Examination of evolving opioid misuse and overdose risk among American Indians

检查美洲印第安人中不断变化的阿片类药物滥用和过量风险

• 批准号: 10438466
• 负责人: Tommi Lynn Gaines
• 金额: $ 37.89万
• 依托单位: INDIAN HEALTH COUNCIL, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10438466
• 关键词: Address; Adult; Affect; Age; Alaska Native; American Indians; Area; Attention; Back; COVID-19 pandemic; California; Chairperson; Communities; Community Actions; Country; Cross-Sectional Studies; Data; Drug usage; Emergency department visit; Environment; Epidemic; Ethnic group; Etiology; Fatality rate; Geographic Locations; Geography; Goals; Harm Reduction; Health; Heroin; Hospitalization; Illicit Drugs; Indian reservation; Individual; Interview; Lead; Medical Examiners; Morphologic artifacts; Naloxone; National Institute of Drug Abuse; Native American Research Center for Health; Opioid; Overdose; Pattern; Pharmaceutical Preparations; Population; Prevention; Program Sustainability; Public Health; Reaction Time; Reporting; Research; Research Methodology; Resources; Risk; Services; Social isolation; Source; Strategic Planning; Surveys; Sustainable Development; Time; Tribes; United States; Work; addiction; base; community engagement; community intervention; diverse data; experience; health care availability; medication-assisted treatment; mortality; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use; opioid use disorder; overdose death; overdose risk; pill; prescription opioid; prescription opioid misuse; prevention service; programs; racial and ethnic; response; social; social structure; surveillance data; synthetic opioid; tool; treatment services; trend

Project Summary American Indian communities have been greatly affected by the opioid epidemic with many communities being overwhelmed by opioid use and opioid overdose. Among all racial/ethnic groups in the U.S, American Indians and Alaska Natives have the second highest rate of overdose fatalities from all opioids and second and third highest overdose fatality rates from heroin and synthetic opioids. As with other parts of the country, opioids are the main driver of drug overdose deaths in California. Within Southern California, surveillance data indicates that areas encompassing American Indian reservations have experienced some of the highest age- adjusted rates of opioid-related overdose deaths, hospitalization, and emergency department visits. While there have been efforts to curtail the opioid crisis, much of this work has focused on population-level strategies without enough focus on the community dynamics and local-level context of opioid use. The overarching goal of this study is to characterize the changing etiology of opioid misuse and overdose risk among Southern California American Indian (AI) adults by implementing research methods to promote community engagement and inform a timely public health response to the opioid epidemic. Over a 4-year period, we will collect locally relevant data from diverse sources (80 interviews, 200 surveys, and population-level data on opioid overdose fatalities) to capture emerging patterns of risks and triangulate that information to inform the planning and allocation of prevention and treatment services for AI adults. Our study will be guided by the following Specific Aims: 1. Identify the epidemic profile of individuals at risk for opioid misuse and opioid overdose; 2. Examine community assets and capacity to address prevention and treatment of opioid use/misuse and resulting overdose; and 3. Develop community-based surveillance tool to inform community action towards reducing opioid overdose fatalities. By combining multiple information sources, a more comprehensive analysis and accurate picture of the opioid crisis can be generated. The public health significance of this study will be to continuously assess the environment contributing to opioid misuse and overdose risk across different social and geographical settings among AI Tribes. We anticipate that our findings will inform the short-term and long-term planning of prevention and treatment services that are responsive to the needs of California Tribes.

项目概要 美洲印第安人社区受到阿片类药物流行病的严重影响，许多人 社区因阿片类药物使用和阿片类药物过量而不堪重负。在所有种族/族裔中 美国印第安人和阿拉斯加原住民的患病率位居第二 所有阿片类药物过量致死率中，第二和第三高的过量致死率来自 海洛因和合成阿片类药物。与该国其他地区一样，阿片类药物是主要驱动力 加利福尼亚州因药物过量死亡。在南加州，监测数据表明 包括美洲印第安人保留地在内的地区经历了一些最高的年龄- 调整后的阿片类药物相关过量死亡、住院和急诊率 访问。尽管人们一直在努力遏制阿片类药物危机，但这项工作的大部分重点是 人口层面的战略没有充分关注社区动态和地方层面 阿片类药物使用的背景。本研究的总体目标是描述不断变化的特征 南加州美洲印第安人 (AI) 中阿片类药物滥用和过量风险的病因学 成年人通过实施研究方法来促进社区参与并告知 对阿片类药物流行病及时做出公共卫生反应。我们将在 4 年的时间内在当地收集 来自不同来源的相关数据（80 次访谈、200 次调查以及人口层面的数据） 阿片类药物过量死亡）捕获新出现的风险模式并对信息进行三角测量 为成人人工智能的预防和治疗服务的规划和分配提供信息。我们的 研究将遵循以下具体目标： 1. 确定个人的流行病概况 存在阿片类药物滥用和阿片类药物过量的风险； 2. 检查社区资产和能力 解决阿片类药物使用/滥用以及由此导致的过量用药的预防和治疗； 3. 开发 基于社区的监测工具，为社区减少阿片类药物的行动提供信息 服药过量死亡。结合多种信息源，进行更全面的分析 并可以生成阿片类药物危机的准确情况。这对公共卫生的意义 研究将持续评估导致阿片类药物滥用和过量的环境 人工智能部落之间不同社会和地理环境的风险。我们预计我们的 研究结果将为预防和治疗服务的短期和长期规划提供信息 满足加州部落的需求。