Fentanyl and Drug Overdose: Perceptions of Fentanyl Risk, Overdose Risk Behaviors, and Opportunities for Intervention among People who use Opioids in Baltimore, USA

Research output: Contribution to journalArticle

Abstract

Background: Fentanyl-related mortality has skyrocketed among people who use opioids (PWUO) in North America. The current study of PWUO aims to examine the perceived fentanyl risk and training needs; fatal overdose prevention behaviors; and, feasibility of a peer education approach to reducing fentanyl-related fatal overdoses in Baltimore, Maryland, USA. Methods: 316 street-recruited PWUO were interviewed about fentanyl in Baltimore, MD. Results: Most participants (56%) reported that “all” or “almost all” heroin in Baltimore was adulterated with fentanyl and were worried (75%) about their drug buddies overdosing on fentanyl. Half (54%) the participants felt that they needed more training to respond to an overdose. Many participants (66%) reported receiving naloxone or a prescription for it, yet only 17% carried naloxone with them “often” or “always.” Among people who inject drugs (PWID) only 13% had naloxone available “often” or “always” when they injected with others, and 51% “often” or “always” injected alone. Almost half of participants (47%) were “very willing” to talk with people in their neighborhood about fentanyl. Conclusions: The majority of PWUO perceived that most heroin in Baltimore was adulterated with fentanyl, yet most did not carry naloxone and PWID often did so alone. Given the high perceived risk of fentanyl and relatively low uptake of fatal overdose prevention behaviors, there is an urgency for safe injection facilities, access to medically assisted treatment, and programs that work with the drug-using community to deliver overdose prevention training as well as promote behaviors to carry naloxone and not use drugs alone.

Original languageEnglish (US)
JournalSubstance Use and Misuse
DOIs
StatePublished - Jan 1 2019

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Drug Overdose
Baltimore
Fentanyl
Risk-Taking
risk behavior
Opioid Analgesics
drug
Naloxone
Pharmaceutical Preparations
Heroin
Homeless Persons
Architectural Accessibility
drug use
medication
North America
mortality
Prescriptions
Education

Keywords

  • Fentanyl
  • naloxone
  • opioid
  • overdose

ASJC Scopus subject areas

  • Health(social science)
  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

@article{843357c676ff4a82afdddf1777eb3eb4,
title = "Fentanyl and Drug Overdose: Perceptions of Fentanyl Risk, Overdose Risk Behaviors, and Opportunities for Intervention among People who use Opioids in Baltimore, USA",
abstract = "Background: Fentanyl-related mortality has skyrocketed among people who use opioids (PWUO) in North America. The current study of PWUO aims to examine the perceived fentanyl risk and training needs; fatal overdose prevention behaviors; and, feasibility of a peer education approach to reducing fentanyl-related fatal overdoses in Baltimore, Maryland, USA. Methods: 316 street-recruited PWUO were interviewed about fentanyl in Baltimore, MD. Results: Most participants (56{\%}) reported that “all” or “almost all” heroin in Baltimore was adulterated with fentanyl and were worried (75{\%}) about their drug buddies overdosing on fentanyl. Half (54{\%}) the participants felt that they needed more training to respond to an overdose. Many participants (66{\%}) reported receiving naloxone or a prescription for it, yet only 17{\%} carried naloxone with them “often” or “always.” Among people who inject drugs (PWID) only 13{\%} had naloxone available “often” or “always” when they injected with others, and 51{\%} “often” or “always” injected alone. Almost half of participants (47{\%}) were “very willing” to talk with people in their neighborhood about fentanyl. Conclusions: The majority of PWUO perceived that most heroin in Baltimore was adulterated with fentanyl, yet most did not carry naloxone and PWID often did so alone. Given the high perceived risk of fentanyl and relatively low uptake of fatal overdose prevention behaviors, there is an urgency for safe injection facilities, access to medically assisted treatment, and programs that work with the drug-using community to deliver overdose prevention training as well as promote behaviors to carry naloxone and not use drugs alone.",
keywords = "Fentanyl, naloxone, opioid, overdose",
author = "Latkin, {Carl A} and Lauren Dayton and Melissa Davey-Rothwell and Tobin, {Karin E}",
year = "2019",
month = "1",
day = "1",
doi = "10.1080/10826084.2018.1555597",
language = "English (US)",
journal = "Substance Use and Misuse",
issn = "1082-6084",
publisher = "Informa Healthcare",

