Associations between perceived illicit fentanyl use and infectious disease risks among people who inject drugs.
Adult
Communicable Diseases
/ epidemiology
Cross-Sectional Studies
Female
Fentanyl
/ administration & dosage
Ill-Housed Persons
/ statistics & numerical data
Humans
Illicit Drugs
Los Angeles
/ epidemiology
Male
Middle Aged
Needle Sharing
/ statistics & numerical data
Opioid-Related Disorders
/ epidemiology
Prevalence
Risk Factors
San Francisco
/ epidemiology
Substance Abuse, Intravenous
/ epidemiology
HCV
HIV
Illicit fentanyl use
Injection frequency
Syringe sharing
Journal
The International journal on drug policy
ISSN: 1873-4758
Titre abrégé: Int J Drug Policy
Pays: Netherlands
ID NLM: 9014759
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
25
03
2019
revised:
02
10
2019
accepted:
04
10
2019
pubmed:
18
11
2019
medline:
4
9
2020
entrez:
18
11
2019
Statut:
ppublish
Résumé
Over the last several years, fentanyl has been introduced into the illicit drug supply in the United States. While the impact of fentanyl on overdose fatalities is clear, the increase in fentanyl use may also be affecting drug use practices with implications for infectious disease transmission. We conducted a cross-sectional survey to explore associations of perceived illicit fentanyl use with opioid use frequency, injection frequency and syringe sharing among people who inject drugs in two California cities. People who inject drugs (PWID) were recruited from community settings in Los Angeles and San Francisco, CA from June 2017 to September 2018. Multivariable logistic regression was used to explore adjusted associations between perceived illicit fentanyl use and high frequency opioid use, high frequency injection and syringe sharing. Among the 395 study participants, the median age of participants was 44 years; 74% of participants were cisgender male; 73% reported to be homeless; 61% lived in San Francisco and 39% in Los Angeles. The prevalence of perceived illicit fentanyl use in the past six months was 50.4% (95% confidence interval (CI): 45.4%-55.3%) among PWID. Findings from our adjusted logistic regression models suggested that people reporting perceived illicit fentanyl use had a greater odds of high frequency opioid use (adjusted odds ratio (aOR) = 2.36; 95% CI: 1.43-3.91; p = 0.001), high frequency injection (aOR = 1.84; 95% CI: 1.08-3.13; p = 0.03) and receptive syringe sharing (aOR = 2.16; 95% CI: 1.06-4.36; p = 0.03), as compared to people using heroin and other street drugs but not fentanyl. People reporting perceived illicit fentanyl use were at increased risk for injection-related infectious disease risks. Actions must be taken to reduce these risks, including improved access to syringe service programs and opioid treatment and consideration of innovative approaches, such as supervised consumption services.
Sections du résumé
BACKGROUND
Over the last several years, fentanyl has been introduced into the illicit drug supply in the United States. While the impact of fentanyl on overdose fatalities is clear, the increase in fentanyl use may also be affecting drug use practices with implications for infectious disease transmission. We conducted a cross-sectional survey to explore associations of perceived illicit fentanyl use with opioid use frequency, injection frequency and syringe sharing among people who inject drugs in two California cities.
METHODS
People who inject drugs (PWID) were recruited from community settings in Los Angeles and San Francisco, CA from June 2017 to September 2018. Multivariable logistic regression was used to explore adjusted associations between perceived illicit fentanyl use and high frequency opioid use, high frequency injection and syringe sharing.
RESULTS
Among the 395 study participants, the median age of participants was 44 years; 74% of participants were cisgender male; 73% reported to be homeless; 61% lived in San Francisco and 39% in Los Angeles. The prevalence of perceived illicit fentanyl use in the past six months was 50.4% (95% confidence interval (CI): 45.4%-55.3%) among PWID. Findings from our adjusted logistic regression models suggested that people reporting perceived illicit fentanyl use had a greater odds of high frequency opioid use (adjusted odds ratio (aOR) = 2.36; 95% CI: 1.43-3.91; p = 0.001), high frequency injection (aOR = 1.84; 95% CI: 1.08-3.13; p = 0.03) and receptive syringe sharing (aOR = 2.16; 95% CI: 1.06-4.36; p = 0.03), as compared to people using heroin and other street drugs but not fentanyl.
