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.

七、项目概要 与药物相关的过量死亡现已成为美国伤害死亡的最大原因，超过了 2011 年与机动车相关的死亡人数。有证据表明，开始滥用处方阿片类药物的个人 过去 10 年内，阿片类药物滥用者的人口结构与前几代人有所不同。他们是 农村和郊区比城市多，而且起始年龄范围更广。以前的研究 从非注射吸毒到注射吸毒的转变主要是在高度城市化的环境中进行的， 对美国注射吸毒者艾滋病毒危险行为的研究也主要 在城市环境中进行。令人惊讶的是，人们对郊区和郊区的处方阿片类药物使用者知之甚少。 远郊环境，或与从处方阿片类药物使用或滥用到注射的过渡相关的因素 或使用海洛因。 南加州有三个县，主要由郊区/远郊和农村社区组成，高 文图拉县、奥兰治县和圣地亚哥县的艾滋病毒感染率以及为注射吸毒者提供的服务有限。 这三个县的阿片类药物处方率高于州中位数，并且高于 说明与阿片类药物相关的意外服用过量死亡的中位率。我们建议利用我们独特的访问权限 大量郊区和远郊吸毒者招募使用处方阿片类药物的个人 不按规定服用，或最近（<6 个月）转为注射阿片类药物和/或使用海洛因，以便 对 a) 开始使用阿片类药物处方，b) 相关因素进行定性和定量探索 过渡到注射和/或使用海洛因，以及 c) 获得药物辅助治疗的障碍、艾滋病毒 HCV 检测、过量预防和清洁针头。 我们将通过三阶段混合方法来实现这些目标。我们将使用定性 确定与阿片类药物滥用开始以及向注射过渡相关的因素的方法， 和/或转向使用海洛因；定量调查和分析以确定之间的统计关系 更大样本的处方阿片类药物滥用者的预测因素和结果；和定性访谈 协调第一阶段的定性研究结果与定量研究结果。 这项研究的结果对于设计预防阿片类药物的有针对性的干预措施具有独特的价值 高危人群中止痛药滥用、海洛因开始注射、开始注射和过量服用 地理上分散的郊区和远郊社区，这一群体如今很少受到关注。 研究。