People Preferring Fentanyl (PPF): Characteristics, Outcomes, and Perspectives

人们偏好芬太尼 (PPF)：特征、结果和前景

• 批准号: 9973245
• 负责人: Jan Gryczynski
• 金额: $ 20万
• 依托单位: FRIENDS RESEARCH INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9973245
• 关键词: AIDS/HIV problem; Accident and Emergency department; Accounting; Adult; Automobile Driving; Baltimore; Cessation of life; Characteristics; Clinical Trials; Communities; Data; Data Collection; Data Linkages; Databases; Development; Dose; Epidemic; Ethnography; Euphoria; Event; Fentanyl; Firearms; Floods; Health; Health Care Costs; Healthcare; Hearing; Heroin; Hospital Departments; Illicit Drugs; Individual; Injections; Intervention; Interview; Laboratories; Lead; Learning; Maryland; Medical Examiners; Methods; Morphine; Naloxone; Naloxone Training; Names; New England; Opioid; Outcome; Overdose; Participant; Patients; Penetration; Pharmaceutical Preparations; Pharmacologic Substance; Pharmacology; Policies; Population; Preparation; Public Health; Records; Reporting; Research Design; Risk; Risk-Taking; Sampling; Scientific Inquiry; Severities; Side; Structure; System; Testing; Time; Treatment outcome; Ventilatory Depression; Withdrawal; Work; analog; attributable mortality; carfentanil; drug market; health care service utilization; high risk population; illicit opioid; improved; innovation; mortality; novel; opioid injection; opioid mortality; opioid overdose; opioid use; opioid use disorder; overdose death; overdose prevention; overdose risk; preference; prescription opioid; prevent; public health emergency; public health intervention; recruit; response; synthetic opioid; therapy design; therapy development; trafficking; treatment comparison; treatment program; vehicular accident; AIDS/HIV problem; Accident and Emergency department; Accounting; Adult; Automobile Driving; Baltimore; Cessation of life; Characteristics; Clinical Trials; Communities; Data; Data Collection; Data Linkages; Databases; Development; Dose; Epidemic; Ethnography; Euphoria; Event; Fentanyl; Firearms; Floods; Health; Health Care Costs; Healthcare; Hearing; Heroin; Hospital Departments; Illicit Drugs; Individual; Injections; Intervention; Interview; Laboratories; Lead; Learning; Maryland; Medical Examiners; Methods; Morphine; Naloxone; Naloxone Training; Names; New England; Opioid; Outcome; Overdose; Participant; Patients; Penetration; Pharmaceutical Preparations; Pharmacologic Substance; Pharmacology; Policies; Population; Preparation; Public Health; Records; Reporting; Research Design; Risk; Risk-Taking; Sampling; Scientific Inquiry; Severities; Side; Structure; System; Testing; Time; Treatment outcome; Ventilatory Depression; Withdrawal; Work; analog; attributable mortality; carfentanil; drug market; health care service utilization; high risk population; illicit opioid; improved; innovation; mortality; novel; opioid injection; opioid mortality; opioid overdose; opioid use; opioid use disorder; overdose death; overdose prevention; overdose risk; preference; prescription opioid; prevent; public health emergency; public health intervention; recruit; response; synthetic opioid; therapy design; therapy development; trafficking; treatment comparison; treatment program; vehicular accident

Project Summary/Abstract The opioid overdose epidemic is a public health emergency, claiming more lives each year than HIV/AIDS, motor vehicle accidents, or firearms at their peak. A significant development in illicit drug markets has been the emergence of illicit fentanyl and its high-potency analogues, often manufactured in clandestine labs overseas. Within just the last few years, fentanyl has become a driver of opioid overdose deaths. The escalation in mortality has been rapid and unprecedented, and fentanyl is now implicated in more deaths than heroin or prescription opioids. Fentanyl’s extreme potency leaves very little room for error in discerning between lethal and non-lethal doses. Illicit fentanyl is often used as an adulterant in the heroin supply, and is increasingly sold on the street by name. Recent evidence suggests that demand-side responses to fentanyl have ranged from avoidance strategies to the development of distinct preferences for fentanyl. The wide availability of fentanyl has led to the emergence of a new group of individuals with opioid use disorder (OUD) for whom fentanyl has become a preferred drug of choice. Very little is known about this high-risk group of people who prefer fentanyl (PPF). It is not known how PPF differ from other individuals with OUD who prefer less potent opioids, how they fare in OUD treatment, or how they perceive overdose prevention and treatment interventions. This study seeks to learn more about intentional vs. unintentional fentanyl exposure and preferences among people entering OUD treatment. The study will: (1) Characterize fentanyl preferences among patients starting OUD treatment, (2) Compare 6-month OUD treatment outcomes for PPF and non-PPF, and (3) examine PPF perspectives on public health interventions to prevent overdose and improve OUD treatment engagement. The study will recruit 250 fentanyl-exposed adults newly admitted to a large community OUD treatment program. Participants will complete a structured assessment, and 6-month outcomes will be tracked via innovate data linkage across OUD treatment, healthcare, and judiciary record systems. A subset of 40 participants will complete semi-structured, qualitative interviews focused on fentanyl preferences and perspectives on interventions. This study will yield timely data on the public health emergency of fentanyl, and will inform intervention design for a high-risk group of patients who have developed distinct preferences for fentanyl.

项目摘要/摘要 阿片类药物过量流行是公共卫生的紧急情况，每年的生命都比艾滋病毒/艾滋病更多 汽车事故，或在其峰值处发生枪支。非法药物市场的重大发展是 非法芬太尼及其高产类似物的出现，通常是在海外秘密实验室制造的。 在过去的几年中，芬太尼已成为阿片类药物过量死亡的驱动力。升级 死亡率一直迅速且前所未有，芬太尼现在涉及比海洛因或 处方阿片类药物。芬太尼的极端效力几乎没有辨别的空间 和非致命剂量。非法芬太尼通常用作海洛因供应中的掺假剂，并且越来越出售 在街上的名字。 最近的证据表明，需求方对芬太尼的反应从回避策略到 芬太尼不同偏好的发展。芬太尼的广泛可用性导致了出现 芬太尼已成为阿片类药物使用障碍（OUD）的一组新的人 选择。对于那些喜欢芬太尼（PPF）的高风险人群，知之甚少。这是不知道的 PPF与其他偏爱潜在阿片类药物的人不同，他们在OUD中的表现如何 治疗或他们如何看待预防和治疗干预措施。 这项研究旨在了解有关故意与无意的芬太尼暴露和偏好的更多信息 进入Oud治疗的人。该研究将：（1）表征开始的患者中的芬太尼偏好 OUD处理，（2）比较PPF和非PPF的6个月OUD治疗结果，（3）检查PPF 关于公共卫生干预措施的观点，以防止服药过量和改善OUD治疗参与。 该研究将招募250名芬太尼暴露的成年人，新招募了大型社区Oud治疗 程序。参与者将完成结构化的评估，并将通过6个月的结果通过 在OUD治疗，医疗保健和司法记录系统之间进行创新的数据链接。 40子集 参与者将完成针对芬太尼偏好和的半结构化定性访谈和 干预措施的观点。 这项研究将产生有关芬太尼公共卫生紧急情况的及时数据，并将为干预设计提供信息 对于一群对芬太尼产生独特偏好的高风险患者。