CONCLUSION
People reporting perceived illicit fentanyl use were at increased risk for injection-related infectious disease risks. Actions must be taken to reduce these risks, including improved access to syringe service programs and opioid treatment and consideration of innovative approaches, such as supervised consumption services.
Identifiants
pubmed: 31733979
pii: S0955-3959(19)30278-6
doi: 10.1016/j.drugpo.2019.10.004
pmc: PMC6949008
mid: NIHMS1544449
pii:
doi:
Substances chimiques
Illicit Drugs
0
Fentanyl
UF599785JZ
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
299-304Subventions
Organisme : NIDA NIH HHS
ID : R01 DA038965
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA046444
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.
Références
Clin Infect Dis. 2014 Nov 15;59(10):1411-9
pubmed: 25114031
Addiction. 2012 Jul;107(7):1318-27
pubmed: 22248184
Addiction. 1997 Oct;92(10):1339-47
pubmed: 9489050
Lancet. 2005 Jul 23-29;366(9482):316-8
pubmed: 16039335
J Urban Health. 2010 Sep;87(5):839-50
pubmed: 20582573
Drug Alcohol Depend. 2018 Apr 1;185:253-259
pubmed: 29477084
Int J STD AIDS. 1997 Jul;8(7):437-45
pubmed: 9228591
Harm Reduct J. 2018 May 16;15(1):26
pubmed: 29769132
Lancet Infect Dis. 2014 Jan;14(1):5-6
pubmed: 24076276
Lancet. 2011 Apr 23;377(9775):1429-37
pubmed: 21497898
Int J Drug Policy. 2017 Aug;46:146-155
pubmed: 28735775
J Infect Dis. 2010 Oct 1;202(7):984-90
pubmed: 20726768
Addiction. 2004 Jul;99(7):885-96
pubmed: 15200584
Int J Drug Policy. 2009 Jan;20(1):90-2
pubmed: 18508256
Drug Alcohol Rev. 2018 Apr;37 Suppl 1:S314-S322
pubmed: 29405465
Clin Infect Dis. 2008 Jun 15;46(12):1852-8
pubmed: 18462109
Psychiatr Serv. 2014 Feb 1;65(2):158-70
pubmed: 24247147
Am J Epidemiol. 2002 Apr 1;155(7):645-53
pubmed: 11914192
Psychiatr Serv. 2014 Feb 1;65(2):146-57
pubmed: 24248468
Addiction. 2018 Mar;113(3):545-563
pubmed: 28891267
N Engl J Med. 2016 Jul 21;375(3):229-39
pubmed: 27468059
PLoS One. 2014 Jul 02;9(7):e101554
pubmed: 24988388
Mol Psychiatry. 2019 Dec;24(12):1868-1883
pubmed: 29934549
MMWR Morb Mortal Wkly Rep. 2017 Apr 14;66(14):382-386
pubmed: 28406883
Addiction. 2007 Apr;102(4):638-46
pubmed: 17286637
Am J Public Health. 2010 Aug;100(8):1449-53
pubmed: 20558797
Drug Alcohol Depend. 2007 Jul 10;89(2-3):214-22
pubmed: 17280802
Natl Vital Stat Rep. 2018 Dec;67(9):1-14
pubmed: 30707673
MMWR Morb Mortal Wkly Rep. 2015 May 1;64(16):443-4
pubmed: 25928470
NIDA Res Monogr. 1995;157:212-30
pubmed: 8684438
N Engl J Med. 2017 Feb 16;376(7):605-607
pubmed: 28199808
Clin Toxicol (Phila). 2018 Jan;56(1):37-42
pubmed: 28681615
Drug Alcohol Depend. 2018 Dec 1;193:69-74
pubmed: 30343236
J Acquir Immune Defic Syndr. 2004 Oct 1;37(2):1307-12
pubmed: 15385739
Subst Use Misuse. 2006;41(6-7):777-813
pubmed: 16809167
Addiction. 2009 Apr;104(4):614-9
pubmed: 19215603
Int J Drug Policy. 2010 Jan;21(1):56-63
pubmed: 19395249