Fentanyl Polysubstance Use Patterns and Their Associations With Hepatitis C Virus, Skin and Soft Tissue Infections, and Non-Fatal Overdose Among People Who Inject Drugs in New York City

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review Pub Date : 2025-06-03 DOI:10.1111/dar.14093

Mehrdad Khezri, Sarah Kimball, Chenziheng Allen Weng, Courtney McKnight, Don Des Jarlais

{"title":"Fentanyl Polysubstance Use Patterns and Their Associations With Hepatitis C Virus, Skin and Soft Tissue Infections, and Non-Fatal Overdose Among People Who Inject Drugs in New York City","authors":"Mehrdad Khezri, Sarah Kimball, Chenziheng Allen Weng, Courtney McKnight, Don Des Jarlais","doi":"10.1111/dar.14093","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Fentanyl's euphoric effects and short half-life may increase infectious disease transmission risks through frequent injecting and syringe sharing. We examined fentanyl polysubstance use (PSU) patterns and associations with hepatitis C virus (HCV), skin and soft tissue infections (SSTI), and non-fatal overdose among people who inject drugs (PWID) in New York City.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We recruited 495 PWID between October 2021 and July 2024. Participants were tested for HCV antibody and underwent urine toxicology screenings using the Premier Biotech 13-panel BioCup.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Fentanyl was identified in 83.6% of the sample; however, only 23.0% self-reported recent intentional fentanyl use. The most common fentanyl PSU combinations were fentanyl with methadone (67.9%), opiates (66.9%), cocaine (65.9%), cannabis (45.4%), xylazine (36.7%), heroin (35.5%), benzodiazepines (32.5%) and alcohol (29.3%). Compared to no fentanyl use, intentional fentanyl use was associated with HCV antibody seropositivity (aOR 3.44, 95% CI 1.75, 6.93), SSTIs (aOR 4.75, 1.66, 17.20) and non-fatal overdose (aOR 2.35, 1.15, 5.00). Co-use of fentanyl with opiates (aOR 2.08, 1.16, 3.82), cocaine (aOR 2.71, 1.52, 4.97), heroin (aOR 2.06, 1.11, 3.91), benzodiazepines (aOR 2.91, 1.55, 5.63) and alcohol (aOR 3.27, 1.72, 6.37) were associated with HCV. Co-use of fentanyl with benzodiazepines (aOR 2.08, 1.04, 4.34) and alcohol (aOR 2.57, 1.29, 5.37) were associated with non-fatal overdose.</p>\n </section>\n \n <section>\n \n <h3> Discussion and Conclusions</h3>\n \n <p>In addition to overdose, when combined with other psychoactive substances, fentanyl PSU is associated with a higher prevalence of infectious diseases. This underscores the need for tailored medication dosing for opioid use disorder and expanding access to syringe service programs and medical care for PWID in the fentanyl era.</p>\n </section>\n </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 5","pages":"1543-1555"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug and alcohol review","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/dar.14093","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Fentanyl's euphoric effects and short half-life may increase infectious disease transmission risks through frequent injecting and syringe sharing. We examined fentanyl polysubstance use (PSU) patterns and associations with hepatitis C virus (HCV), skin and soft tissue infections (SSTI), and non-fatal overdose among people who inject drugs (PWID) in New York City.

Methods

We recruited 495 PWID between October 2021 and July 2024. Participants were tested for HCV antibody and underwent urine toxicology screenings using the Premier Biotech 13-panel BioCup.

Results

Fentanyl was identified in 83.6% of the sample; however, only 23.0% self-reported recent intentional fentanyl use. The most common fentanyl PSU combinations were fentanyl with methadone (67.9%), opiates (66.9%), cocaine (65.9%), cannabis (45.4%), xylazine (36.7%), heroin (35.5%), benzodiazepines (32.5%) and alcohol (29.3%). Compared to no fentanyl use, intentional fentanyl use was associated with HCV antibody seropositivity (aOR 3.44, 95% CI 1.75, 6.93), SSTIs (aOR 4.75, 1.66, 17.20) and non-fatal overdose (aOR 2.35, 1.15, 5.00). Co-use of fentanyl with opiates (aOR 2.08, 1.16, 3.82), cocaine (aOR 2.71, 1.52, 4.97), heroin (aOR 2.06, 1.11, 3.91), benzodiazepines (aOR 2.91, 1.55, 5.63) and alcohol (aOR 3.27, 1.72, 6.37) were associated with HCV. Co-use of fentanyl with benzodiazepines (aOR 2.08, 1.04, 4.34) and alcohol (aOR 2.57, 1.29, 5.37) were associated with non-fatal overdose.

Discussion and Conclusions

In addition to overdose, when combined with other psychoactive substances, fentanyl PSU is associated with a higher prevalence of infectious diseases. This underscores the need for tailored medication dosing for opioid use disorder and expanding access to syringe service programs and medical care for PWID in the fentanyl era.

查看原文本刊更多论文

纽约市注射毒品人群中芬太尼多物质使用模式及其与丙型肝炎病毒、皮肤和软组织感染以及非致命性过量的关系

芬太尼的兴奋作用和较短的半衰期可能通过频繁注射和共用注射器增加传染病传播的风险。我们研究了芬太尼多物质使用（PSU）模式及其与丙型肝炎病毒（HCV）、皮肤和软组织感染（SSTI）和纽约市注射吸毒者（PWID）中非致命性过量使用（PSU）的关系。方法：我们于2021年10月至2024年7月招募了495名PWID患者。参与者接受HCV抗体测试，并使用Premier Biotech的13组BioCup进行尿液毒理学筛查。结果：芬太尼检出率为83.6%；然而，只有23.0%的人自我报告最近有意使用芬太尼。最常见的芬太尼PSU组合是芬太尼与美沙酮（67.9%）、阿片类药物（66.9%）、可卡因（65.9%）、大麻（45.4%）、噻嗪（36.7%）、海洛因（35.5%）、苯二氮卓类药物（32.5%）和酒精（29.3%）。与不使用芬太尼相比，故意使用芬太尼与HCV抗体血清阳性（aOR 3.44, 95% CI 1.75, 6.93）、SSTIs （aOR 4.75, 1.66, 17.20）和非致命性用药过量（aOR 2.35, 1.15, 5.00）相关。芬太尼与阿片类药物（aOR 2.08、1.16、3.82）、可卡因（aOR 2.71、1.52、4.97）、海洛因（aOR 2.06、1.11、3.91）、苯二氮卓类药物（aOR 2.91、1.55、5.63）和酒精（aOR 3.27、1.72、6.37）共使用与HCV相关。芬太尼与苯二氮卓类药物（aOR 2.08、1.04、4.34）和酒精（aOR 2.57、1.29、5.37）合用与非致死性用药过量相关。讨论和结论：除了过量使用外，当与其他精神活性物质联合使用时，芬太尼PSU与较高的传染病流行率有关。这强调了需要为阿片类药物使用障碍量身定制药物剂量，并扩大芬太尼时代PWID获得注射器服务计划和医疗保健的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Drug and alcohol review SUBSTANCE ABUSE-

CiteScore

4.80

自引率

10.50%

发文量

151

期刊介绍： Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.