Leveraging Psychological Autopsies to Accelerate Research into Stimulant Overdose Mortality

利用心理尸检加速兴奋剂过量死亡率的研究

• 批准号: 10387934
• 负责人: PHILLIP O COFFIN
• 金额: $ 36.24万
• 依托单位: PUBLIC HEALTH FOUNDATION ENTERPRISES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2024-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10387934
• 关键词: Leveraging; Psychological; Autopsies; Accelerate; Research; Leveraging; Psychological; Autopsies; Accelerate; Research

Project Summary/Abstract Drug poisoning (aka “overdose”) is a complex construct, particularly for stimulants. While opioid overdose is generally caused by respiratory depression, stimulant overdose is multi-faceted. Non-fatal events are likely driven by cardiac and psychiatric complaints. However, fatal events are less well understood. Psychological autopsies have been shown to be immensely valuable in understanding opioid overdose deaths, identifying many of the key elements of overdose that still drive overdose prevention efforts today, and we propose to leverage that mechanism to accelerate our understanding of and response to stimulant overdose mortality. For example, cardiac disease has previously been identified as more common among stimulant overdose decedents than heroin overdose or suicide-by-hanging. However, the majority of stimulant overdose deaths lack an additional medical explanation. With psychological autopsies, we can leverage not just medical examiner data, but also medical records and informant interviews to identify cardiac disease and complaints antecedent to death. This approach, responsive to Objective 2 of the RFA, also allows for a detailed understanding of the intent of overdose (i.e. suicidality), as well as an opportunity to determine the intentionality of fentanyl use in stimulant/fentanyl overdose events. We will identify 100 stimulant overdose decedents (divided among cocaine, methamphetamine, and cocaine or methamphetamine with fentanyl), conduct informant interviews (including scales and qualitative data), and gather data from the post mortem investigation (e.g., vital records, toxicology, autopsy, case narrative, death scene photographs) and medical record abstraction. Subsequently, we will conduct qualitative interviews with 40-60 living people who use stimulants (half MA, half cocaine) to explore elements of resilience and risk reduction strategies.

项目摘要/摘要 药物中毒（又称“用药过量”）是一种复杂的结构，尤其是对于兴奋剂。阿片类药物过量是 通常由呼吸道抑郁症引起，刺激性过量是多方面的。非致命事件可能是 受心脏和精神病投诉的驱动。但是，致命事件的理解不太了解。心理 尸检已被证明在理解阿片类药物过量死亡方面非常有价值，并确定 当今仍在推动过量预防努力的过量用药的许多关键要素，我们建议 利用该机制加速我们对刺激过量死亡率的理解和反应。为了 例如，心脏病以前已被确定为在刺激过量中更常见 死者比海洛因过量或自杀。但是，大多数刺激性过量死亡 缺乏其他医学解释。有了心理尸检，我们不仅可以利用医疗 审查员数据，以及医疗记录和线人访谈，以识别心脏病和投诉 死刑。对RFA目标2响应的这种方法也允许详细 了解过量的意图（即自杀），以及确定的机会 芬太尼在刺激/芬太尼过量事件中使用的意图。我们将确定100种兴奋剂过量 死者（在可卡因，甲基苯丙胺和可卡因或甲基苯丙胺中划分），芬太尼），） 进行线人访谈（包括量表和定性数据），并从验尸中收集数据 调查（例如，生命记录，毒理学，尸检，案例叙述，死亡场景照片）和医疗 记录抽象。随后，我们将对使用的40-60名活着的人进行定性访谈 兴奋剂（半MA，半可卡因）探索弹性和降低风险策略的要素。