Beyond a spec: assessing heterogeneity in the unregulated opioid supply

Harm Reduction Journal, Год журнала: 2024, Номер 21(1)

Опубликована: Март 15, 2024

Drug checking services aim to provide compositional information for the illicit drug supply and are being employed in public health responses extreme rates of overdose associated with fentanyl within street opioids. The technologies used these range from basic qualitative tests, such as immunoassay test strips, comprehensive quantitative analyses, mass spectrometry. In general, there is concern that heterogeneity a mixture adds significant uncertainty when using results based on small subsamples. presence hot spots active components this context often termed 'chocolate chip cookie effect'. Establishing limitations service essential interpretation results.

Язык: Английский

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Utilization of drug checking services in Austria: a cross-sectional online survey

Harm Reduction Journal, Год журнала: 2025, Номер 22(1)

Опубликована: Фев. 15, 2025

The use of psychoactive substances is a key public health issue due to its impact on mental, physical, and social health. Integrated drug checking well-known harm reduction addiction prevention measure currently implemented in four federal states Austria. aim this study investigate the prevalence among web-survey sample people who drugs (PWUD) Austria examine differences socio-demographic substance characteristics between individuals with without experience. In addition, reasons for not using these services are explored. A secondary data analysis Austrian from European Web Survey Drugs (EWSD), targeted survey conducted March May 2021 was performed. Based reported experience, set divided into two groups - those experience – compared. PWUD (n = 1113), 20.1% prior service 224) 889) differed significantly both univariate multivariate analyses. Univariate revealed significant terms age, household composition, highest level education, employment status, region residence, prevalences treatment Participants used cannabis only had less checking. No were found regarding gender income. While logistic regression showed relationship sociodemographic predictors relatively weak. main having yet included high trust source supply (68%), confidence receiving quality (64%), lack availability near place residence (62%). results indicate that well-accepted trusted but equally accessed by accessible all PWUD. Specifically, residing parents or rural small-town areas access less. conclusion, there considerable potential expanding accessibility Austria, particularly reach underserved could benefit intervention.

Язык: Английский

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Challenges and future perspective of illicit drug sensors and strategies

Elsevier eBooks, Год журнала: 2025, Номер unknown, С. 351 - 373

Опубликована: Янв. 1, 2025

Язык: Английский

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“Everyone says ‘safe sex’ but no one ever says ‘safe drugs’, you know?”: Perspectives on the intersection of drug checking services, drug policy and the overdose crisis

PLoS ONE, Год журнала: 2025, Номер 20(4), С. e0321574 - e0321574

Опубликована: Апрель 17, 2025

Background Overdose deaths have continued to rise in the US despite heightened public attention and resources. Drug checking shows promise for integration into existing services people who use drugs (PWUD) across North America. Amidst backdrop of rising overdose emerging funds harm reduction initiatives, this manuscript explores landscape drug America perspectives on improved with a diverse set PWUD based San Francisco American experts. Methods Two separate samples stakeholders, ‘providers’ ‘clients’ were recruited. Providers participated in-depth semi-structured qualitative interviews over Zoom their experiences advocating operating Canada. Clients used lived or commuted Bay Area November 2022. Interviews transcribed fully analyzed using thematic analysis methods. Results clients identified ongoing instability supply that is exacerbating risk while also identifying groups would benefit from greater access services. Both believed paradoxical impacts fentanyl crisis at core created barriers implementation expansion these services, hurting providers. Additionally, providers reflected social policy challenges improvement communities. Conclusion remains underleveraged, particularly respect most vulnerable PWUD. contended must become more responsive an ever changing dangerous

Язык: Английский

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Recommendations from people who use drugs in Philadelphia, PA about structuring point-of-care drug checking

Harm Reduction Journal, Год журнала: 2024, Номер 21(1)

Опубликована: Янв. 30, 2024

Abstract Background Adulterants, such as fentanyl and xylazine, among others, are present in a high percentage of the illicit drug supply, increasing risk for overdose other adverse health events people who use drugs (PWUD). Point-of-care checking identifies components sample delivers results consumers. To successfully meet diverse needs PWUD, more information is needed about utility checking, motivations using services contextualized broader comments on hypothesized actions to be taken after receiving results, ideal structure program. Methods In December 2021, semi-structured interviews were conducted with 40 PWUD accessing harm reduction Philadelphia, PA. Participants asked opinions preferences future Interviews audio recorded, transcribed coded content analysis identify themes. Results primarily White (52.5%) male (60%). Heroin/fentanyl was most frequently reported used (72.5%, n = 29), followed by crack cocaine (60.0%, 24) powder (47.5%, 19). Emerging themes from potential consumers included universal interest program, intentions change based deep concern unpredictability engaging multiple practices, concerns privacy while service. Conclusions We offer recommendations sites considering point-of-care regarding staffing, safety, logistics, cultural competency. Programs should leverage pre-existing relationships organizations serving hire lived experiences use. They work local or state government issue protections programs ensure service anonymous that data collection minimized keep program low-threshold. will ideally operate locations span “atmosphere” (e.g., clinical drop-in culture), in-depth education participants engage community advisory board, not partner law enforcement.

