Purposeful Fentanyl Use and Associated Factors among Opioid-Dependent People Who Inject Drugs

Datos Bibliográficos

ID21645313
AutoresDivya K Chandra (Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA, autor de correspondencia), Frederick L Altice (0000-0002-7860-693X, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA), Michael M Copenhaver (Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, Connecticut, USA), Michael D Miller (0000-0002-4929-2257, University of Connecticut), Xin Zhou (0000-0003-2640-6431, Yale University), Zhou Xin (0000-0002-5186-6053, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA), Elizabeth DiDomizio (Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA), Roman Shrestha (0000-0003-4340-3101, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA)
Año2021
Volumen56
Número7
Páginas979-987
Fecha de publicación2021-06-07
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaSubstance Use & Misuse (JOURNAL)
Identificadores de la revistaISSN: 1082-6084 • E-ISSN: 1532-2491
EditorialInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10826084.2021.1901931
PMID33769199
OpenAlexW3138555976
IdiomaEN
Citas recibidas5
Referencias citadas36

Introduction: In recent years, opioid-related mortality has increased steadily in the United States. Fentanyl, a synthetic opioid, has been a primary driver of the current wave of overdose-related deaths. Little is known, however, about fentanyl use among opioid-dependent people who inject drugs (PWID). We, therefore, sought to characterize purposeful fentanyl use among PWID. Methods: A cross-sectional survey was administrated to 104 opioid-dependent PWID on methadone who self-reported drug- or sex-related risk behaviors. Participants were recruited between July 2018 and October 2019 from a methadone clinic in New Haven, Connecticut. Multivariable logistic regressions were used to identify independent correlates of purposeful fentanyl use. Results: Overall, 43.2% and 22.1% of the participants reported any (lifetime) or recent (past 30 days) purposeful fentanyl use, respectively. Independent correlates of any purposeful fentanyl use were younger age (aOR= 0.94; p = 0.021), recent daily injection (aOR= 3.52; p = 0.047), recent cocaine use (aOR= 3.54; p = 0.041), and moderate/severe depression (aOR= 3.82; p = 0.028). Independent correlates of recent purposeful fentanyl use were moderate/severe depression (aOR= 10.94; p = 0.031), recently sharing injection equipment (aOR= 2.96; p = 0.044), and recently engaging in transactional sex (aOR= 3.60; p = 0.026). Conclusions: These findings indicate that opioid-dependent PWID on methadone remain at increased risk for overdose given the high prevalence of ongoing purposeful fentanyl exposure. Interventions to reduce the harms associated with fentanyl use should target young PWID and active fentanyl users, with an emphasis on achieving adequate methadone dosage and screening and treating depression in methadone-maintained patients who preferentially seek fentanyl

Anesthesia · Drug · Fentanyl · Heroin · Logistic regression · Methadone · Opioid · Opioid overdose · Psychiatry · Forensic Toxicology and Drug Analysis · Medicine · Opioid Use Disorder Treatment · Substance Abuse Treatment and Outcomes · Emergency Medicine · Internal Medicine