Katherine McLean1, Shannon M Monnat2, Khary Rigg3, Glenn E Sterner4, Ashton Verdery5. 1. a Administration of Justice , Penn State Greater Allegheny , McKeesport , Pennsylvania , USA. 2. b Sociology , Maxwell School of Citizenship and Public Affairs, Syracuse University , Syracuse , New York , USA. 3. c Department of Mental Health Law and Policy, College of Behavioral and Community Sciences , University of South Florida, Tampa , Florida, USA. 4. d The Justice Center for Research , The Pennsylvania State University, University Park , Pennsylvania, USA. 5. e Department of Sociology and Criminology , The Pennsylvania State University, University Park , Pennsylvania, USA.
Abstract
BACKGROUND: Urban areas in the United States have experienced a dramatic surge in fentanyl overdose deaths since 2014, a trend affecting both larger and smaller metropolitan areas. Encompassing only 1.2 million residents, Allegheny County, Pennsylvania, nevertheless saw 412 fentanyl-involved deaths in 2016, a number surpassed only by New York City and Cook County (Chicago), Illinois. OBJECTIVES: This article seeks to describe opioid users' perceptions of fentanyl in Allegheny and three adjacent counties; it further considers how the drug's emergence shapes some users' market behaviors and consumption practices. METHODS: This article reports on qualitative interview data (N = 30) collected as part of a larger, multi-phase, mixed methods study (N = 125) among individuals reporting past-year prescription opioid misuse or heroin use in four southwest Pennsylvania Counties. RESULTS: Most interviewees reported past-year suspected exposure to fentanyl, and many reported suffering or seeing suspected fentanyl overdoses. Where roughly one-third reported strategies for avoiding fentanyl, a small group of interviewees identified advantages to fentanyl, while still acknowledging its associated risks. Conclusions/Importance: Given users' diverse opinions around fentanyl, the distribution of fentanyl test strips may represent an effective response to the current crisis.
BACKGROUND: Urban areas in the United States have experienced a dramatic surge in fentanyloverdose deaths since 2014, a trend affecting both larger and smaller metropolitan areas. Encompassing only 1.2 million residents, Allegheny County, Pennsylvania, nevertheless saw 412 fentanyl-involved deaths in 2016, a number surpassed only by New York City and Cook County (Chicago), Illinois. OBJECTIVES: This article seeks to describe opioid users' perceptions of fentanyl in Allegheny and three adjacent counties; it further considers how the drug's emergence shapes some users' market behaviors and consumption practices. METHODS: This article reports on qualitative interview data (N = 30) collected as part of a larger, multi-phase, mixed methods study (N = 125) among individuals reporting past-year prescription opioid misuse or heroin use in four southwest Pennsylvania Counties. RESULTS: Most interviewees reported past-year suspected exposure to fentanyl, and many reported suffering or seeing suspected fentanyloverdoses. Where roughly one-third reported strategies for avoiding fentanyl, a small group of interviewees identified advantages to fentanyl, while still acknowledging its associated risks. Conclusions/Importance: Given users' diverse opinions around fentanyl, the distribution of fentanyl test strips may represent an effective response to the current crisis.
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