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Erinoso O, Daugherty R, Kirk MR, Harding RW, Etchart H, Reyes A, Page K, Fiuty P, Wagner KD. Safety strategies and harm reduction for methamphetamine users in the era of fentanyl contamination: A qualitative analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 128:104456. [PMID: 38761461 DOI: 10.1016/j.drugpo.2024.104456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION In the United States, methamphetamine use is increasing and the context of its use has changed, with reports of illicitly manufactured fentanyl being mixed with methamphetamine (either deliberately or inadvertently). We explore risk-mitigating actions taken by people who use drugs to protect their health when using methamphetamine in that context. METHODS We conducted qualitative interviews with 48 adults (18+) who used methamphetamine in the past three months at two sites in Nevada, USA and two sites in New Mexico, USA. Interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS Respondents described two rationales for employing harm reduction strategies. First, to prevent harm from methamphetamine containing illicit fentanyl, and second, to maintain their general wellbeing while using methamphetamine. Regarding methamphetamine containing illicit fentanyl, our findings highlight how respondents employ primary strategies like buying from trusted sources and secondary strategies such as spotting and selective use of harm reduction tools (i.e., fentanyl test strips) to reduce risks. To maintain their general wellbeing, participants reduced their use of methamphetamine as reasonably as possible, and used other substances like marijuana and alcohol alongside methamphetamine to counter the unwanted side effects of methamphetamine (i.e., hallucinations and paranoia). Use of these harm reduction strategies varied within situational and social contexts, and respondents usually developed these strategies based on their lived experiences. CONCLUSION Our findings uniquely demonstrate that people who use methamphetamine prioritize community driven, trust-based strategies within their social networks to mitigate risks in a fentanyl-contaminated drug environment. Additionally, our results indicate that harm reduction behaviors are influenced by multilevel risk environments, which include social, physical, economic, and political factors. Overall, these results highlight the potential for targeted interventions at the network level, which are responsive to complexities and shifts in drug market dynamics- such as illicit fentanyl in methamphetamine.
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Affiliation(s)
- Olufemi Erinoso
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Robbie Daugherty
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Mia R Kirk
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Robert W Harding
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Haley Etchart
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Andres Reyes
- Department of Internal Medicine, University of New Mexico Health Sciences, Albuquerque, NM, United States
| | - Kimberly Page
- Department of Internal Medicine, University of New Mexico Health Sciences, Albuquerque, NM, United States
| | - Phillip Fiuty
- New Mexico Health, Albuquerque, New Mexico, United States
| | - Karla D Wagner
- Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, United States.
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Sason A, Adelson M, Schreiber S, Peles E. Fentanyl abuse proportion in methadone maintenance treatment, and patients' knowledge about its risks. J Psychiatr Res 2024; 173:254-259. [PMID: 38554621 DOI: 10.1016/j.jpsychires.2024.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/12/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Fentanyl is not yet routinely monitored among methadone maintenance treatment (MMT) patients in Israel. We aimed 1. to evaluate urine fentanyl proportion changes over 3 years and characterize patients' characteristics 2. To study patients' self-report on fentanyl usage, and compare knowledge about fentanyl risk, before and following brief educational intervention. METHODS Fentanyl in the urine of all current MMT patients was tested every 3 months year between 2021 and 2023, and patients with positive urine fentanyl were characterized. Current patients were interviewed using a fentanyl knowledge questionnaire (effects, indications, and risks) before and following an explanation session. RESULTS Proportion of fentanyl ranged between 9.8 and 15.1%, and patients with urine positive for fentanyl (September 2023) were characterized as having positive urine for pregabalin, cocaine, and benzodiazepine (logistic regression). Of the current 260 patients (87% compliance), 78(30%) self-reported of fentanyl lifetime use ("Ever"), and 182 "never" use. The "Ever" group had higher Knowledge scores than the "Never", both groups improved following the explanatory session (repeated measure). The "Ever" group patients were found with urine positive for cannabis and benzodiazepine on admission to MMT, they were younger, did not manage to gain take-home dose privileges and had a higher fentanyl knowledge score (logistic regression). CONCLUSIONS In the absence of routine fentanyl tests, a high knowledge score, shorter duration in MMT, benzodiazepine usage on admission, and current cannabis usage, may hint of the possibility of fentanyl abuse.
