Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut Street, Curtis Building, Suite 704, Philadelphia, PA, 19107, USA.
Center for Connected Care, Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut Street, Philadelphia, PA, 19107, USA.
Harm Reduct J. 2024 Jan 30;21(1):26. doi: 10.1186/s12954-024-00937-8.
Adulterants, such as fentanyl and xylazine, among others, are present in a high percentage of the illicit drug supply, increasing the risk for overdose and other adverse health events among people who use drugs (PWUD). Point-of-care drug checking identifies components of a drug sample and delivers results consumers. To successfully meet the diverse needs of PWUD, more information is needed about the utility of drug checking, motivations for using services contextualized in broader comments on the drug supply, hypothesized actions to be taken after receiving drug checking results, and the ideal structure of a program.
In December 2021, semi-structured interviews were conducted with 40 PWUD who were accessing harm reduction services in Philadelphia, PA. Participants were asked about opinions and preferences for a future drug checking program. Interviews were audio recorded, transcribed and coded using content analysis to identify themes.
Participants were primarily White (52.5%) and male (60%). Heroin/fentanyl was the most frequently reported drug used (72.5%, n = 29), followed by crack cocaine (60.0%, n = 24) and powder cocaine (47.5%, n = 19). Emerging themes from potential drug checking consumers included universal interest in using a drug checking program, intentions to change drug use actions based on drug checking results, deep concern about the unpredictability of the drug supply, engaging in multiple harm reduction practices, and concerns about privacy while accessing a service.
We offer recommendations for sites considering point-of-care drug checking regarding staffing, safety, logistics, and cultural competency. Programs should leverage pre-existing relationships with organizations serving PWUD and hire people with lived experiences of drug use. They should work with local or state government to issue protections to people accessing drug checking programs and ensure the service is anonymous and that data collection is minimized to keep the program low-threshold. Programs will ideally operate in multiple locations and span "atmosphere" (e.g., from clinical to a drop-in culture), offer in-depth education to participants about results, engage with a community advisory board, and not partner with law enforcement.
芬太尼和唑烷等掺杂物在非法毒品供应中占很大比例，增加了吸毒者（PWUD）用药过量和其他不良健康事件的风险。即时药物检测识别药物样本的成分并向消费者提供结果。为了成功满足 PWUD 的多样化需求，需要更多关于药物检测效用的信息，需要更多关于在更广泛的药物供应背景下使用服务的动机的信息，需要更多关于在收到药物检测结果后假设采取的行动的信息，以及关于理想的项目结构的信息。
2021 年 12 月，对宾夕法尼亚州费城接受减少伤害服务的 40 名 PWUD 进行了半结构式访谈。参与者被问及对未来药物检测计划的意见和偏好。使用内容分析对访谈进行录音、转录和编码，以确定主题。
参与者主要是白人（52.5%）和男性（60%）。报告使用最多的药物是海洛因/芬太尼（72.5%，n=29），其次是可卡因（60.0%，n=24）和可卡因粉（47.5%，n=19）。潜在药物检测消费者提出的新主题包括普遍有兴趣使用药物检测计划、根据药物检测结果改变药物使用行为的意图、对药物供应不可预测性的深切关注、从事多种减少伤害的做法、以及在获取服务时对隐私的担忧。
我们为考虑即时药物检测的地点提供了关于人员配备、安全、后勤和文化能力的建议。计划应利用为 PWUD 服务的组织现有的关系，并聘请有吸毒经历的人员。他们应与当地或州政府合作，为使用药物检测计划的人提供保护，并确保该服务是匿名的，并且数据收集最小化，以保持计划的低门槛。这些项目最好在多个地点运作，并跨越“氛围”（例如，从临床到即插即用文化），为参与者提供有关结果的深入教育，与社区咨询委员会合作，并且不与执法部门合作。
