Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
Integración Social Verter, A.C., Calle José Azueta 230, Primera, 21100 Mexicali, B.C., México; School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada.
Int J Drug Policy. 2022 Aug;106:103745. doi: 10.1016/j.drugpo.2022.103745. Epub 2022 May 26.
Fentanyl has led to an increased number of overdose deaths in North America. Testing substances for fentanyl may be a harm reduction strategy to prevent overdose. Little is known about behavior change after fentanyl testing and the attitudes around fentanyl knowledge and testing along the US-Mexico border in the context of a safe consumption site.
This was a pilot quantitative and qualitative study with 30 women who use drugs at an unsanctioned safe consumption site in Mexicali, Mexico. Women participated in a quantitative survey, a semi-structured interview, and fentanyl testing of substances. Injection behavior was observed after fentanyl testing results were provided. Qualitative data were collected to explore the meanings participants attributed to fentanyl and fentanyl testing.
Half of the substances tested positive for fentanyl (n=15, 50%), and all of them were in samples of black tar heroin. Among those participants who tested positive for fentanyl, 7 (47%) subsequently used less of the intended substance, 1 did not use the intended substance, and 7 (47%) did not change their behavior (i.e., used as originally intended). In qualitative interviews, a predominant theme was a description of fentanyl as dangerous and deadly and fentanyl testing as being helpful for modifying drug use behaviors. However, participants recognized that there could be no change in behavior following a positive fentanyl test in the context of not being able to find substances free of fentanyl.
We observed mixed results related to behavior change after women's intended substance for use tested positive for fentanyl. Fentanyl testing was acceptable to women, but behavior change was hampered by the inability to find substances free of fentanyl. Further research is needed to maximize the potential of fentanyl testing as a harm reduction tool especially in the context of a changing drug supply.
芬太尼的使用导致北美的过量死亡人数增加。对物质进行芬太尼检测可能是一种减少伤害的策略，以防止过量用药。在美国-墨西哥边境的安全消费场所，关于芬太尼检测后的行为变化以及围绕芬太尼知识和检测的态度，人们知之甚少。
这是一项在墨西哥墨西卡利一个未经批准的安全消费场所使用毒品的 30 名女性参与的试点定量和定性研究。女性参与了一项定量调查、半结构化访谈和物质芬太尼检测。在提供芬太尼检测结果后观察注射行为。收集定性数据以探讨参与者对芬太尼和芬太尼检测的含义。
一半的物质检测出芬太尼阳性（n=15，50%），且均为黑焦油海洛因的样本。在芬太尼检测呈阳性的参与者中，有 7 人（47%）随后减少了原本打算使用的物质的用量，1 人未使用原本打算使用的物质，而 7 人（47%）未改变行为（即按原计划使用）。在定性访谈中，一个主要主题是描述芬太尼的危险和致命性，以及芬太尼检测有助于改变用药行为。然而，参与者认识到，在无法找到不含芬太尼的物质的情况下，即使物质检测呈阳性，也无法改变行为。
我们观察到女性打算使用的物质检测出芬太尼阳性后，行为变化的结果喜忧参半。芬太尼检测得到了女性的认可，但由于无法找到不含芬太尼的物质，行为改变受到阻碍。需要进一步研究以充分发挥芬太尼检测作为减少伤害工具的潜力，特别是在不断变化的毒品供应背景下。
