Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study.
Background: Illicit fentanyl use has become wide spread in the US, causing high rates of overdose deaths among people who use drugs. This study describes patterns and perceptions of fentanyl exposure among opioid users in Rhode Island.Methods: A mixed methods study was conducted via questionnaire wi...
| Publicado en: | International Journal of Drug Policy Vol. 46; pp. 136 - 146 |
|---|---|
| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Aug2017
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124440205&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 124440205 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09553959 GPD jtl: International Journal of Drug Policy issn: 09553959 maglogo: N pubinfo: dt: Aug2017 vid: 46 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 124440205 124440205 NLM28578864 124440205 10.1016/j.drugpo.2017.05.023 NLM28578864 124440205 ppf: 136 ppct: 10 formats: tig: atl: Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study. aug: au: Carroll, Jennifer J. Marshall, Brandon D.L. Rich, Josiah D. Green, Traci C. affil: The Warren Alpert School of Medicine of Brown University, 222 Richmond St., Providence, RI 02903, USA sug: subj: Heroin Poisoning Fentanyl Poisoning Substance Use Disorders Complications Overdose Epidemiology Adolescence Young Adult Street Drugs Adult Interviews Relative Risk Rhode Island Middle Age Prevalence Male Female Harm Reduction Drug Contamination Analgesics, Opioid Poisoning Funding Source Human Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background: Illicit fentanyl use has become wide spread in the US, causing high rates of overdose deaths among people who use drugs. This study describes patterns and perceptions of fentanyl exposure among opioid users in Rhode Island.Methods: A mixed methods study was conducted via questionnaire with a convenience sample of 149 individuals using illicit opioids or misusing prescription opioids in Rhode Island between January and November 2016. Of these, 121 knew of fentanyl and reported known or suspected exposure to fentanyl in the past year. Semi-structured interviews were conducted with the first 47 participants.Results: Study participants were predominantly male (64%) and white (61%). Demographic variables were similar across sample strata. Heroin was the most frequently reported drug of choice (72%). Self-reported exposure to illicit fentanyl in the past year was common (50.4%, n=61). In multivariate models, regular (at least weekly) heroin use was independently associated with known or suspected fentanyl exposure in the past year (adjusted prevalence ratio (APR)=4.07, 95% CI: 1.24-13.3, p=0.020). In interviews, users described fentanyl as unpleasant, potentially deadly, and to be avoided. Participants reporting fentanyl exposure routinely experienced or encountered non-fatal overdose. Heroin users reported limited ability to identify fentanyl in their drugs. Harm reduction strategies used to protect themselves from fentanyl exposure and overdose, included test hits, seeking prescription opioids in lieu of heroin, and seeking treatment with combination buprenorphine/naloxone. Participants were often unsuccessful in accessing structured treatment programs.Conclusion: Among illicit opioid users in Rhode Island, known or suspected fentanyl exposure is common, yet demand for fentanyl is low. Fentanyl-contaminated drugs are generating user interest in effective risk mitigation strategies, including treatment. Responses to the fentanyl epidemic should be informed by the perceptions and experiences of local users. The rapid scale-up of buprenorphine/naloxone provision may slow the rate of fentanyl-involved overdose deaths. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|