Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA.
Center for Drug Use and HIV/HCV Research, New York, NY 10003, USA.
Int J Environ Res Public Health. 2023 Jan 16;20(2):1648. doi: 10.3390/ijerph20021648.
Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths.
Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service providers) from rural southern Illinois. Data were analyzed using constant comparison and theoretical sampling methods.
Participants were concerned about the growing presence of fentanyl in both opioids and stimulants, and many disclosed overdose experiences. Strategies participants reported using to lower overdose risk included purchasing drugs from trusted sellers and modifying drug use practices by partially injecting and/or changing the route of transmission. Approximately half of persons who inject drugs sampled had heard of fentanyl test strips, however fentanyl test strip use was low. To reverse overdoses, participants reported using cold water baths. Use of naloxone to reverse overdose was low. Barriers to naloxone access and use included fear of arrest and opioid withdrawal.
People who inject drugs understood fentanyl to be a potential contaminant in their drug supply and actively engaged in harm reduction techniques to try to prevent overdose. Interventions to increase harm reduction education and information about and access to fentanyl test strips and naloxone would be beneficial.
药物过量是注射吸毒者发病和死亡的主要原因。非法制造的芬太尼现在是阿片类药物过量死亡的主要驱动因素。
对来自伊利诺伊州南部农村的 23 名参与者（19 名吸毒者和 4 名服务提供者）进行了半结构化访谈。使用恒定性比较和理论抽样方法对数据进行分析。
参与者对阿片类药物和兴奋剂中芬太尼的大量出现感到担忧，许多人披露了过量用药的经历。参与者报告的降低药物过量风险的策略包括从可信赖的卖家购买药物以及通过部分注射和/或改变传输途径来改变药物使用方式。大约一半的抽样吸毒者听说过芬太尼检测条，但芬太尼检测条的使用率很低。为了逆转药物过量，参与者报告使用冷水浴。使用纳洛酮逆转药物过量的情况很少。纳洛酮获取和使用的障碍包括对逮捕和阿片类药物戒断的恐惧。
吸毒者认为芬太尼可能是其药物供应中的一种污染物，并积极采取减少伤害的技术，试图预防药物过量。增加减少伤害教育，以及关于芬太尼检测条和纳洛酮的信息和获取的干预措施将是有益的。
