Jawa Raagini, Murray Stephen, Blakemore Samantha, Ventura Alicia S, Hristova Tavita, Wilder Alexa, Shang Margaret, LaBelle Colleen
Center for Research on Healthcare, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Grayken Center for Addiction Training and Technical Assistance, Boston Medical Center, Boston, MA, USA.
Subst Use Addctn J. 2024 Apr;45(2):168-175. doi: 10.1177/29767342241231114. Epub 2024 Feb 20.
Novel adulterants and synthetic substances are rapidly infiltrating the US drug supply causing new clinical harms. There is an urgent need for responsive education and training to address these evolving harms and mitigate new risks. Since 2020, xylazine, a veterinary tranquilizer, has become increasingly common in the illicit opioid supply, especially alongside fentanyl. Training and technical assistance (TTA) programs employing an adaptive model can quickly disseminate emerging information and provide the tools to respond effectively. We describe our TTA program's experience developing and delivering virtual instructor-led xylazine training to a diverse group of addiction care professionals. The training objectives included the following: (1) introducing epidemiologic trends, pharmacology, and existing literature related to xylazine; (2) reviewing xylazine-associated harms and management; and (3) discussing harm reduction strategies related to xylazine use. We conducted 14 training sessions between October 2022 and July 2023, which were attended by over 2000 individuals across 49 states. We review our experience developing innovative training content and managing flexible training logistics and highlight our lessons learned, including targeting multidisciplinary professionals, leveraging online synchronous delivery methods, and a need for sustainable funding for TTA programs.
新型掺假物和合成物质正在迅速渗透到美国的毒品供应中，造成新的临床危害。迫切需要开展针对性的教育和培训，以应对这些不断演变的危害并降低新风险。自2020年以来，兽用镇静剂赛拉嗪在非法阿片类药物供应中越来越常见，尤其是与芬太尼一起出现。采用适应性模式的培训和技术援助（TTA）项目能够迅速传播新出现的信息，并提供有效应对的工具。我们描述了我们的TTA项目为不同的成瘾护理专业人员开发和提供虚拟教师指导的赛拉嗪培训的经验。培训目标包括：（1）介绍与赛拉嗪相关的流行病学趋势、药理学和现有文献；（2）回顾赛拉嗪相关的危害及管理方法；（3）讨论与赛拉嗪使用相关的减少危害策略。我们在2022年10月至2023年7月期间举办了14次培训课程，来自49个州的2000多人参加了培训。我们回顾了我们在开发创新培训内容和管理灵活培训后勤方面的经验，并强调了我们的经验教训，包括针对多学科专业人员、利用在线同步授课方式，以及TTA项目需要可持续的资金支持。
