, San Francisco, CA, United States; University of Washington, Seattle, WA, United States.
University of Southern California, Los Angeles, CA, United States.
Int J Drug Policy. 2019 Dec;74:299-304. doi: 10.1016/j.drugpo.2019.10.004. Epub 2019 Nov 13.
Over the last several years, fentanyl has been introduced into the illicit drug supply in the United States. While the impact of fentanyl on overdose fatalities is clear, the increase in fentanyl use may also be affecting drug use practices with implications for infectious disease transmission. We conducted a cross-sectional survey to explore associations of perceived illicit fentanyl use with opioid use frequency, injection frequency and syringe sharing among people who inject drugs in two California cities.
People who inject drugs (PWID) were recruited from community settings in Los Angeles and San Francisco, CA from June 2017 to September 2018. Multivariable logistic regression was used to explore adjusted associations between perceived illicit fentanyl use and high frequency opioid use, high frequency injection and syringe sharing.
Among the 395 study participants, the median age of participants was 44 years; 74% of participants were cisgender male; 73% reported to be homeless; 61% lived in San Francisco and 39% in Los Angeles. The prevalence of perceived illicit fentanyl use in the past six months was 50.4% (95% confidence interval (CI): 45.4%-55.3%) among PWID. Findings from our adjusted logistic regression models suggested that people reporting perceived illicit fentanyl use had a greater odds of high frequency opioid use (adjusted odds ratio (aOR) = 2.36; 95% CI: 1.43-3.91; p = 0.001), high frequency injection (aOR = 1.84; 95% CI: 1.08-3.13; p = 0.03) and receptive syringe sharing (aOR = 2.16; 95% CI: 1.06-4.36; p = 0.03), as compared to people using heroin and other street drugs but not fentanyl.
People reporting perceived illicit fentanyl use were at increased risk for injection-related infectious disease risks. Actions must be taken to reduce these risks, including improved access to syringe service programs and opioid treatment and consideration of innovative approaches, such as supervised consumption services.
在过去几年中，芬太尼已被引入美国的非法毒品供应中。虽然芬太尼对过量死亡的影响是明确的，但芬太尼使用的增加也可能影响药物使用方式，从而影响传染病的传播。我们进行了一项横断面调查，以探索在加利福尼亚州的两个城市中，人们对感知到的非法芬太尼使用与阿片类药物使用频率、注射频率和注射器共享之间的关联。
从 2017 年 6 月至 2018 年 9 月，从加利福尼亚州洛杉矶和旧金山的社区环境中招募注射毒品者（PWID）。使用多变量逻辑回归来探讨感知到的非法芬太尼使用与高频阿片类药物使用、高频注射和注射器共享之间的调整关联。
在 395 名研究参与者中，参与者的中位年龄为 44 岁；74%的参与者为跨性别男性；73%报告无家可归；61%居住在旧金山，39%居住在洛杉矶。在过去六个月中，PWID 中感知到的非法芬太尼使用的患病率为 50.4%（95%置信区间（CI）：45.4%-55.3%）。我们的调整后逻辑回归模型的结果表明，报告感知到的非法芬太尼使用的人高频阿片类药物使用的可能性更高（调整后的优势比（aOR）=2.36；95%CI：1.43-3.91；p=0.001），高频注射（aOR=1.84；95%CI：1.08-3.13；p=0.03）和接受性注射器共享（aOR=2.16；95%CI：1.06-4.36；p=0.03），与使用海洛因和其他街头毒品但不使用芬太尼的人相比。
报告感知到的非法芬太尼使用的人感染注射相关传染病的风险增加。必须采取行动降低这些风险，包括改善获得注射器服务计划和阿片类药物治疗的机会，并考虑采用监督消费服务等创新方法。
