Department of Human Development and Family Studies, Pennsylvania State University.
Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University.
Psychol Addict Behav. 2023 Mar;37(2):191-198. doi: 10.1037/adb0000834. Epub 2022 May 5.
People who inject drugs (PWID) have an elevated risk of fentanyl-related overdoses. This study explores fentanyl overdose concerns among PWID and the role of sex, racial minority status, and overdose prevention efforts in these concerns.
Data were from 498 PWID from Baltimore City, MD, recruited using street-based outreach between 2016 and 2019. Multinomial logistic regressions assessed correlates of participants' level of concern for themselves and their peers overdosing from fentanyl.
A third of participants were female, half were Black, over two-thirds perceived fentanyl to be in all/most of heroin, 40% expressed low fentanyl overdose concern, and a third overdosed in the past 6 months. After controlling for sociodemographic characteristics, female sex was associated with being very concerned about fentanyl overdoses for oneself (adjusted relative risk [aRR]: 2.13; 95% CI: 1.22, 3.72) and peers (aRR: 1.98; 95% CI: 1.14, 3.45). Compared to Black participants, White participants were less likely to be very concerned about fentanyl overdoses for themselves (aRR: 0.35; 95% CI: 0.19, 0.65). Participants who often/always carried naloxone (aRR: 2.91; 95% CI: 1.42, 5.95) perceived fentanyl in most heroin (aRR: 2.78; 95% CI: 1.29, 5.97) or were on medications for opioid use disorder (MOUD) (quite a bit concerned aRR: 2.18; 95% CI: 1.28, 3.69; very concerned: aRR: 1.96; 95% CI: 1.19, 3.22) were more likely than their counterparts to report being concerned for their peers, but not for themselves.
Female sex and racial minority status were associated with greater concern regarding fentanyl overdoses for oneself. Increasing overdose deaths in these populations suggests disparate access to harm-reduction initiatives rather than interest or concern. Furthermore, findings on naloxone, MOUD, and concerns for peers support social network-based interventions among PWID. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
注射毒品者（PWID）芬太尼相关过量的风险增加。本研究探讨了 PWID 对芬太尼过量的担忧，以及性别、少数族裔地位和过量预防措施在这些担忧中的作用。
数据来自巴尔的摩市的 498 名 PWID，于 2016 年至 2019 年期间通过街头外展招募。多项逻辑回归评估了参与者对自己和同伴因芬太尼过量的担忧程度与性别的相关性。
三分之一的参与者为女性，一半为黑人，超过三分之二的人认为芬太尼存在于所有/大部分海洛因中，40%的人对芬太尼过量的担忧较低，三分之一的人在过去 6 个月内过量用药。在控制社会人口特征后，女性性别与对自身（调整后的相对风险 [ARR]：2.13；95%CI：1.22，3.72）和同伴（ARR：1.98；95%CI：1.14，3.45）的芬太尼过量非常担忧有关。与黑人参与者相比，白人参与者不太可能对自己的芬太尼过量非常担忧（ARR：0.35；95%CI：0.19，0.65）。经常/总是携带纳洛酮的参与者（ARR：2.91；95%CI：1.42，5.95）或使用阿片类药物使用障碍（MOUD）药物（ARR：2.78；95%CI：1.29，5.97）的参与者更有可能报告对同伴的担忧，而不是对自己的担忧。
女性性别和少数族裔地位与对自身芬太尼过量的担忧增加有关。这些人群的过量死亡增加表明，他们获得减少伤害的干预措施的机会不平等，而不是缺乏兴趣或关注。此外，关于纳洛酮、MOUD 和对同伴的担忧的发现支持在 PWID 中开展基于社交网络的干预措施。