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TY - JOUR

T1 - Fentanyl and Drug Overdose

T2 - Perceptions of Fentanyl Risk, Overdose Risk Behaviors, and Opportunities for Intervention among People who use Opioids in Baltimore, USA

AU - Latkin, Carl A

AU - Dayton, Lauren

AU - Davey-Rothwell, Melissa

AU - Tobin, Karin E

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Fentanyl-related mortality has skyrocketed among people who use opioids (PWUO) in North America. The current study of PWUO aims to examine the perceived fentanyl risk and training needs; fatal overdose prevention behaviors; and, feasibility of a peer education approach to reducing fentanyl-related fatal overdoses in Baltimore, Maryland, USA. Methods: 316 street-recruited PWUO were interviewed about fentanyl in Baltimore, MD. Results: Most participants (56%) reported that “all” or “almost all” heroin in Baltimore was adulterated with fentanyl and were worried (75%) about their drug buddies overdosing on fentanyl. Half (54%) the participants felt that they needed more training to respond to an overdose. Many participants (66%) reported receiving naloxone or a prescription for it, yet only 17% carried naloxone with them “often” or “always.” Among people who inject drugs (PWID) only 13% had naloxone available “often” or “always” when they injected with others, and 51% “often” or “always” injected alone. Almost half of participants (47%) were “very willing” to talk with people in their neighborhood about fentanyl. Conclusions: The majority of PWUO perceived that most heroin in Baltimore was adulterated with fentanyl, yet most did not carry naloxone and PWID often did so alone. Given the high perceived risk of fentanyl and relatively low uptake of fatal overdose prevention behaviors, there is an urgency for safe injection facilities, access to medically assisted treatment, and programs that work with the drug-using community to deliver overdose prevention training as well as promote behaviors to carry naloxone and not use drugs alone.

AB - Background: Fentanyl-related mortality has skyrocketed among people who use opioids (PWUO) in North America. The current study of PWUO aims to examine the perceived fentanyl risk and training needs; fatal overdose prevention behaviors; and, feasibility of a peer education approach to reducing fentanyl-related fatal overdoses in Baltimore, Maryland, USA. Methods: 316 street-recruited PWUO were interviewed about fentanyl in Baltimore, MD. Results: Most participants (56%) reported that “all” or “almost all” heroin in Baltimore was adulterated with fentanyl and were worried (75%) about their drug buddies overdosing on fentanyl. Half (54%) the participants felt that they needed more training to respond to an overdose. Many participants (66%) reported receiving naloxone or a prescription for it, yet only 17% carried naloxone with them “often” or “always.” Among people who inject drugs (PWID) only 13% had naloxone available “often” or “always” when they injected with others, and 51% “often” or “always” injected alone. Almost half of participants (47%) were “very willing” to talk with people in their neighborhood about fentanyl. Conclusions: The majority of PWUO perceived that most heroin in Baltimore was adulterated with fentanyl, yet most did not carry naloxone and PWID often did so alone. Given the high perceived risk of fentanyl and relatively low uptake of fatal overdose prevention behaviors, there is an urgency for safe injection facilities, access to medically assisted treatment, and programs that work with the drug-using community to deliver overdose prevention training as well as promote behaviors to carry naloxone and not use drugs alone.

KW - Fentanyl

KW - naloxone

KW - opioid

KW - overdose

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