Megan Buresh1, Becky L Genberg2, Jacquie Astemborski3, Gregory D Kirk4, Shruti H Mehta5. 1. Division of Addiction Medicine, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Mason Lord Building, East Tower, 2nd floor, Baltimore, MD 21224, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, United States. Electronic address: mburesh2@jhmi.edu. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, United States. Electronic address: bgenberg@jhu.edu. 3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, United States. Electronic address: jastemb1@jhu.edu. 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, United States; Department of Infectious Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States. Electronic address: gdk@jhu.edu. 5. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, United States. Electronic address: smehta@jhu.edu.
Abstract
BACKGROUND: Fentanyl-related mortality continues to increase in the US, but knowledge of the drivers of fentanyl use (both intentional and unintentional) remains limited. We conducted a rapid assessment to characterize knowledge, attitudes and practices related to fentanyl use in a community-based cohort of current and former people who inject drugs (PWID) in Baltimore, Maryland. METHODS: Between November 2017 and June 2018, participants of the AIDS Linked to the IntraVenous Experience (ALIVE) cohort completed a survey related to fentanyl use. Correlates of recent (past 6 months) fentanyl use and preference for fentanyl-contaminated and -substituted heroin (FASH) were examined using logistic regression among persons who reported using drugs in the prior six months. RESULTS: Of 994 participants, 28% reported ever having used fentanyl, with 58% of those reporting recent use. Independent correlates of recent fentanyl use among the subset of participants reporting recent (past 6 month) drug use were younger age, male sex, homelessness, opioid use, cocaine use, and daily injection (p < 0.05 for all). 18% of those who recently used fentanyl reported preference for FASH, which was associated with younger age, homelessness and daily injection (p < 0.05 for all). CONCLUSIONS: Recent fentanyl use was commonly reported. Interventions to reduce the harms associated with fentanyl use should target young, homeless PWID who may be more likely to seek out fentanyl.
BACKGROUND: Fentanyl-related mortality continues to increase in the US, but knowledge of the drivers of fentanyl use (both intentional and unintentional) remains limited. We conducted a rapid assessment to characterize knowledge, attitudes and practices related to fentanyl use in a community-based cohort of current and former people who inject drugs (PWID) in Baltimore, Maryland. METHODS: Between November 2017 and June 2018, participants of the AIDS Linked to the IntraVenous Experience (ALIVE) cohort completed a survey related to fentanyl use. Correlates of recent (past 6 months) fentanyl use and preference for fentanyl-contaminated and -substituted heroin (FASH) were examined using logistic regression among persons who reported using drugs in the prior six months. RESULTS: Of 994 participants, 28% reported ever having used fentanyl, with 58% of those reporting recent use. Independent correlates of recent fentanyl use among the subset of participants reporting recent (past 6 month) drug use were younger age, male sex, homelessness, opioid use, cocaine use, and daily injection (p < 0.05 for all). 18% of those who recently used fentanyl reported preference for FASH, which was associated with younger age, homelessness and daily injection (p < 0.05 for all). CONCLUSIONS: Recent fentanyl use was commonly reported. Interventions to reduce the harms associated with fentanyl use should target young, homeless PWID who may be more likely to seek out fentanyl.
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