Mehrdad Khezri, Sarah Kimball, Chenziheng Allen Weng, Courtney McKnight, Don Des Jarlais
{"title":"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","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":"{\"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}","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}
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
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.
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.
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