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Affiliation(s)
- Anat Sason
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Miriam Adelson
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shaul Schreiber
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel; Tel Aviv University Faculty of Medical and Health Sciences, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Einat Peles
- Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel; Tel Aviv University Faculty of Medical and Health Sciences, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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Tan M, Park C, Goldman J, Biello KB, Buxton J, Hadland SE, Park JN, Sherman SG, Macmadu A, Marshall BDL. Association between willingness to use an overdose prevention center and probation or parole status among people who use drugs in Rhode Island. Harm Reduct J 2024; 21:54. [PMID: 38424553 PMCID: PMC10905878 DOI: 10.1186/s12954-024-00969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Overdose prevention centers (OPCs) are being implemented in the United States as a strategy to reduce drug-related mortality and morbidity. Previous studies have suggested that people who use drugs (PWUD) with a history of criminal legal system (CLS) involvement (e.g. current probation/parole) are at greater risk of overdose but may also encounter significant barriers to OPC use. The objective of this study was to explore the association between willingness to use an OPC and probation/parole status in a sample of PWUD in Rhode Island. METHODS This study utilized data from the Rhode Island Prescription and Illicit Drug Study, which enrolled adult PWUD from August 2020 to February 2023. We used Pearson's chi-square and Wilcoxon rank-sum tests to assess bivariate associations between willingness to use an OPC and probation/parole status (current/previous/never), as well as other sociodemographic and behavioral characteristics. In multivariable Poisson analyses, we examined the association between willingness to use an OPC and probation/parole status, adjusting for key sociodemographic and behavioral characteristics. RESULTS Among 482 study participants, 67% were male, 56% identified as white, 20% identified as Hispanic/Latine, and the median age was 43 (IQR 35-53). Nearly a quarter (24%) had never been on probation/parole, 44% were not currently on probation/parole but had a lifetime history of probation and parole, and 32% were currently on probation/parole. Most participants (71%) reported willingness to use an OPC, and in both bivariate and multivariable analyses, willingness to use an OPC did not vary by probation/parole status. Crack cocaine use and lifetime non-fatal overdose were associated with greater willingness to use an OPC (all p < 0.05). CONCLUSIONS These data demonstrate high willingness to use OPC among PWUD in Rhode Island regardless of CLS-involvement. As OPCs begin to be implemented in Rhode Island, it will be imperative to engage people with CLS-involvement and to ensure access to the OPC and protection against re-incarceration due to potential barriers, such as police surveillance of OPCs.
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Affiliation(s)
- Michael Tan
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Carolyn Park
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Jacqueline Goldman
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Katie B Biello
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Jane Buxton
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Scott E Hadland
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ju Nyeong Park
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Susan G Sherman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alexandria Macmadu
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
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Swartz JA, Lieberman M, Jimenez AD, Mackesy-Amiti ME, Whitehead HD, Hayes KL, Taylor L, Prete E. Current attitudes toward drug checking services and a comparison of expected with actual drugs present in street drug samples collected from opioid users. Harm Reduct J 2023; 20:87. [PMID: 37420196 DOI: 10.1186/s12954-023-00821-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 07/03/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND The opioid epidemic continues to be associated with high numbers of fatalities in the USA and other countries, driven mainly by the inclusion of potent synthetic opioids in street drugs. Drug checking by means of various technologies is being increasingly implemented as a harm reduction strategy to inform users about constituent drugs in their street