OPR mis/use and transitions to heroin and injecting in suburban and exurban Southern California

南加州郊区和远郊 OPR 误用/使用以及转向海洛因和注射

• 批准号: 9336235
• 负责人: Peter John Davidson
• 金额: $ 30万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9336235
• 关键词: OPR; mis; use; transitions; heroin

7. Project Summary Drug-related overdose deaths are now the largest cause of injury death in the United States, having eclipsed motor vehicle-related deaths in 2011. Evidence suggests that individuals initiating prescription opioid abuse within the last 10 years are demographically different from opioid abusers of previous generations. They are more rural and suburban than urban, and have a broader range of age of initiation. Previous studies of transition from non-injecting to injecting drug use has largely been conducted in highly urban environments, and studies of HIV risk behaviors among injecting drug users in the United States have also predominantly been conducted in urban settings. Surprisingly little is known about prescription opioid users in suburban and exurban settings, or about factors associated with transition from prescription opioid use or misuse to injecting or to use of heroin. Southern California has three counties largely comprised of suburban/exurban and rural communities, high rates of HIV, and limited services for people who inject drugs: Ventura, Orange, and San Diego Counties. These three counties have higher than state median rates of prescription opioid prescribing, and higher than state median rates of accidental opioid-related overdose death. We propose to utilize our unique access to a large population of suburban and exurban drug users to recruit individuals who are using prescription opioids not as prescribed, or who have recently (<6 months) transitioned to injecting opioids and/or heroin use, in order to conduct qualitative and quantitative exploration of a) initiation of prescription opioids, b) factors associated with transition to injecting and/or heroin use, and c) barriers to accessing medication assisted treatment, HIV and HCV testing, overdose prevention, and clean needles. We will achieve these aims through a three-stage mixed methods approach. We will use qualitative approaches to determine factors associated with initiation of opioid misuse, as well as transition to injecting, and/or transition to heroin use; quantitative surveys and analysis to determine statistical relationships between predictor factors and outcomes in a larger sample of prescription opioid misusers; and qualitative interviews to reconcile first-stage qualitative findings with quantitative findings. Findings from this study will be uniquely valuable in designing targeted interventions for preventing opioid pain reliever misuse, heroin initiation, injection initiation and overdose among high risk populations in geographically dispersed suburban and exurban communities, a group that to day has been the subject of little research.

7。项目摘要 现在，与药物有关的过量死亡是美国受伤死亡的最大原因，已黯然失色 2011年与机动车有关的死亡。证据表明，发起处方阿片类药物滥用的个人 在过去的十年中，人口统计学上与前几代的阿片类药物滥用者不同。他们是 与城市相比，农村和郊区更多，并且具有更广泛的启动年龄。先前的研究 从非注射到注射药物使用的过渡很大程度上是在高度城市环境中进行的， 在美国注射吸毒者中对艾滋病毒风险行为的研究也主要是 在城市环境中进行。令人惊讶的是，关于郊区的处方阿片用户和 外城设置，或与处方阿片类药物使用或滥用到注射的因素有关的因素 或使用海洛因。 南加州有三个县主要由郊区/外城和农村社区组成 艾滋病毒率和对注射毒品的人的服务有限：文图拉，橙色和圣地亚哥县。 这三个县的处方药处方处处方率高，高于 州意外阿片类药物相关过量死亡的中位数。我们建议利用我们对 大量郊区和外城吸毒者招募使用处方阿片类药物的个人 没有规定，或者最近（<6个月）过渡到注射阿片类药物和/或海洛因的使用 为了进行定性和定量探索a）启动处方阿片类药物的启动，b）相关的因素 过渡到注射和/或海洛因的使用，以及c）获得药物辅助治疗的障碍，艾滋病毒 以及HCV测试，预防过量和清洁针。 我们将通过三阶段混合方法方法实现这些目标。我们将使用定性 确定与阿片类药物滥用起始以及向注射过渡相关的因素的方法 和/或过渡到海洛因的使用；定量调查和分析以确定 预测因子和较大处方阿片类药物滥用者样本的结果；和定性采访 与定量发现调和第一阶段定性发现。 这项研究的发现将在设计有针对性的干预措施以防止阿片类药物方面具有独特的价值 止痛药滥用，海洛因启动，注射启动和高风险人群中的过量 地理分散的郊区和郊区社区，这一群体是白天很少的主题 研究。