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.

项目概要 近年来，非法可卡因、甲基苯丙胺和其他兴奋剂的过量服用有所增加 全国范围内以及药物过量热点州马萨诸塞州 (MA) 和罗德岛州 (RI)。多物质使用 长期以来一直是已知的服用过量的危险因素。然而，毒品缉获数据表明可卡因、 甲基苯丙胺和假药可能掺有芬太尼。无意识的消费 含有非法芬太尼的兴奋剂是阿片类药物过量的主要危险因素，而 在马萨诸塞州和罗德岛州增加强效可卡因和甲基苯丙胺的供应和使用会带来以下风险： 仅服用兴奋剂过量。了解吸毒者的吸毒模式和策略 防止服用兴奋剂过量是必要的，以确定兴奋剂相关的风险和保护因素 服药过量。对参与药物分销的个人进行混合方法研究也可以提供关键的信息 有关芬太尼和其他掺假物可能进入兴奋剂供应的机制的信息。 药物样品的测试可以进一步分析消费者和经销商对药效的看法 以及药品供应的掺假。使用傅里叶变换红外 (FTIR) 光谱进行药物检查 能够检测样品中的所有活性掺杂物，包括芬太尼及其类似物。当与 验证性测试、药物检查可以深入了解药物供应的变化、接触药物的风险 强效兴奋剂或芬太尼掺假兴奋剂以及高风险社区的过量服用风险。最后，协作 需要与社区利益相关者一起努力确定最佳、可行和可接受的策略来预防 高风险社区中致命和非致命的药物过量。我们的总体目标是减少涉及兴奋剂的 受药物过量流行影响特别严重的地区发生药物过量。我们满足这一长期目标的方法 长期目标是利用多管齐下的方法来确定涉及兴奋剂的风险和保护因素 过量服用并利用这些发现开始制定一套针对当地情况的干预措施 可以在未来的研究中迅速实施的策略，以防止兴奋剂过量。持续的 根据 RFA-CE-21-002 的目标 2，我们的目标是 [1] 与使用或 分发非法兴奋剂，以确定兴奋剂过量的风险和保护因素； [2] 进行药物 检查兴奋剂的效力以及芬太尼和其他物质的存在和相对数量 兴奋剂供应中掺假； [3] 召集一系列由参与的人员组成的工作组 MA 和 RI 的一级和二级药物过量预防，以结合我们的混合方法研究结果和 确定多层次干预策略以防止兴奋剂过量。完成本研究将 对两个州兴奋剂过量的社会流行病学有深入的了解 受到药物过量危机的影响尤为严重。研究结果将产生社区衍生的干预策略 可以很容易地实施和扩展，以防止在 MA、RI 等情况下涉及兴奋剂的过量服用。