samples. We assessed how valued drug checking services (DCS) would be for opioid street drug users given the ubiquity of fentanyl and related analogs in the drug supply, the information they would most value from drug checking, and compared expected versus actual constituent drugs in collected samples. METHODS A convenience sample of opioid street drug users (N = 118) was recruited from two syringe service exchange programs in Chicago between 2021 and 2022. We administered brief surveys asking about overdose history, whether fentanyl was their preferred opioid, and interest in DCS. We also collected drug samples and asked participants what drug(s) they expected were in the sample. Provided samples were analyzed using LC-MS technology and the results compared to their expected drugs. RESULTS Participants reported an average of 4.4 lifetime overdoses (SD = 4.8, range = 0-20) and 1.1 (SD = 1.8, range = 0-10) past-year overdoses. A majority (92.1%) believed they had recently used drugs containing fentanyl whether intentionally or unintentionally. Opinions about the desirability of fentanyl were mixed with 56.1% indicating they did not and 38.0% indicating they did prefer fentanyl over other opioids, mainly heroin. Attitudes toward DCS indicated a general but not uniform receptiveness with a majority indicating interest in DCS though sizeable minorities believed DCS was "too much trouble" (25.2%) or there was "no point" in testing (35.4%). Participants were especially inaccurate identifying common cutting agents and potentiating drugs such as diphenhydramine in their samples (sensitivity = .17). CONCLUSIONS Results affirmed street drug users remain interested in using DCS to monitor their drugs and such services should be more widely available. Advanced checking technologies that provide information on the relative quantities and the different drugs present in a given sample available at point-of-care, would be most valuable but remain challenging to implement.
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Affiliation(s)
- James A Swartz
- Jane Addams College of Social Work, University of Illinois Chicago, 1040 W. Harrison Street, (MC 309), Chicago, IL, 60607, USA.
| | - Marya Lieberman
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, USA
| | - A David Jimenez
- Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, USA
| | - Mary Ellen Mackesy-Amiti
- Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, USA
| | - Heather D Whitehead
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, USA
| | - Kathleen L Hayes
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, USA
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Feder KA, Sun J, Rudolph JE, Cepeda J, Astemborski J, Baker PA, Piggott DA, Kirk GD, Mehta SH, Genberg BL. Mortality by cause of death during year 1 of the COVID-19 pandemic in a cohort of older adults from Baltimore Maryland who have injected drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 109:103842. [PMID: 36067723 PMCID: PMC9395292 DOI: 10.1016/j.drugpo.2022.103842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND In 2020, the first year of the COVID-19 pandemic, overdose deaths increased. However, no studies have characterized changes in mortality during the pandemic in a well-characterized cohort of people who use drugs in active follow-up at the time of pandemic onset. DESIGN We compared all-cause and cause-specific mortality in the first year of the pandemic (Mar-Dec 2020) to the five years preceding (Jan 2015-Feb 2020), among participants in the AIDS Linked to the IntraVenous Experience (ALIVE) study: a community-recruited cohort of adults from Baltimore who have injected drugs. 3510 participants contributed 17,498 person-years [py] of follow-up time. Cause and dates of death were ascertained through the National Death Index. Comparisons were made for the full cohort and within subgroups with potentially differential levels of vulnerability. RESULTS All-cause mortality in 2020 was 39.6 per 1000 py, as compared to 37.2 per 1000 py pre- pandemic (Adjusted Incidence Rate Ratio = 1.09, 95%: confidence interval: 0.84-1.41). Increases were mostly attributable to chronic disease deaths; injury/poisoning deaths did not increase. No pre-post differences were statistically significant. CONCLUSION In this exploratory analysis of an older cohort of urban-dwelling adults who have injected drugs, mortality changes during the first year of the pandemic differed from national trends and varied across potentially vulnerable subgroups. More research is needed to understand determinants of increased risk of mortality during the pandemic among subgroups of people who use drugs.
