CE23-002 - Assessing the Impact of Overdose Prevention Centers as a Polysubstance Use and Behavioral Health Intervention in New York City

CE23-002 - 评估纽约市过量预防中心作为多物质使用和行为健康干预措施的影响

• 批准号: 10783253
• 负责人: Bennett Allen
• 金额: $ 15万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2026-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10783253
• 关键词: CE23; 002; Assessing; Impact; Overdose

PROJECT SUMMARY/ABSTRACT The overdose epidemic continues unabated in the United States. Changes to the drug supply and increases in stimulant-involved overdose deaths have shifted what was an opioid overdose epidemic to a polysubstance overdose epidemic. Over half of overdose deaths nationally now involve multiple substances, leading some researchers to identify the current polysubstance era as the epidemic’s “fourth wave.” Increases in polysubstance use (PSU) and PSU overdose pose a host of challenges for practitioners and researchers to address. Knowing whether and to what extent emerging harm reduction interventions can reduce PSU-involved overdose risk is critical for public health authorities and service providers. Overdose prevention centers (OPCs), community- based facilities at which individuals consume pre-obtained controlled substances under the supervision of trained staff who can intervene in event of an overdose, are one such intervention. Over 200 OPCs operate globally, but the first two publicly recognized OPCs in the United States opened in New York City in 2021. OPCs in other countries are associated with reduced fatal and non-fatal overdose risk and reduced emergency service utilization. However, prior research has not assessed the impact of OPC use on overdose risk among PSU- involved populations. In addition, concurrent mental health disorders remain a critical yet underexplored risk factor for PSU overdose and other harms, yet studies to date have not assessed the association between OPC use and mental health outcomes, despite estimates suggesting a high untreated mental health burden among OPC clients. As such, the objective of this K01 proposal is to address these critical research gaps to: (1) identify heterogeneous impacts of OPC use on non-fatal and fatal overdose risk among individuals engaging in PSU; (2) estimate the impact of OPC use on treated psychiatric events among clients with PSU; and (3) assess the needs of harm reduction providers to integrate mental health services into existing syringe service and OPC delivery models, with a particular focus on the needs of PSU-involved populations. The research plan is bolstered by an exceptional mentorship team and training plan. The proposed project builds on the candidate’s background in substance use epidemiology and data science and provides new training in several areas: (1) novel statistical methods for the identification of heterogeneous treatment effects of OPC use on overdose risk among PSU- involved individuals; (2) psychiatric epidemiology and the complex relationship between mental health, substance use disorders, and PSU; and (3) implementation science to conceptualize and evaluate novel integrated behavioral health care models for PSU-involved populations. The combined research and training plan will enable the candidate to transition into an independent researcher of policy-relevant social and behavioral factors that shape overdose risk. This research aligns with CDC’s Overdose Prevention Research Priorities to identify PSU overdose risk and protective factors across multiple levels of the social ecology.

项目摘要/摘要 在美国，过量的流行病持续不断。药物供应的变化并增加 刺激性涉及的过量死亡使阿片类药物过量的流行转移到了多刺激 过量的流行病。现在，全国范围内有多种物质的过量死亡人数超过一半，领导了一些物质 研究人员将当前的Polysubstance时代确定为流行病的“第四波”。多物质的增加 使用（PSU）和PSU过量对从业者和研究人员构成了许多挑战。会心 是否以及在多大程度上减少危害的干预措施可以减少PSU涉及过量的过量风险是 公共卫生当局和服务提供商至关重要。过量预防中心（OPC），社区 - 在经过训练的监督下，个人在该设施中消耗了预先注射的受控物质 如果服用过量，可以干预的工作人员就是这样的干预。超过200个OPC在全球运行，但 前两个在美国公开认可的OPC于2021年在纽约市开业。 国家与减少致命和非致命过量风险以及急诊服务减少有关 利用率。但是，先前的研究尚未评估OPC使用对PSU- 涉及人群。此外，同时心理健康障碍仍然是一个关键但毫无疑问的风险 PSU过量和其他危害的因素，但迄今为止的研究尚未评估OPC之间的关联 使用和心理健康成果，任务估计表明，未经治疗的心理健康燃烧很高 OPC客户。因此，该K01提案的目的是解决这些关键研究差距：（1）确定 OPC使用对参与PSU的人的非致命和致命过量风险的异质影响； （2） 估计使用PSU客户对经过治疗的精神病事件的影响； （3）评估需求 减少危害的提供者将心理健康服务整合到现有注射器服务和OPC交付中 模型，特别关注PSU参与人群的需求。该研究计划由 杰出的巡回团队和培训计划。拟议的项目以候选人的背景为基础 药物使用流行病学和数据科学，并在多个领域提供新的培训：（1）新型统计 鉴定OPC使用异质治疗对PSU- 涉及个人； （2）精神病流行病学和心理健康之间的复杂关系， 药物使用障碍和PSU； （3）实施科学以概念化和评估新颖 PSU参与人群的综合行为保健模型。研究和培训的合并 计划将使候选人能够过渡到与政策相关的社会和 塑造过量风险的行为因素。这项研究与CDC的预防过量研究保持一致 识别多个社会生态层次的PSU过量风险和保护因素的优先事项。