将家庭毒品检测作为加拿大不列颠哥伦比亚省的一种新的减少伤害策略。
Take-home drug checking as a novel harm reduction strategy in British Columbia, Canada.
机构信息
British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
出版信息
Int J Drug Policy. 2022 Aug;106:103741. doi: 10.1016/j.drugpo.2022.103741. Epub 2022 Jun 4.
BACKGROUND
Drug checking is a harm reduction strategy used to identify components of illicitly obtained drugs, including adulterants, to prevent overdose. This study evaluated the distribution of take-home fentanyl test strips to people who use drugs (PWUD) in British Columbia, Canada. The primary aim was to assess if the detection of fentanyl in opioid samples was concordant between a take-home model and testing by trained drug checking staff.
METHODS
Take-home fentanyl test strips were distributed at ten sites providing drug checking services from April to July 2019. The fentanyl positivity of the aggregate take-home and on-site drug checking groups were compared by class of substance tested. An administered survey assessed acceptability and behaviour change.
RESULTS
1680 take-home results were obtained from 218 unique participants; 68% of samples (n=1142) were identified as opioids and 23% (n=382) were stimulant samples. During this period, 852 samples were tested using on-site drug checking. The fentanyl positivity of opioid samples was 90.0% for take-home samples and 89.1% for on-site samples (Difference 0.8% (95% CI -2.3% to 3.9%)). These results were not affected by previous experience with test strips. Fentanyl positivity of stimulants in the take-home group was higher than on-site (24.7% vs. 3.2%), but the study was underpowered to conduct statistical analysis on this sub-group. When fentanyl was detected, 27% of individuals reported behaviour change that was considered safer/positive. Greater than 95% of participants stated they would use fentanyl test strips again.
CONCLUSIONS
Take-home fentanyl test strips used by PWUD on opioid samples can provide similar results to formal drug checking services and are a viable addition to existing overdose prevention strategies. Use of this strategy for detection of fentanyl in stimulant samples requires further evaluation. This intervention was well accepted and in some participants was associated with positive behaviour change.
背景
药物检测是一种减少伤害的策略，用于识别非法获得的药物中的成分，包括掺杂物，以防止过量用药。本研究评估了在加拿大不列颠哥伦比亚省向吸毒者（PWUD）分发家庭用药检测试剂盒的情况。主要目的是评估家庭用药检测试剂盒和经过培训的药物检测人员现场检测之间在检测阿片类药物样本中的芬太尼时的一致性。
方法
2019 年 4 月至 7 月，在提供药物检测服务的 10 个地点分发家庭用药检测试剂盒。通过检测物质的类别比较汇总的家庭用药检测试剂盒组和现场药物检测组的芬太尼阳性率。一份管理调查评估了可接受性和行为改变。
结果
从 218 名独特的参与者中获得了 1680 个家庭用药检测试剂盒结果；68%（n=1142）的样本被确定为阿片类药物，23%（n=382）为兴奋剂样本。在此期间，使用现场药物检测检测了 852 个样本。家庭用药检测试剂盒检测到的阿片类药物样本的芬太尼阳性率为 90.0%，现场检测的芬太尼阳性率为 89.1%（差值 0.8%（95%CI-2.3%至 3.9%））。这些结果不受之前使用检测试剂盒的经验影响。家庭用药检测试剂盒中兴奋剂的芬太尼阳性率高于现场检测（24.7%比 3.2%），但该研究在这个亚组上的统计分析能力不足。当检测到芬太尼时，27%的人报告了被认为更安全/积极的行为改变。超过 95%的参与者表示他们将再次使用芬太尼检测试剂盒。
结论
吸毒者在阿片类药物样本上使用家庭用药检测试剂盒可以提供与正规药物检测服务相似的结果，是现有预防过量用药策略的可行补充。使用这种策略检测兴奋剂中的芬太尼需要进一步评估。这种干预措施得到了很好的接受，在一些参与者中与积极的行为改变有关。
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