The Medical Consequences of Different Types of Heroin

不同类型海洛因的医疗后果

• 批准号: 6745863
• 负责人: DANIEL H CICCARONE
• 金额: $ 16.11万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6745863
• 关键词: AIDS /HIV test; HIV infections; audiotape; behavioral /social science research tag; belief; clinical research; culture; geographic difference; health behavior; health care service utilization; heroin; high risk behavior /lifestyle; human subject; inflammation; interview; intravenous drug abuse; medical complication; medical records; overdose; patient oriented research; psychometrics; substance abuse epidemiology; substance abuse related behavior

DESCRIPTION (provided by applicant): As a junior faculty member at the University of California, San Francisco, Daniel Ciccarone, MD, MPH, has begun exploring the medical consequences of the use of black tar heroin. Through mentoring relationships, course work, structured tutorials and development of a research program, Dr. Ciccarone will advance his independence in conducting patient-oriented clinical research. The consequences of heroin use have long been documented. However, little attention has been given to the medical consequences of the specific type of heroin used. Heroin exists in two major morphologies in the United States. Black tar heroin (BTH), the form of heroin that predominates in the Western U.S., has been associated with soft tissue infections including abscesses, necrotizing fasciitis and various clostridial infections. BTH use may also account for the lower HIV prevalence among IDUs in the Western U.S. Behavioral patterns and health outcomes associated with the use of specific heroin types deserves further exploration. Study sites will include San Francisco, California and Hartford, Connecticut. Ethnographic study of street-based injection drug users (IDUs) will examine injection related behaviors including drug acquisition, storage, preparation, use and hygiene. Indigenous beliefs related to disease and specific heroin use will be explored. A survey instrument will be developed using results from the ethnographic study, current literature and expert opinion and will examine prevalence of disease outcomes and predictors of those outcomes. The survey will be administered to IDUs in the two cities, which differ on the predominant type of heroin available. The three goals of this study are: 1) To examine the behaviors and belief systems related to use of specific types of heroin with particular attention to issues of risk and hygiene; 2) To examine the health related outcomes of specific heroin use; and 3) To determine the independent effects of specific types of heroin on health outcomes, i.e., soft tissue infection, HIV and heroin related overdose.

描述（由申请人提供）： 作为加州大学旧金山分校的一名初级教员，Daniel Ciccarone（医学博士、公共卫生硕士）已开始探索使用黑焦油海洛因的医疗后果。通过指导关系、课程作业、结构化教程和研究项目的开发，Ciccarone 博士将提高他在进行以患者为导向的临床研究方面的独立性。 使用海洛因的后果早已有记载。然而，人们很少关注所使用的特定类型海洛因的医疗后果。海洛因在美国有两种主要形态。黑焦油海洛因 (BTH) 是一种在美国西部占主导地位的海洛因，与软组织感染有关，包括脓肿、坏死性筋膜炎和各种梭菌感染。 BTH 的使用也可能是美国西部注射吸毒者中艾滋病毒感染率较低的原因。与使用特定海洛因类型相关的行为模式和健康结果值得进一步探索。 研究地点将包括加利福尼亚州旧金山和康涅狄格州哈特福德。对街头注射吸毒者 (IDU) 的人种学研究将检查注射相关行为，包括药物获取、储存、准备、使用和卫生。将探讨与疾病和特定海洛因使用相关的土著信仰。将利用人种学研究的结果、当前文献和专家意见开发一项调查工具，并将检查疾病结果的患病率和这些结果的预测因素。该调查将针对两个城市的吸毒者进行，这两个城市的海洛因主要类型有所不同。 本研究的三个目标是： 1) 检查与使用特定类型海洛因相关的行为和信仰体系，特别注意风险和卫生问题； 2) 检查特定海洛因使用的健康相关结果； 3) 确定特定类型海洛因对健康结果的独立影响，即软组织感染、艾滋病毒和海洛因相关过量。