Язык: Английский

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How do we understand the value of drug checking as a component of harm reduction services? A qualitative exploration of client and provider perspectives

Harm Reduction Journal, Год журнала: 2024, Номер 21(1)

Опубликована: Май 11, 2024

Abstract Background Mortality related to opioid overdose in the U.S. has risen sharply past decade. In California, death rates more than tripled from 2018 2021, and deaths synthetic opioids such as fentanyl increased seven times those three years alone. Heightened attention this crisis attracted funding programming opportunities for prevention harm reduction interventions. Drug checking services offer people who use drugs opportunity test chemical content of their own supply, but are not widely used North America. We report on qualitative data providers clients drug services, explore how these used, experienced, considered. Methods conducted in-depth semi-structured key informant interviews across two samples stakeholders: “clients” (individuals receive services) “providers” (subject matter experts providing clinical drugs). Provider were via Zoom June-November, 2022. Client person San Francisco over a one-week period November Data analyzed following tenets thematic analysis. Results found that value includes extends well beyond prevention. Participants discussed ways can fill regulatory vacuum, serve tool informal market regulation at community level, empower public health surveillance systems response. present our findings within themes: (1) role prevention; (2) benefits overall agency, health, wellbeing drugs; (3) impacts levels. Conclusion This study contributes growing evidence effectiveness mitigating risks associated with substance use, including overdose, through enabling sell supply. It further discussions around utility reduction, order inform legislation allocation.

Язык: Английский

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Associations among drug acquisition and use behaviors, psychosocial attributes, and opioid-involved overdoses

BMC Public Health, Год журнала: 2024, Номер 24(1)

Опубликована: Июнь 25, 2024

Abstract Aims This study sought to develop and assess an exploratory model of how demographic psychosocial attributes, drug use or acquisition behaviors interact affect opioid-involved overdoses. Design We conducted confirmatory factor analysis (EFA/CFA) identify a structure for ten behaviors. then evaluated alternative structural equation models incorporating the identified factors, adding attributes as predictors past-year opioid overdose. Setting participants used interview data collected two studies recruiting opioid-misusing receiving services from community-based syringe program. The first investigated current attitudes toward drug-checking ( N = 150). second was RCT assessing telehealth versus in-person medical appointment disorder treatment referral 270). Measurements Demographics included gender, age, race/ethnicity, education, socioeconomic status. Psychosocial measures were homelessness, psychological distress, trauma. Self-reported drug-related risk using alone, having new supplier, opioids with benzodiazepines/alcohol, preferring fentanyl. Past-year overdoses dichotomized into experiencing none any. Findings EFA/CFA revealed two-factor one reflecting selected (CFI .984, TLI .981, RMSEA .024) accounted 13.1% overdose probability variance. A latent variable representing indirectly associated increase in (β .234, p .001), mediated by variables: .683, < .001) .567, .001). Drug .287, .04) but not .105, .461) also had significant, positive direct effect on No significant indirect predictors. Conclusions particularly through associations risky drug-using Further research is needed replicate these findings populations at high-risk opioid-related generalizability refine metrics characteristics.

Язык: Английский

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Barriers to, and Facilitators of, Checking Drugs for Adulterants in the Era of Fentanyl and Xylazine: Qualitative Study

JMIR Formative Research, Год журнала: 2024, Номер 8, С. e56755 - e56755

Опубликована: Июль 3, 2024

Overdose deaths continue to reach new records in New York City and nationwide, largely driven by adulterants such as fentanyl xylazine the illicit drug supply. Unknowingly consuming adulterated substances dramatically increases risks of overdose other health problems, especially when individuals consume multiple are exposed a combination drugs they did not intend take. Although test strips more sophisticated devices enable people check for including prior consumption often available free charge, many who use decline them.

Язык: Английский

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Feasibility study of using mobile phone-based experience sampling to assess drug checking by opioid street drug users

Pilot and Feasibility Studies, Год журнала: 2023, Номер 9(1)

Опубликована: Май 26, 2023

Abstract Background To date, evaluations of take-home fentanyl (and/or benzodiazepine) test strip use — the most common form drug checking services and potential effects on overdose risk have relied retrospective accounts for some preceding time period, usually a week to several months. Such accounts, however, are subject recall memory biases. This pilot study assessed feasibility using experiential sampling collect daily information in situ associated reduction primary outcomes among sample street opioid users compared results reports. Methods We recruited 12 participants from Chicago-based syringe program. Participants were 18 years age or older, reported opioids purchased 3 + times per past month, had an available Android mobile phone. A phone-based app was programmed provided each participant along with supply benzodiazepine strips instructions over 21 days. Comparable data collected via follow-up in-person surveys at conclusion report collection. Results found reasonably high rate reporting (63.5%) submitting reports 160 “person-days” out 252 possible submitted average 13 Reports frequency varied between relatively higher percentage days/time obtained also proportions behaviors reviews. Conclusions believe support experience users. Although resource intensive comparison reports, potentially provides more detailed its association and, ultimately, fewer overdoses. Needed larger trials validation studies identify optimum protocol collecting accurate behavior.

Язык: Английский

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Development and validation of a liquid chromatography tandem mass spectrometry method for the analysis of 53 benzodiazepines in illicit drug samples

Forensic Chemistry, Год журнала: 2023, Номер 35, С. 100512 - 100512

Опубликована: Июнь 16, 2023

Язык: Английский

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