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Affiliation(s)
- Kenneth A Feder
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, United States.
| | - Jing Sun
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Jacqueline E Rudolph
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Javier Cepeda
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Jacquie Astemborski
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Pieter A Baker
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Damani A Piggott
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States; Department of Medicine, Johns Hopkins University School of Medicine, United States
| | - Gregory D Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States; Department of Medicine, Johns Hopkins University School of Medicine, United States
| | - Shruti H Mehta
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Becky L Genberg
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, United States
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LaForge K, Stack E, Shin S, Pope J, Larsen JE, Leichtling G, Leahy JM, Seaman A, Hoover D, Byers M, Barrie C, Chisholm L, Korthuis PT. Knowledge, attitudes, and behaviors related to the fentanyl-adulterated drug supply among people who use drugs in Oregon. J Subst Abuse Treat 2022; 141:108849. [PMID: 35932759 PMCID: PMC10635798 DOI: 10.1016/j.jsat.2022.108849] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/26/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Nonpharmaceutical fentanyl has reconfigured the U.S. illicit drug market, contributing to a drastic increase in overdose drug deaths. While illicit fentanyl has subsumed the drug supply in the Northeast and Midwest, it has more recently reached the West. For this study, we explored knowledge, attitudes, and behaviors among people who use drugs in Oregon in the context of the emergence of fentanyl in the drug supply. METHODS We conducted in-depth interviews by phone with 34 people who use drugs in Oregon from May to June 2021. We used thematic analysis to analyze transcripts and construct themes. RESULTS People who use drugs knew about fentanyl, expressed doubt that fentanyl could be found in methamphetamine; believed those who were younger or less experienced were at higher risk for harm; and received information about fentanyl from drug dealers, syringe service programs, or peers (other people who use drugs). Preference for fentanyl's presence in drugs like heroin or methamphetamine was mixed. Some felt that their preference was irrelevant since fentanyl was unavoidable. Participants reported engaging in harm reduction practices, including communicating about fentanyl with dealers and peers, testing for fentanyl, using smaller quantities of drugs, switching from injecting to smoking, and using naloxone. CONCLUSION People who use drugs are responding to the rise of fentanyl on the West Coast and are concerned about the increasing uncertainty and hazards of the drug supply. They are willing and motivated to adopt harm reduction behaviors. Harm reduction promotion from syringe service programs and public health agencies is essential to reduce injury and death from nonpharmaceutical fentanyl.
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Affiliation(s)
- Kate LaForge
- Comagine Health, 650 NE Holladay St # 1700, Portland, OR 97232, United States of America.
| | - Erin Stack
- Comagine Health, 650 NE Holladay St # 1700, Portland, OR 97232, United States of America
| | - Sarah Shin
- Comagine Health, 650 NE Holladay St # 1700, Portland, OR 97232, United States of America
| | - Justine Pope
- Comagine Health, 650 NE Holladay St # 1700, Portland, OR 97232, United States of America
| | - Jessica E Larsen
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, United States of America
| | - Gillian Leichtling
- Comagine Health, 650 NE Holladay St # 1700, Portland, OR 97232, United States of America
| | - Judith M Leahy
- Oregon Health Authority, Acute and Communicable Disease Prevention, Public Health Division, Oregon Health Authority, Salem, OR, United States of America
| | - Andrew Seaman
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, United States of America; Old Town Clinic/Central City Concern, Portland, OR, United States of America; Better Life Partners, Hanover, NH, United States of America
| | - Dan Hoover
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, United States of America
| | | | - Caiti Barrie
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, United States of America
| | - Laura Chisholm
- Oregon Health Authority, Injury, and Violence Prevention Program, Public Health Division, Oregon Health Authority, Portland, OR, United States of America
| | - P Todd Korthuis
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, United States of America; Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, United States of America
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Masterton W, Falzon D, Burton G, Carver H, Wallace B, Aston EV, Sumnall H, Measham F, Gittins R, Craik V, Schofield J, Little S, Parkes T. A Realist Review of How Community-Based Drug Checking Services Could Be Designed and Implemented to Promote Engagement of People Who Use Drugs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911960. [PMID: 36231262 PMCID: PMC9564958 DOI: 10.3390/ijerph191911960] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 05/06/2023]
Abstract
With rising numbers of drug-related deaths in the UK and globally, exploration of interventions that seek to reduce drug-related harm is essential. Drug checking services (DCS) allow people to submit drug samples for chemical analysis and receive feedback about the sample, as well as harm reduction advice. The use of DCS is often linked to festival and/or nightlife settings and to so-called 'recreational' drug use, but research has also shown the potential of community-based DCS as an intervention serving more varied demographics of people who use drugs, including more marginalised individuals and those experiencing drug dependence. Whilst there is a growing evidence base on the effectiveness of drug checking as a harm reduction intervention, there is still limited evidence of the underlying mechanisms and processes within DCS which may aid implementation and subsequent engagement of people who use drugs. This presents a challenge to understanding why engagement differs across types of DCS, and how best to develop and deliver services across different contexts and for different populations. To explore the contexts and mechanisms which impact engagement in community-based DCS, a realist review was undertaken to synthesise the international evidence for the delivery and implementation of DCS. There were 133 sources included in the review. From these sources the underlying contexts, mechanisms, and outcomes relating to DCS implementation and engagement were developed and refined into seven programme theories. The findings of this review are theoretically novel and hold practical relevance for the design of DCS, with implications for optimisation, tailoring, and implementing services to reach individuals in different settings.
