Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, 03766, USA.
Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 315, Lebanon, NH, 03766, USA; The Dartmouth Institute, Lebanon, NH, 03766, USA.
Drug Alcohol Depend. 2020 Apr 1;209:107893. doi: 10.1016/j.drugalcdep.2020.107893. Epub 2020 Feb 7.
New Hampshire (NH) has had among the highest rates of fentanyl-related overdose deaths per capita in the United States for several years in a row-more than three times the national average in 2016. This mixed-methods study investigated drug-using practices and perspectives of NH residents who use opioids to inform policy in tackling the overdose crisis.
Seventy-six participants from six NH counties completed demographic surveys and semi-structured interviews focused on drug-using practices and perspectives, including use precursors, fentanyl-seeking behaviors, and experiences with overdose. Rigorous qualitative methods were used to analyze interview data including transcription, coding and content analysis. Descriptive statistics were calculated on quantitative survey data.
Eighty-four percent of interviewees had knowingly used fentanyl in their lifetime, 70 % reported overdosing at least once, and 42 % had sought a batch of drugs known to have caused an overdose. The majority stated most heroin available in NH was laced with fentanyl and acknowledged that variability across batches increased overdose risk. Participants reported high availability of fentanyl and limited access to prevention, treatment, and harm reduction programs. There was widespread support for expanding education campaigns for youth, increasing treatment availability, and implementing needle exchange programs.
A confluence of factors contribute to the NH opioid overdose crisis. Despite consensus that fentanyl is the primary cause of overdoses, individuals continue to use it and affirm limited availability of resources to address the problem. Policies targeting innovative prevention, harm reduction, and treatment efforts are needed to more effectively address the crisis.
新罕布什尔州（NH）连续多年的人均芬太尼类药物过量死亡人数在美国各州中一直处于最高水平之列——2016 年的这一数字是全美平均水平的三倍多。这项混合方法研究调查了 NH 居民的吸毒行为和观点，这些居民使用阿片类药物是为了为解决过量危机提供政策信息。
来自 NH 六个县的 76 名参与者完成了人口统计调查和半结构化访谈，重点关注吸毒行为和观点，包括使用前体、寻找芬太尼的行为以及与过量有关的经历。采用严格的定性方法对访谈数据进行分析，包括转录、编码和内容分析。对定量调查数据进行描述性统计。
84%的受访者在有生之年曾有意使用过芬太尼，70%的受访者报告至少有过一次过量用药，42%的受访者曾寻求过一批已知会导致过量用药的药物。大多数受访者表示 NH 可获得的大多数海洛因都掺有芬太尼，并承认不同批次之间的差异增加了过量用药的风险。参与者报告说，芬太尼的供应非常充足，而预防、治疗和减少伤害的方案却有限。扩大针对青少年的教育宣传、增加治疗方案的可及性和实施针具交换项目得到了广泛支持。
多种因素共同导致了 NH 阿片类药物过量危机。尽管人们普遍认为芬太尼是导致过量用药的主要原因，但个人仍在继续使用它，并确认解决这一问题的资源有限。需要采取有针对性的创新预防、减少伤害和治疗措施的政策，以更有效地应对这一危机。
