Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA.
Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA.
J Community Health. 2021 Apr;46(2):349-357. doi: 10.1007/s10900-020-00928-3. Epub 2020 Sep 30.
The evolving opioid epidemic in the United States has increased drug-related overdose rates exponentially (Centers for Disease Control and Prevention in Opioid overdose, 2020c, https://www.cdc.gov/drugoverdose/data/otherdrugs.html#:~:text=Polysubstance%20drug%20use%20occurs%20with,or%20other%20non%2Dopioid%20substances ). Fentanyl, a synthetic opioid, has recently fueled the epidemic, increasing overdose death rates (Centers for Disease Control and Prevention in Drug overdose deaths involving fentanyl, 2011-2016, 2019a, https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_03-508.pdf ). Harm reduction strategies (drug checking, naloxone administration, etc.) are at the forefront of preventing opioid-related overdoses in high-risk populations (Kennedy et al. in Drug Alcohol Depend 185:248-252, 2018, https://doi.org/10.1016/j.drugalcdep.2017.12.026 ; Laing et al. in Int J Drug Policy 62:59-66, 2018, https://doi.org/10.1016/j.drugpo.2018.10.001 ). Little is known, however, about how people who inject drugs (PWID) may modify their drug use behaviors after suspected fentanyl contamination in their drugs. We conducted a cross-sectional survey among 105 opioid-dependent PWID enrolled in a methadone maintenance program. We assessed their willingness to engage in various harm reduction methods (i.e., slowing down drug use, not using drugs, carrying naloxone, using with someone who has naloxone) after suspected fentanyl contamination of their drugs. In a multivariable analysis, participants who were white, low-income, polysubstance users, and had previously experienced an overdose or had previously administered naloxone were more likely to report a willingness to engage in harm reduction measures. These findings provide an evidence-based understanding of PWID's engagement in harm reduction behaviors after suspecting potential fentanyl exposure as well as a basis for tailoring intervention strategies in the context of fentanyl-adulterated markets.
美国不断演变的阿片类药物流行已使与药物相关的过量服用率呈指数级增长（疾病预防控制中心，2020c，https://www.cdc.gov/drugoverdose/data/otherdrugs.html#:~:text=Polysubstance%20drug%20use%20occurs%20with,or%20other%20non%2Dopioid%20substances ）。芬太尼是一种合成阿片类药物，最近加剧了这一流行，导致过量服用死亡率上升（疾病预防控制中心，涉及芬太尼的药物过量死亡，2011-2016 年，2019a，https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_03-508.pdf ）。减少伤害策略（药物检查、纳洛酮管理等）是预防高危人群中阿片类药物相关过量服用的最前沿措施（Kennedy 等人，《药物与酒精依赖》185:248-252，2018 年，https://doi.org/10.1016/j.drugalcdep.2017.12.026 ；Laing 等人，《国际药物政策》62:59-66，2018 年，https://doi.org/10.1016/j.drugpo.2018.10.001 ）。然而，人们对吸毒者（PWID）在怀疑其毒品中含有芬太尼后可能会如何改变其吸毒行为知之甚少。我们对 105 名参加美沙酮维持治疗计划的阿片类药物依赖的 PWID 进行了横断面调查。我们评估了他们在怀疑其毒品中含有芬太尼后参与各种减少伤害方法的意愿（即减缓吸毒速度、不吸毒、携带纳洛酮、与携带纳洛酮的人一起使用）。在多变量分析中，白人、低收入、多药物使用者、以前有过过量服用或以前使用过纳洛酮的参与者更有可能报告愿意采取减少伤害措施。这些发现为 PWID 在怀疑潜在芬太尼暴露后参与减少伤害行为提供了循证理解，并为在芬太尼掺假市场背景下制定干预策略提供了基础。
