Synthetics in Combination (SYNC)

合成材料组合 (SYNC)

• 批准号: 10666633
• 负责人: DANIEL H CICCARONE
• 金额: $ 69.81万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 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 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10666633
• 关键词: Accounting; Adverse effects; Benzodiazepines; Cessation of life; Communities; Data; Databases; Drug Combinations; Drug usage; Drug user; Economics; Environment; Epidemic; Epidemiology; Ethnography; Fentanyl; Health; Heroin; Hospitalization; Illicit Drugs; Injections; Intervention; Interview; Investments; Knowledge; Marketing; Measures; Methamphetamine; Methods; Modeling; Monitor; Morbidity - disease rate; Naloxone; Opioid; Outcome; Outcome Study; Overdose; Pattern; Peer Review; Persons; Pharmaceutical Preparations; Pharmacologic Substance; Play; Price; Proliferating; Public Health; Research; Resources; Review Literature; Risk; Risk Factors; Role; Shapes; Smoking; Stimulant; Study models; Techniques; Youth; adverse outcome; design; drug market; epidemiological model; fentanyl analog; high risk; high risk population; innovation; insight; methamphetamine use; mortality; multiple drug use; novel; opioid epidemic; opioid overdose; overdose death; pill; predictive modeling; preference; prescription opioid; protective factors; public health intervention; response; synthetic drug; synthetic opioid; tool

Summary Over the last decade fentanyls, methamphetamine and benzodiazepines have proliferated in US illicit drug markets. These synthetic drugs, increasingly in combinations, are implicated in the ongoing rise in overdose fatalities. Although drug overdoses commonly involve more than one substance, polydrug use has long been understudied. Now, the replacement of heroin with novel synthetics such as fentanyls, the resurgence of methamphetamine, and the proliferation of counterfeit pills, have created a situation of new complexity and unknown risks with an urgent need for knowledge. People who use drugs are creating new patterns and modes of polydrug use, for which their motives and influences are yet to be understood. Some polydrug use may be unintentional due to contamination or counterfeit products. For example, the contamination or co-use of methamphetamine with fentanyls may explain the recent rise in stimulant-related mortality. Examination of the use of the once rare but resurgently popular methamphetamine and heroin cocktail, aka `goofball', now remodeled with fentanyl, may give clues to the salience and rationale of polysynthetics in drug use repertoires as well as their adverse outcomes. Aim 1 (Ethnography): To elucidate the effects of synthetic drug supply changes (primarily fentanyls and methamphetamine) on people who use drugs in combination and to understand their preferences for and responses and adaptations to these changes. Aim 2 (Epidemiology): To examine the shift towards polysynthetic drug use through studies of local and national drug supply and health outcome databases and to determine a) the roles of unintentional co-use from cross-contamination and counterfeit pharmaceuticals, intentional co-use and drug price/purity/potency in patterns of synthetic polydrug use and b) the morbidity and mortality outcomes of these use patterns. Aim 3 (Modeling): To forecast overdose mortality based on evolving risk and protective factors from synthetic drug combinations. We will use mechanistic (agent-based modeling) and statistical predictive modeling tools, accounting for the effects of different modes of administration (smoking vs injecting), adaptation (eg tester shots) and interventions (eg naloxone). The Synthetics in Combination (SYNC) study will integrate micro-to-macro-level anthropological, economic, epidemiological and modeling approaches to gain insight into polydrug use on the ground, to measure and predict both adverse effects and model methods of mitigating harm. Achieving its objectives will advance understanding of drug epidemics and morbidities, help tailor public health interventions and provide community level tools for better monitoring and allocation of scarce resources.

概括 过去十年，芬太尼、甲基苯丙胺和苯二氮卓类药物在美国非法药物中激增 市场。这些合成药物越来越多地组合使用，与药物过量的持续上升有关 死亡人数。尽管药物过量通常涉及不止一种物质，但多种药物的使用长期以来一直是 待研究。现在，随着芬太尼等新型合成物取代海洛因，海洛因的复兴 甲基苯丙胺和假药的泛滥造成了新的复杂性和 未知的风险，迫切需要知识。 吸毒者正在创造多种药物使用的新模式和方式，他们的动机和方式 影响尚待了解。由于污染或原因，某些多种药物的使用可能是无意的。 假冒产品。例如，甲基苯丙胺与芬太尼的污染或共同使用可能 解释最近与兴奋剂相关的死亡率上升的原因。对曾经罕见但又重新流行的使用的检查 流行的甲基苯丙胺和海洛因鸡尾酒，又名“傻瓜”，现在用芬太尼进行了改造，可能会提供线索 多合成药物在药物使用中的显着性和基本原理及其不良后果。 目标 1（人种学）：阐明合成药物供应变化（主要是芬太尼和芬太尼）的影响 甲基苯丙胺）对联合使用药物的人进行研究，并了解他们的偏好和 对这些变化的反应和适应。 目标 2（流行病学）：通过对当地和地区的研究来检验向多合成药物使用的转变 国家药品供应和健康结果数据库，并确定 a) 无意共同使用的作用 交叉污染和假冒药品、故意共同使用以及药品价格/纯度/效力 合成多种药物的使用模式，以及 b) 这些使用模式的发病率和死亡率结果。 目标 3（建模）：根据合成药物不断变化的风险和保护因素来预测用药过量死亡率 药物组合。我们将使用机械（基于代理的建模）和统计预测建模工具， 考虑不同给药方式（吸烟与注射）、适应（例如测试仪）的影响 注射）和干预措施（例如纳洛酮）。 综合合成（SYNC）研究将整合微观到宏观层面的人类学、经济、 流行病学和建模方法，以深入了解多种药物的实际使用情况，以测量和 预测不利影响并建立减轻伤害的模型方法。实现其目标将取得进展 了解毒品流行病和发病率，帮助制定公共卫生干预措施并为社区提供帮助 更好地监控和分配稀缺资源的水平工具。

项目成果

Testing the test strips: laboratory performance of fentanyl test strips.

• DOI: 10.1186/s12954-023-00921-8
• 发表时间: 2024-01-18
• 期刊: HARM REDUCTION JOURNAL
• 影响因子: 4.4
• 作者: Halifax, John C.;Lim, Lilly;Ciccarone, Daniel;Lynch, Kara L.
• 通讯作者: Lynch, Kara L.

The Opioid Industry Documents Archive: A Living Digital Repository.

阿片类药物行业文档档案：动态数字存储库。

• DOI: 10.2105/ajph.2022.306951
• 发表时间: 2022
• 期刊: American journal of public health
• 影响因子: 12.7
• 作者: CalebAlexander,G;Mix,LisaA;Choudhury,Sayeed;Taketa,Rachel;Tomori,Cecília;Mooghali,Maryam;Fan,Anni;Mars,Sarah;Ciccarone,Dan;Patton,Mark;Apollonio,DorieE;Schmidt,Laura;Steinman,MichaelA;Greene,Jeremy;Ling,PamelaM;Seymour,
• 通讯作者: Seymour,