使用芬太尼检测条和不使用芬太尼检测条的人群中，药物使用行为的差异会影响到药物过量的风险。
Differences in drug use behaviors that impact overdose risk among individuals who do and do not use fentanyl test strips for drug checking.
机构信息
Department of Family Medicine, Boston Medical Center, Boston University, 771 Albany St.Dowling 5 South, Rm 5507A, Boston, MA, 02118, USA.
Department of Biostatistics & Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
出版信息
Harm Reduct J. 2023 Mar 28;20(1):41. doi: 10.1186/s12954-023-00767-0.
BACKGROUND
Opioid-involved overdose continues to rise, largely explained by fentanyl adulteration of the illicit opioid supply. Fentanyl test strips are a novel drug checking tool that can be used by people who use drugs to detect the presence of fentanyl in drug products. However, it is unclear whether fentanyl test strip use can prompt behavior changes that impact risk of overdose.
METHODS
In this mixed-methods study involving a structured survey (n = 341) of syringe service program clients in southern Wisconsin, we examined the association between fentanyl test strip use and overdose risk behaviors in scenarios where the presence of fentanyl is confirmed and unknown. Individual items were transformed into summary scales representing the performance of riskier and safer behaviors. Linear regression examined the association of behaviors with FTS use. Models are adjusted for study site, race/ethnicity, age, gender, drug of choice, indicator of polysubstance use, times used per day, and lifetime overdose count.
RESULTS
In response to survey questions before prompting about fentanyl risk, people who used fentanyl test strips reported an increased number of safer (p = 0.001) as well as riskier behaviors (p = 0.018) relative to people who did not use fentanyl test strips. The same held true in situations when fentanyl adulteration was suspected, though fentanyl test strip use lost significance in the fully adjusted model examining safer behaviors (safer: p = 0.143; riskier: p = 0.004). Among people who use fentanyl test strips, in unadjusted models, a positive test result was associated with more safer behaviors and fewer riskier behaviors, but these associations became nonsignificant in fully adjusted models (safer: p = 0.998; riskier: p = 0.171). Loss of significance was largely due to the addition of either polysubstance use or age to the model.
CONCLUSIONS
Fentanyl test strip use is associated with behaviors that may impact overdose risk, including safer and riskier behaviors. Specifically, a positive test result may promote more risk reducing behaviors and fewer risk enhancing behaviors than a negative test result. Results suggest that while FTS may promote safer drug use behaviors, outreach and education should emphasize the need for multiple harm reduction techniques in all scenarios.
背景
阿片类药物相关药物过量的情况仍在不断上升，这主要是由于非法阿片供应中掺入了芬太尼。芬太尼检测条是一种新的毒品检测工具，可被吸毒者用于检测毒品产品中是否含有芬太尼。然而，目前尚不清楚芬太尼检测条的使用是否能促使行为发生变化，从而影响药物过量的风险。
方法
本研究采用混合方法，对威斯康星州南部的 341 名注射服务项目客户进行了结构调查，在已知和未知芬太尼存在的情况下，我们检测了芬太尼检测条使用与药物过量风险行为之间的关联。我们将个别项目转化为代表风险行为和安全行为的综合指标。线性回归分析了行为与 FTS 使用之间的关联。模型调整了研究地点、种族/民族、年龄、性别、首选药物、多药物使用指标、每日使用次数和终身药物过量次数。
结果
在回答关于芬太尼风险的调查问题之前，与未使用芬太尼检测条的人相比，使用芬太尼检测条的人报告了更多的安全（p=0.001）和风险行为（p=0.018）。在怀疑芬太尼被掺假的情况下，情况也是如此，尽管在全面调整后的模型中，芬太尼检测条的使用在检查安全行为时失去了意义（安全：p=0.143；风险：p=0.004）。在使用芬太尼检测条的人群中，在未调整的模型中，阳性检测结果与更多的安全行为和更少的风险行为相关，但这些关联在完全调整的模型中变得不显著（安全：p=0.998；风险：p=0.171）。显著性的丧失主要是由于在模型中加入了多药物使用或年龄因素。
结论
芬太尼检测条的使用与可能影响药物过量风险的行为有关，包括安全行为和风险行为。具体来说，阳性检测结果可能比阴性检测结果更能促进减少风险的行为，减少增强风险的行为。结果表明，虽然 FTS 可能促进更安全的药物使用行为，但宣传和教育应强调在所有情况下都需要多种减少伤害的技术。
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