School of Public Health, University of Nevada, Reno, Reno, NV, USA.
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Harm Reduct J. 2024 Aug 16;21(1):150. doi: 10.1186/s12954-024-01070-2.
Fueled by the prescription opioid overdose crisis and increased influx of illicitly manufactured fentanyl, fentanyl overdoses continue to be a public health crisis that has cost the US economy over $1 trillion in reduced productivity, health care, family assistance, criminal justice, and accounted for over 74,000 deaths in 2023. A recent demographic shift in the opioid crisis has led to a rise in overdose deaths among the Latinx population. Harm reduction interventions, including the use of naloxone and fentanyl test strips, have been shown to be effective measures at reducing the number of opioid overdose deaths. The aim of this scoping review is to summarize naloxone and fentanyl test strip interventions and public health policies targeted to Latinx communities.
PubMed, CINHAL, Web of Science, Embase, and PsycINFO research databases using the keywords "fentanyl," "Latinx," "Harm Reduction," "Naloxone," and "Fentanyl Test Strips'' to identify studies published between January 1, 2013 and December 31, 2023. Endnote and Covidence software were used to catalog and manage citations for review of studies. Subsequently, studies that met inclusion criteria were then summarized using resulting themes.
Twenty-seven articles met the inclusion criteria and were further abstracted for the scoping review. Of these articles, 77.7% (n = 21) included a naloxone intervention, while only 11.1% (n = 3) included a fentanyl test strip intervention. Furthermore, 30.1% (n = 8) of these studies were Latinx targeted, and 7.7% (n = 2) of the studies were adapted for Latinx populations. Four themes, including an overall lack of knowledge and awareness, a lack of access to harm reduction or opioid overdose prevention resources, an overall lack of culturally adapted and/or targeted interventions, and restrictive and punitive policies that limit the effectiveness of protective factors were highlighted in this scoping review.
Limited published research exists on the use of emerging harm reduction behaviors, such as the use of naloxone and fentanyl test strips as community intervention strategies to prevent opioid overdose deaths. Even fewer publications exist on the targeting and cultural adaptation of harm reduction interventions responsive to Latinx communities, especially those using theoretical approaches or frameworks to support these interventions. Future research is needed to assess the unique needs of Latinx populations and to develop culturally responsive programs to prevent opioid-related overdose deaths among this population.
受处方类阿片类药物过量危机和非法制造芬太尼流入量增加的推动，芬太尼过量问题持续成为公共卫生危机，导致美国经济损失超过 1 万亿美元的生产力、医疗保健、家庭援助、刑事司法，2023 年芬太尼过量死亡人数超过 74000 人。阿片类药物危机中的最近人口结构变化导致拉丁裔人群中的过量死亡人数上升。减少伤害干预措施，包括使用纳洛酮和芬太尼检测条，已被证明是减少阿片类药物过量死亡人数的有效措施。本范围综述的目的是总结针对拉丁裔社区的纳洛酮和芬太尼检测条干预措施和公共卫生政策。
使用“芬太尼”、“拉丁裔”、“减少伤害”、“纳洛酮”和“芬太尼检测条”等关键词，在 PubMed、CINHAL、Web of Science、Embase 和 PsycINFO 研究数据库中搜索 2013 年 1 月 1 日至 2023 年 12 月 31 日期间发表的研究。使用 Endnote 和 Covidence 软件对引文进行编目和管理，以进行研究综述。随后，使用出现的主题对符合纳入标准的研究进行总结。
27 篇文章符合纳入标准，并进一步进行了范围综述摘要。这些文章中，77.7%（n=21）包含纳洛酮干预，而只有 11.1%（n=3）包含芬太尼检测条干预。此外，30.1%（n=8）的研究针对拉丁裔人群，7.7%（n=2）的研究针对拉丁裔人群进行了调整。本范围综述强调了四个主题，包括总体缺乏知识和意识、缺乏获得减少伤害或阿片类药物过量预防资源的机会、总体缺乏文化适应和/或针对性干预措施以及限制保护性因素有效性的限制性和惩罚性政策。
关于新兴减少伤害行为的使用，例如将纳洛酮和芬太尼检测条用作社区干预策略以预防阿片类药物过量死亡的研究很少。针对拉丁裔社区的减少伤害干预措施的针对性和文化适应性的出版物甚至更少，尤其是使用理论方法或框架来支持这些干预措施的出版物。需要开展未来研究，评估拉丁裔人群的独特需求，并制定针对该人群的文化响应性计划，以预防该人群的阿片类药物相关过量死亡。
