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.

项目概要/摘要 美国的药物过量流行现象有增无减，药物供应发生变化，药物数量有所增加。 与兴奋剂相关的过量死亡已将阿片类药物过量流行转变为多种物质 目前全国超过一半的药物过量死亡涉及多种药物，导致一些药物过量。 研究人员将当前的多物质时代视为流行病的“第四波”。 使用（PSU）和 PSU 过量给从业者和研究人员带来了许多需要解决的挑战。 新兴的减害干预措施是否以及在多大程度上可以降低 PSU 涉及的用药过量风险 对于公共卫生当局和服务提供者至关重要。 个人在训练有素的监督下消费预先获得的受控物质的设施 全球有超过 200 家 OPC 开展此类干预活动，但此类干预措施包括在服药过量情况下进行干预的工作人员。 美国首批两家获得公众认可的 OPC 于 2021 年在纽约市开业。其他国家的 OPC 国家与减少致命和非致命用药过量风险以及减少紧急服务有关 然而，先前的研究尚未评估 OPC 的使用对 PSU 中过量服用风险的影响。 此外，并发的精神健康障碍仍然是一个严重但尚未得到充分研究的风险。 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 尽管估计表明未经治疗的心理健康负担很高 因此，本 K01 提案的目标是解决这些关键的研究差距：(1) 确定 OPC 使用对 PSU 个体非致命和致命过量风险的影响不同 (2)； 估计 OPC 的使用对 PSU 患者所治疗的精神事件的影响；以及 (3) 评估需求； 减少危害提供者将心理健康服务整合到现有的注射器服务和 OPC 交付中 模型，特别关注 PSU 相关人群的需求。该研究计划得到了一项支持。 卓越的指导团队和培训计划建立在候选人的背景之上。 物质使用流行病学和数据科学，并在以下几个领域提供新的培训：（1）新颖的统计 鉴定 OPC 使用对 PSU 中过量风险的异质治疗效果的方法 (2)精神流行病学与心理健康之间的复杂关系， 物质使用障碍和 PSU；以及 (3) 科学实施以概念化和评估新颖的 针对 PSU 相关人群的综合行为保健模式 结合研究和培训。 计划将使候选人能够转变为政策相关社会和问题的独立研究员 这项研究与疾病预防控制中心的过量预防研究一致。 优先确定社会生态多个层面的 PSU 过量风险和保护因素。