Susan G Sherman1, Kenneth B Morales2, Ju Nyeong Park2, Michelle McKenzie3, Brandon D L Marshall4, Traci Craig Green5. 1. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. Electronic address: ssherman@jhu.edu. 2. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. 3. Miriam Hospital and Alpert Medical School of Brown University, Providence, RI, United States. 4. Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States. 5. Department of Emergency Medicine, Boston University School of Medicine, Boston, MA, United States; Departments of Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, RI, United States.
Abstract
BACKGROUND: North America is experiencing a rising trend of opioid overdose exacerbated primarily in recent years through adulteration of the heroin supply with fentanyl and its analogues. The east coast of the United States has been particularly hard hit by the epidemic. In three east coast states of Maryland, Massachusetts and Rhode Island, fentanyl has been detected in over half of all overdoses with available toxicology screens. To determine the acceptability of drug checking involving fentanyl test strips (FTS) or other technologies among those at high risk for overdose, we assessed correlates of intention to utilize such services and logistical preferences among people who use drugs (PWUD). METHODS: Through FORECAST (the Fentanyl Overdose REduction Checking Analysis STudy), street-based PWUD (N = 334) were recruited in Baltimore, Maryland, Boston, Massachusetts, and Providence, Rhode Island. Questionnaires 7were administered from June to October 2017 and ascertained drug use, overdose history, fentanyl knowledge, and drug checking intent and logistical preferences. Pearson's χ2 and logistic regression determined factors associated with drug checking intent. RESULTS: Overall, 84% were concerned about fentanyl, 63% had ever overdosed, and 42% had ever witnessed a fatal overdose. Ninety percent felt drug checking would help them prevent an overdose, the majority of those interested would utilize drug checking at least daily (54%). Factors independently associated with intent to use drug checking included: older age (aOR: 1.5, 95% CI: 1.3-1.8); homelessness (aOR: 0.6, 95% CI: 0.5-0.7); being non-white (aOR: 2.0, 95% CI: 1.0-4.0); witnessing ≥1 fatal overdose (aOR: 1.6, 95% CI:1.1-2.3); and suspected recent fentanyl exposure (aOR: 1.8, 95% CI: 1.1-3.1). CONCLUSIONS: The majority of PWUD endorsed drug checking for overdose prevention, with intent amplified by having witnessed a fatal overdose and recent fentanyl exposure. Drug checking should be part of a comprehensive approach to address the risks associated with the proliferation of fentanyl.
BACKGROUND: North America is experiencing a rising trend of opioid overdose exacerbated primarily in recent years through adulteration of the heroin supply with fentanyl and its analogues. The east coast of the United States has been particularly hard hit by the epidemic. In three east coast states of Maryland, Massachusetts and Rhode Island, fentanyl has been detected in over half of all overdoses with available toxicology screens. To determine the acceptability of drug checking involving fentanyl test strips (FTS) or other technologies among those at high risk for overdose, we assessed correlates of intention to utilize such services and logistical preferences among people who use drugs (PWUD). METHODS: Through FORECAST (the FentanylOverdose REduction Checking Analysis STudy), street-based PWUD (N = 334) were recruited in Baltimore, Maryland, Boston, Massachusetts, and Providence, Rhode Island. Questionnaires 7were administered from June to October 2017 and ascertained drug use, overdose history, fentanyl knowledge, and drug checking intent and logistical preferences. Pearson's χ2 and logistic regression determined factors associated with drug checking intent. RESULTS: Overall, 84% were concerned about fentanyl, 63% had ever overdosed, and 42% had ever witnessed a fatal overdose. Ninety percent felt drug checking would help them prevent an overdose, the majority of those interested would utilize drug checking at least daily (54%). Factors independently associated with intent to use drug checking included: older age (aOR: 1.5, 95% CI: 1.3-1.8); homelessness (aOR: 0.6, 95% CI: 0.5-0.7); being non-white (aOR: 2.0, 95% CI: 1.0-4.0); witnessing ≥1 fatal overdose (aOR: 1.6, 95% CI:1.1-2.3); and suspected recent fentanyl exposure (aOR: 1.8, 95% CI: 1.1-3.1). CONCLUSIONS: The majority of PWUD endorsed drug checking for overdose prevention, with intent amplified by having witnessed a fatal overdose and recent fentanyl exposure. Drug checking should be part of a comprehensive approach to address the risks associated with the proliferation of fentanyl.
Authors: Alyona Mazhnaya; Allison O'Rourke; Rebecca Hamilton White; Ju Nyeong Park; Michael E Kilkenny; Susan G Sherman; Sean T Allen Journal: Subst Use Misuse Date: 2020-05-22 Impact factor: 2.164
Authors: Ju Nyeong Park; Susan G Sherman; Saba Rouhani; Kenneth B Morales; Michelle McKenzie; Sean T Allen; Brandon D L Marshall; Traci C Green Journal: J Urban Health Date: 2019-06 Impact factor: 3.671
Authors: Keri N Althoff; Kathryn M Leifheit; Ju Nyeong Park; Aruna Chandran; Susan G Sherman Journal: Drug Alcohol Depend Date: 2020-09-25 Impact factor: 4.492
Authors: Ju Nyeong Park; Saba Rouhani; Leo Beletsky; Louise Vincent; Brendan Saloner; Susan G Sherman Journal: Milbank Q Date: 2020-08-18 Impact factor: 4.911