Preventing Overdoses Involving Stimulants (POINTS)Study

预防涉及兴奋剂的药物过量（点）研究

• 批准号: 10392020
• 负责人: TRACI C GREEN
• 金额: $ 36.25万
• 依托单位: BROWN UNIVERSITY
• 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/10392020
• 关键词: Preventing; Overdoses; Involving; Stimulants; POINTS

PROJECT SUMMARY In recent years, overdoses involving illicit cocaine, methamphetamine, and other stimulants, have increased nationally and in the overdose hotspot states of Massachusetts (MA) and Rhode Island (RI). Polysubstance use has long been a known risk factor for overdose. However, drug seizure data suggest that cocaine, methamphetamine, and counterfeit pills may be adulterated with fentanyl. The unintentional consumption of stimulants containing illicit fentanyl represents a major risk factor for opioid-driven overdoses, whereas the increasing availability and use of highly potent cocaine and methamphetamine in MA and RI pose a risk for stimulant-only overdoses. Understanding the drug use patterns and strategies used by people who use stimulants to prevent overdose is necessary to identify risk and protective factors for stimulant-involved overdoses. Mixed-methods research with individuals involved in drug distribution can also provide critical information into the mechanisms through which fentanyl and other adulterants may enter the stimulant supply. The testing of drug samples can further triangulate consumer and distributor perspectives regarding the potency and adulteration of the drug supply. Drug checking using Fourier-Transform Infrared (FTIR) spectroscopy enables the detection of all active adulterants in a sample, including fentanyl and its analogs. When paired with confirmatory testing, drug checking can provide insights into the changing drug supply, the risk of exposure to highly potent or fentanyl-adulterated stimulants and overdose risk for high-risk communities. Finally, collaborative efforts with community stakeholders are needed to identify optimal, feasible, and acceptable strategies to prevent fatal and non-fatal overdoses in high-risk communities. Our overall objective is to reduce stimulant-involved overdoses in regions disproportionately affected by the overdose epidemic. Our approach to meeting this long- term objective is to utilize a multi-pronged approach to identify risk and protective factors for stimulant-involved overdose and use these findings to begin the process of developing a package of locally-tailored intervention strategies that can be swiftly implemented in future research to prevent stimulant-involved overdoses. Consistent with Objective 2 of RFA-CE-21-002, we aim to [1] Carry out mixed-methods research with people who use or distribute illicit stimulants to identify risk and protective factors for stimulant-involved overdoses; [2] Conduct drug checking to examine the potency of stimulants and the presence and relative quantity of fentanyl and other adulterants in the stimulant supply; and [3] Convene a series of working groups with individuals involved in primary and secondary overdose prevention in MA and RI to contextualize our mixed-methods findings and identify multilevel intervention strategies to prevent stimulant-involved overdoses. Completion of this study will yield a rich understanding of the social epidemiology of stimulant-involved overdoses in two states disproportionately affected by the overdose crisis. Findings will yield community-derived intervention strategies that can be readily implemented and scaled to prevent stimulant-involved overdoses in MA, RI, and beyond.

项目摘要 近年来，涉及非法可卡因，甲基苯丙胺和其他兴奋剂的过量药物增加了 全国和马萨诸塞州（MA）和罗德岛（RI）的过量热点州。使用多物质 长期以来，已知的过量危险因素。但是，药物癫痫发作的数据表明可卡因， 甲基苯丙胺和假丸可以用芬太尼掺假。无意的消费 含有非法芬太尼的刺激剂代表阿片类药物驱动的过量剂量的主要危险因素，而是 在MA中增加可卡因和甲基苯丙胺的可用性和使用，并有可能 仅刺激性过量。了解使用的毒品使用模式和策略 为了识别刺激性涉及刺激性因素的风险和保护因素，需要预防过量用药的刺激剂 过量服用。与参与药物分配的人的混合方法研究也可以提供关键 芬太尼和其他掺杂物可以进入兴奋剂供应的机制信息。 药物样品的测试可以进一步提出有关效力的消费者和分销商的观点 和药物供应的掺假。使用傅里叶转变红外（FTIR）光谱检查药物检查 可以在包括芬太尼及其类似物在内的样品中检测所有活性掺假物。配对时 验证性测试，药物检查可以提供有关不断变化的药物供应的见解，暴露的风险 高风险社区的高度有效或芬太尼补充的兴奋剂和过量风险。最后，协作 需要与社区利益相关者进行努力，以确定最佳，可行和可接受的策略以防止 高危社区中的致命和非致命性过量。我们的总体目的是减少刺激剂 在过量流行的地区过量服药不成比例。我们满足这一长期的方法 术语目标是利用多种条件的方法来识别刺激性涉及的风险和保护因素 用药过量并使用这些发现开始开发一套本地限制干预措施的过程 可以在未来的研究中迅速实施的策略，以防止刺激性涉及过量服用。持续的 在RFA-CE-21-002的目标2中，我们的目标是[1]与使用或使用的人进行混合方法研究 分发非法兴奋剂，以识别刺激性涉及过量药物的风险和保护因素； [2]进行药物 检查以检查兴奋剂的效力以及芬太尼和其他的存在和相对数量 兴奋剂供应中的掺杂剂； [3]召集一系列工作组 MA和RI中的初级和次要过量预防，以将我们的混合方法的发现和 确定多层次干预策略，以防止刺激性涉及过量服用。这项研究的完成将 对两个州的刺激性涉及刺激剂过量的社会流行病学有丰富的了解 不成比例地受到过量危机的影响。调查结果将产生社区衍生的干预策略 可以很容易地实施和缩放，以防止在MA，RI及其他地区进行刺激性涉及的过量药物。