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Affiliation(s)
- Wendy Masterton
- Salvation Army Centre for Addictions Services and Research, University of Stirling, Stirling FK9 4LA, UK
- Correspondence:
| | - Danilo Falzon
- Salvation Army Centre for Addictions Services and Research, University of Stirling, Stirling FK9 4LA, UK
| | - Gillian Burton
- Salvation Army Centre for Addictions Services and Research, University of Stirling, Stirling FK9 4LA, UK
| | - Hannah Carver
- Salvation Army Centre for Addictions Services and Research, University of Stirling, Stirling FK9 4LA, UK
| | - Bruce Wallace
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Elizabeth V. Aston
- School of Applied Sciences, Edinburgh Napier University, Edinburgh EH11 4BN, UK
| | - Harry Sumnall
- Public Health Institute, Liverpool John Moores University, Liverpool L2 2QP, UK
| | - Fiona Measham
- Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool L69 7ZR, UK
- The Loop, Unclassified Community Interest Company, Manchester M13 9PL, UK
| | | | | | - Joe Schofield
- Salvation Army Centre for Addictions Services and Research, University of Stirling, Stirling FK9 4LA, UK
| | - Simon Little
- Kinbank Social Research Consultancy, Tayport DD6 9AP, UK
| | - Tessa Parkes
- Salvation Army Centre for Addictions Services and Research, University of Stirling, Stirling FK9 4LA, UK
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Acceptability of a HIV self-testing program among people who use illicit drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 103:103613. [DOI: 10.1016/j.drugpo.2022.103613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 12/19/2022]
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Mistler CB, Rosen AO, Eger W, Copenhaver MM, Shrestha R. Fentanyl Test Strip Use and Overdose History among Individuals on Medication for Opioid Use Disorder. AUSTIN JOURNAL OF PUBLIC HEALTH AND EPIDEMIOLOGY 2021; 8:1117. [PMID: 35782633 PMCID: PMC9249264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The number of deaths from drug overdose in the United States has more than doubled in the past decade. In particular, drug overdose deaths involving fentanyl have doubled every year since 2013. Rapid fentanyl test strips (FTS) are a useful strategy for detecting traces of fentanyl in substances and have received overwhelming support from individuals with opioid-dependence. METHODS We investigated fentanyl use, knowledge of FTS, willingness to use FTS, and overdose history among a sample of 105 individuals currently on medication for opioid use disorder (MOUD). RESULTS Results showed that the majority (63%) of the sample had experienced a non-fatal overdose and that 85% of participants were willing to use FTS. The majority of participants reported concern about fentanyl in their drug supply (70%) and 77% reported likelihood of past unintentional fentanyl use. Of note, only about half (47%) of participants knew of FTS prior to being surveyed, and only 17% reported ever using FTS. CONCLUSION These results expand on previous literature that documents high levels of willingness, yet low uptake of FTS among individuals on MOUD. Widespread education about FTS, in addition to the implementation of the use of FTS, is a highly promising and critical primary prevention alternative to overdose treatment and/or death due to fentanyl.
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Affiliation(s)
- C B Mistler
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - A O Rosen
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - W Eger
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA
| | - M M Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - R Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
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