Jaclyn M W Hughto1,2,3, Lily K Gordon4, Thomas J Stopka5, Patricia Case6, Wilson R Palacios7, Abigail Tapper8, Traci C Green2,4,8. 1. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA. 2. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. 3. Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA. 4. Warren Alpert School of Medicine, Brown University, Providence, RI, USA. 5. Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA. 6. Bouve College of Health Sciences, Northeastern University, Boston, MA, USA. 7. School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell, MA, USA. 8. Opioid Policy Research Collaborative, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
Abstract
Background: Fatal overdoses involving cocaine (powdered or crack) and fentanyl have increased nationally and in Massachusetts. It is unclear how overdose risk and preparedness to respond to an overdose differs by patterns of cocaine and opioid use. Methods: From 2017 to 2019, we conducted a nine-community mixed-methods study of Massachusetts residents who use drugs. Using survey data from 465 participants with past-month cocaine and/or opioid use, we examined global differences (p < 0.05) in overdose risk and response preparedness by patterns of cocaine and opioid use. Qualitative interviews (n = 172) contextualized survey findings. Results: The majority of the sample (66%) used cocaine and opioids in the past month; 18.9% used opioids alone; 9.2% used cocaine and had no opioid use history; and 6.2% used cocaine and had an opioid use history. Relative to those with a current/past history of opioid use, significantly fewer of those with no opioid use history were aware of fentanyl in the drug supply, carried naloxone, and had received naloxone training. Qualitative interviews documented how people who use cocaine and have no history of opioid use are largely unprepared to recognize and respond to an overdose. Conclusions: Public health efforts are needed to increase fentanyl awareness and overdose prevention preparedness among people primarily using cocaine.
Background: Fatal overdoses involving cocaine (powdered or crack) and fentanyl have increased nationally and in Massachusetts. It is unclear how overdose risk and preparedness to respond to an overdose differs by patterns of cocaine and opioid use. Methods: From 2017 to 2019, we conducted a nine-community mixed-methods study of Massachusetts residents who use drugs. Using survey data from 465 participants with past-month cocaine and/or opioid use, we examined global differences (p < 0.05) in overdose risk and response preparedness by patterns of cocaine and opioid use. Qualitative interviews (n = 172) contextualized survey findings. Results: The majority of the sample (66%) used cocaine and opioids in the past month; 18.9% used opioids alone; 9.2% used cocaine and had no opioid use history; and 6.2% used cocaine and had an opioid use history. Relative to those with a current/past history of opioid use, significantly fewer of those with no opioid use history were aware of fentanyl in the drug supply, carried naloxone, and had received naloxone training. Qualitative interviews documented how people who use cocaine and have no history of opioid use are largely unprepared to recognize and respond to an overdose. Conclusions: Public health efforts are needed to increase fentanyl awareness and overdose prevention preparedness among people primarily using cocaine.
Authors: Jacqueline E Goldman; Katherine M Waye; Kobe A Periera; Maxwell S Krieger; Jesse L Yedinak; Brandon D L Marshall Journal: Harm Reduct J Date: 2019-01-08
Authors: Karla D Wagner; Robert W Harding; Richard Kelley; Brian Labus; Silvia R Verdugo; Elizabeth Copulsky; Jeanette M Bowles; Maria Luisa Mittal; Peter J Davidson Journal: PLoS One Date: 2019-10-17 Impact factor: 3.240
Authors: P Todd Korthuis; Ryan R Cook; Canyon A Foot; Gillian Leichtling; Judith I Tsui; Thomas J Stopka; Judith Leahy; Wiley D Jenkins; Robin Baker; Brian Chan; Heidi M Crane; Hannah L Cooper; Judith Feinberg; William A Zule; Vivian F Go; Angela T Estadt; Robin M Nance; Gordon S Smith; Ryan P Westergaard; Brent Van Ham; Randall Brown; April M Young Journal: JAMA Netw Open Date: 2022-08-01