TY - JOUR
T1 - Being “hooked up” during a sharp increase in the availability of illicitly manufactured fentanyl
T2 - Adaptations of drug using practices among people who use drugs (PWUD) in New York City
AU - McKnight, C.
AU - Des Jarlais, D. C.
N1 - Funding Information:
Funding for this study was provided through a Pilot Project Award from the Center for Drug Use and HIV Research (CDUHR) at the NYU School of Nursing. Funding for CDUHR is provided by US NIH/NIDA, Grant P30 DA011041. Support for Dr. Des Jarlais was provided by US NIH/NIDA, Grant 5R01DA003574-34. A special thanks to Janie Simmons for assistance with project development and to the three NYC SSP that served as recruitment sites. Finally, we are incredibly grateful for the individuals who participated in the study, particularly for their wisdom, generosity and patience.
Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/10
Y1 - 2018/10
N2 - Illicitly manufactured fentanyl (IMF), a category of synthetic opioids 50–100 times more potent than morphine, is increasingly being added to heroin and other drugs in the United States (US). Persons who use drugs (PWUD) are frequently unaware of the presence of fentanyl in drugs. Use of heroin and other drugs containing fentanyl has been linked to sharp increases in opioid mortality. In New York City (NYC), opioid-related mortality increased from 8.2 per 100,000 residents in 2010 to 19.9 per 100,000 residents in 2016; and, in 2016, fentanyl accounted for 44% of NYC overdose deaths. Little is known about how PWUD are adapting to the increase in fentanyl and overdose mortality. This study explores PWUDs’ adaptations to drug using practices due to fentanyl. In-depth qualitative interviews were conducted with 55 PWUD at three NYC syringe services programs (SSP) about perceptions of fentanyl, overdose experiences and adaptations of drug using practices. PWUD utilized test shots, a consistent drug dealer, fentanyl test strips, naloxone, getting high with or near others and reducing drug use to protect from overdose. Consistent application of these methods was often negated by structural level factors such as stigma, poverty and homelessness. To address these, multi-level overdose prevention approaches should be implemented in order to reduce the continuing increase in opioid mortality.
AB - Illicitly manufactured fentanyl (IMF), a category of synthetic opioids 50–100 times more potent than morphine, is increasingly being added to heroin and other drugs in the United States (US). Persons who use drugs (PWUD) are frequently unaware of the presence of fentanyl in drugs. Use of heroin and other drugs containing fentanyl has been linked to sharp increases in opioid mortality. In New York City (NYC), opioid-related mortality increased from 8.2 per 100,000 residents in 2010 to 19.9 per 100,000 residents in 2016; and, in 2016, fentanyl accounted for 44% of NYC overdose deaths. Little is known about how PWUD are adapting to the increase in fentanyl and overdose mortality. This study explores PWUDs’ adaptations to drug using practices due to fentanyl. In-depth qualitative interviews were conducted with 55 PWUD at three NYC syringe services programs (SSP) about perceptions of fentanyl, overdose experiences and adaptations of drug using practices. PWUD utilized test shots, a consistent drug dealer, fentanyl test strips, naloxone, getting high with or near others and reducing drug use to protect from overdose. Consistent application of these methods was often negated by structural level factors such as stigma, poverty and homelessness. To address these, multi-level overdose prevention approaches should be implemented in order to reduce the continuing increase in opioid mortality.
KW - Fentanyl
KW - Harm reduction
KW - Heroin
KW - Overdose
UR - http://www.scopus.com/inward/record.url?scp=85054050225&partnerID=8YFLogxK
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U2 - 10.1016/j.drugpo.2018.08.004
DO - 10.1016/j.drugpo.2018.08.004
M3 - Article
C2 - 30176422
AN - SCOPUS:85054050225
SN - 0955-3959
VL - 60
SP - 82
EP - 88
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
ER -