Gould Erin E, Ganesh Siddhi S, DiMario Anthony J, Huh Jimi, Bluthenthal Ricky N, Ceasar Rachel Carmen
Keck Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America.
USC Dornsife College of Letters, Arts and Sciences, Department of Sociology, University of Southern California, Los Angeles, California, United States of America.
PLoS One. 2025 Apr 2;20(4):e0320423. doi: 10.1371/journal.pone.0320423. eCollection 2025.
Fentanyl is the leading cause of opioid-related overdose deaths in the United States. Given the exogenous market shock of fentanyl and subsequent transition in the illicit opioid supply, our analysis sought to explore the social and relational experiences of people who use opioids (PWUO).
We conducted qualitative interviews with 30 PWUO (n = 30) in Los Angeles, CA from July 2021 to April 2022. To be eligible for this study, participants had to report being 18 years of age or older and any self-reported opioid, cannabis, and injection drug use within the past 30 days. We used constructivist grounded theory to analyze the contexts that contribute to lived experiences surrounding opioid use behaviors within social networks.
Within an unpredictable drug market contaminated by fentanyl, participants reported: 1) avoiding opioid withdrawal symptoms by sharing financial and material resources within social networks, 2) securing and cultivating known, predictable social ties to prioritize safe/ safer supply of opioids, and 3) avoiding and mitigating risk of overdose fatality by using opioids within peer groups.
Our findings emphasize that while peer support plays a critical role in safety within moral economies of PWUO, structural changes are needed to address the additional harms from an unregulated drug supply. Harm reduction interventions such as fentanyl test strip and naloxone distribution, as well as medication for opioid use disorders may improve safety. However, with a fentanyl-contaminated drug supply increasing risk for PWUO, safer opioid distribution of pharmaceutical-grade opioids and overdose prevention programs are needed to effectively address the burden of withdrawal, overdose, and fatality prevention within peer groups.
芬太尼是美国阿片类药物相关过量死亡的主要原因。鉴于芬太尼带来的外部市场冲击以及随后非法阿片类药物供应的转变，我们的分析旨在探究使用阿片类药物者（PWUO）的社会和人际关系体验。
2021年7月至2022年4月，我们在加利福尼亚州洛杉矶对30名使用阿片类药物者（n = 30）进行了定性访谈。要符合本研究的条件，参与者必须报告年龄在18岁及以上，且在过去30天内有任何自我报告的阿片类药物、大麻和注射毒品使用情况。我们使用建构主义扎根理论来分析有助于在社交网络中围绕阿片类药物使用行为的生活经历的背景。
在受芬太尼污染的不可预测的毒品市场中，参与者报告称：1）通过在社交网络中分享财务和物质资源来避免阿片类药物戒断症状；2）建立和培养已知的、可预测的社会关系，以优先确保阿片类药物的安全/更安全供应；3）通过在同伴群体中使用阿片类药物来避免和减轻过量死亡风险。
我们的研究结果强调，虽然同伴支持在使用阿片类药物者的道德经济中的安全方面起着关键作用，但需要进行结构变革以应对不受监管的毒品供应带来的额外危害。减少伤害的干预措施，如芬太尼检测试纸和纳洛酮分发，以及阿片类药物使用障碍的药物治疗，可能会提高安全性。然而，由于受芬太尼污染的毒品供应增加了使用阿片类药物者的风险，需要更安全地分发药用级阿片类药物和过量预防计划，以有效应对同伴群体中的戒断、过量和预防死亡负担。
