Mixed methods study of polysubstance use to optimize overdose prevention

使用多种物质优化过量预防的混合方法研究

• 批准号: 10708120
• 负责人: DANIELLE GERMAN
• 金额: $ 35万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10708120
• 关键词: Mixed; methods; study; polysubstance; use

Project Summary Polydrug use (PDU) is increasingly implicated as a crucial factor underlying the U.S. overdose crisis, responsible for the deaths of over 100,000 Americans in the past year alone. Overdose is still highly associated with opioid use, but also overwhelmingly occurs in the context of combinations of drugs - notably stimulants and synthetic opioids. In 2019, the Northeast had the highest proportion of overdose deaths involving synthetic opioids and the largest absolute increase in stimulant-involved overdose deaths, and the Maryland overdose rate was among the highest in the country. The overdose prevention infrastructure has not yet been optimized to address PDU and the heterogeneity of associated experiences. With a multi-level perspective informed by life course and social network theories, we propose a multi-phase mixed methods study to examine patterns, trajectories, and risk and protective factors for PDU and overdose among people with various patterns of stimulant and opioid use. We will use behavioral data from the AIDS Linked to the IntraVenous Experience (ALIVE) study to identify PDU patterns and trajectories, mixed methods data from the 2019 Statewide Ethnographic Assessment of Drug Use and Services (SEADS) project to identify descriptive PDU trajectories and contextualize periods of drug use transition and stability, and complementary qualitative life course data collection (n=100) to explore recent changes and life course events aligned with different types of PDU, which will in turn inform statistical models of risk and protective factors for PDU types and overdose. Results from this study will allow program planners to estimate range and scale of heterogeneity among PDU and begin to disentangle intervention needs of unique sub-groups of PDU. This project will result in specific recommendations for tailored overdose risk reduction approaches and supportive resources for the heterogeneous needs of PDU and key turning points of PDU trajectories. We will translate our findings and conduct broad dissemination, working with local stakeholders, partner organizations, and governmental agencies to inform overdose and treatment programs in real time and across all three project years.

项目概要 多种药物的使用（PDU）越来越被认为是美国药物过量危机的一个关键因素， 仅去年一年就造成超过 10 万美国人死亡。过量服用的比例仍然很高 与阿片类药物的使用有关，但也绝大多数发生在药物组合的情况下 - 特别是 兴奋剂和合成阿片类药物。 2019年东北地区吸毒过量死亡比例最高 涉及合成阿片类药物和兴奋剂相关过量死亡的绝对增加幅度最大， 马里兰州用药过量率是全国最高的。预防过量用药的基础设施尚未 尚未针对 PDU 和相关体验的异质性进行优化。具有多层次 从生命历程和社交网络理论的角度来看，我们提出了一种多阶段混合方法 研究调查人群中 PDU 和药物过量的模式、轨迹、风险和保护因素 兴奋剂和阿片类药物的使用方式多种多样。我们将使用与艾滋病有关的行为数据 静脉内经验 (ALIVE) 研究，用于识别 PDU 模式和轨迹，来自混合方法的数据 2019 年全州毒品使用和服务民族志评估 (SEADS) 项目，以确定描述性 PDU 轨迹和药物使用过渡期和稳定性的背景，以及补充定性 生命历程数据收集（n=100）以探索与不同类型相关的近期变化和生命历程事件 PDU，这反过来将为 PDU 类型和过量的风险和保护因素的统计模型提供信息。 这项研究的结果将使项目规划者能够估计 PDU 之间异质性的范围和规模 并开始理清 PDU 独特子群体的干预需求。该项目将产生具体的 针对量身定制的减少用药过量风险方法和支持资源的建议 PDU 的异构需求和 PDU 轨迹的关键转折点。我们将转化我们的发现并 与当地利益相关者、伙伴组织和政府合作进行广泛传播 各机构在所有三个项目年度实时通报用药过量和治疗方案。