Hochstatter Karli, Nadel Talia, Sisco Edward, Bourgois Philippe, Laurel Sarah, Appley Meghan G, Pyfrom Elise M, Montero Fernando
Friends Research Institute, Inc., Baltimore, MD, USA; Social Intervention Group, Columbia University School of Social Work, New York, NY, USA.
Friends Research Institute, Inc., Baltimore, MD, USA.
Drug Alcohol Depend. 2025 Sep 1;274:112763. doi: 10.1016/j.drugalcdep.2025.112763. Epub 2025 Jun 22.
The objective of this observational epidemiological study is to examine recent shifts in the street opioid supply of the largest U.S. open-air drug market, including changes in prevalence and concentration of key compounds.
From March 2024-March 2025, samples of street drugs sold as opioids were collected at a harm reduction program in Philadelphia's Kensington neighborhood and shipped to the National Institute of Standards and Technology, where they underwent qualitative testing using direct analysis in real-time mass spectrometry and quantitative testing using liquid chromatography tandem mass spectrometry. Bootstrapped quantile regression models assessed changes in concentration over time.
Among 260 samples, fentanyl (98 %) and xylazine (65 %) were the most prevalent psychoactive compounds. While fentanyl was consistently present, the median fentanyl concentration decreased significantly, from 9.6 % by mass in May 2024-5.3 % by mass in March 2025 (P = 0.020). Xylazine prevalence declined from 100 % in March 2024-58 % in March 2025. Conversely, lidocaine and tetracaine prevalence increased from 3 % each in March 2024-63 % each in March 2025. Two novel compounds, medetomidine and bis(2,2,6,6-tetramethyl-4-piperidyl) sebacate (BTMPS), were first detected in April and June 2024, reaching prevalence rates of 83 % and 25 % by March 2025, respectively.
The street opioid supply in Kensington is erratic and volatile, with decreasing fentanyl concentrations alongside increasing adulteration with medetomidine and local anesthetics. These shifts underscore urgency for timely systematic drug checking and robust inquiry into the organization of street opioid retail markets to inform harm reduction strategies and prevent drug-related harms.
本观察性流行病学研究的目的是调查美国最大的露天毒品市场街头阿片类药物供应的近期变化，包括关键化合物的流行率和浓度变化。
2024年3月至2025年3月，在费城肯辛顿社区的一个减少伤害项目中收集作为阿片类药物出售的街头毒品样本，并运送到美国国家标准与技术研究院，在那里使用实时质谱直接分析进行定性测试，使用液相色谱串联质谱进行定量测试。自抽样回归模型评估了浓度随时间的变化。
在260个样本中，芬太尼（98%）和赛拉嗪（65%）是最普遍的精神活性化合物。虽然芬太尼一直存在，但其质量中位数浓度显著下降，从2024年5月的9.6%降至2025年3月的5.3%（P = 0.020）。赛拉嗪的流行率从2024年3月的100%降至2025年3月的58%。相反，利多卡因和丁卡因的流行率从2024年3月的各3%增至2025年3月的各63%。两种新型化合物，美托咪定和癸二酸双（2,2,6,6-四甲基-4-哌啶基）酯（BTMPS），分别于2024年4月和6月首次检测到，到2025年3月流行率分别达到83%和25%。
肯辛顿的街头阿片类药物供应不稳定且变化无常，芬太尼浓度下降，同时美托咪定和局部麻醉剂的掺假增加。这些变化凸显了及时进行系统药物检测以及对街头阿片类药物零售市场组织进行深入调查的紧迫性，以便为减少伤害策略提供信息并预防与药物相关的危害。
