Abstract：
BACKGROUND: Fentanyl is not yet routinely monitored among methadone maintenance treatment (MMT) patients in Israel. We aimed 1. to evaluate urine fentanyl proportion changes over 3 years and characterize patients\' characteristics 2. To study patients\' self-report on fentanyl usage, and compare knowledge about fentanyl risk, before and following brief educational intervention.
METHODS: Fentanyl in the urine of all current MMT patients was tested every 3 months year between 2021 and 2023, and patients with positive urine fentanyl were characterized. Current patients were interviewed using a fentanyl knowledge questionnaire (effects, indications, and risks) before and following an explanation session.
RESULTS: Proportion of fentanyl ranged between 9.8 and 15.1%, and patients with urine positive for fentanyl (September 2023) were characterized as having positive urine for pregabalin, cocaine, and benzodiazepine (logistic regression). Of the current 260 patients (87% compliance), 78(30%) self-reported of fentanyl lifetime use (\"Ever\"), and 182 \"never\" use. The \"Ever\" group had higher Knowledge scores than the \"Never\", both groups improved following the explanatory session (repeated measure). The \"Ever\" group patients were found with urine positive for cannabis and benzodiazepine on admission to MMT, they were younger, did not manage to gain take-home dose privileges and had a higher fentanyl knowledge score (logistic regression).
CONCLUSIONS: In the absence of routine fentanyl tests, a high knowledge score, shorter duration in MMT, benzodiazepine usage on admission, and current cannabis usage, may hint of the possibility of fentanyl abuse.
METHODS: Fentanyl in the urine of all current MMT patients was tested every 3 months year between 2021 and 2023, and patients with positive urine fentanyl were characterized. Current patients were interviewed using a fentanyl knowledge questionnaire (effects, indications, and risks) before and following an explanation session.
RESULTS: Proportion of fentanyl ranged between 9.8 and 15.1%, and patients with urine positive for fentanyl (September 2023) were characterized as having positive urine for pregabalin, cocaine, and benzodiazepine (logistic regression). Of the current 260 patients (87% compliance), 78(30%) self-reported of fentanyl lifetime use (\"Ever\"), and 182 \"never\" use. The \"Ever\" group had higher Knowledge scores than the \"Never\", both groups improved following the explanatory session (repeated measure). The \"Ever\" group patients were found with urine positive for cannabis and benzodiazepine on admission to MMT, they were younger, did not manage to gain take-home dose privileges and had a higher fentanyl knowledge score (logistic regression).
CONCLUSIONS: In the absence of routine fentanyl tests, a high knowledge score, shorter duration in MMT, benzodiazepine usage on admission, and current cannabis usage, may hint of the possibility of fentanyl abuse.
摘要：
背景：以色列美沙酮维持治疗（MMT）患者尚未常规监测芬太尼。我们瞄准了1。评估3年内尿芬太尼比例变化并表征患者特征2.为了研究患者对芬太尼使用情况的自我报告，并比较有关芬太尼风险的知识，在简短的教育干预之前和之后。
方法：在2021年至2023年期间，每3个月对所有当前MMT患者的尿液中的芬太尼进行检测，并对尿芬太尼阳性的患者进行表征。使用芬太尼知识问卷(效果，适应症,和风险)在解释会议之前和之后。
结果：芬太尼的比例介于9.8％和15.1％之间，尿中芬太尼阳性（2023年9月）的患者的特征是尿中普瑞巴林阳性，可卡因,和苯二氮卓（逻辑回归）。在目前的260名患者中（87％的依从性），78（30%）芬太尼终生使用自我报告（“永远”），182“从不”使用。“永远”组的知识得分高于“永远”组，两组在解释性会议(重复测量)后有所改善.“Ever”组患者入院时发现尿液中大麻和苯并二氮杂卓呈阳性，他们更年轻,未设法获得带回家剂量权限,芬太尼知识评分较高(逻辑回归).
结论：在没有常规芬太尼试验的情况下，知识得分高,MMT持续时间较短，入院时使用苯二氮卓类药物，和目前的大麻使用情况，可能暗示芬太尼滥用的可能性。
方法：在2021年至2023年期间，每3个月对所有当前MMT患者的尿液中的芬太尼进行检测，并对尿芬太尼阳性的患者进行表征。使用芬太尼知识问卷(效果，适应症,和风险)在解释会议之前和之后。
结果：芬太尼的比例介于9.8％和15.1％之间，尿中芬太尼阳性（2023年9月）的患者的特征是尿中普瑞巴林阳性，可卡因,和苯二氮卓（逻辑回归）。在目前的260名患者中（87％的依从性），78（30%）芬太尼终生使用自我报告（“永远”），182“从不”使用。“永远”组的知识得分高于“永远”组，两组在解释性会议(重复测量)后有所改善.“Ever”组患者入院时发现尿液中大麻和苯并二氮杂卓呈阳性，他们更年轻,未设法获得带回家剂量权限,芬太尼知识评分较高(逻辑回归).
结论：在没有常规芬太尼试验的情况下，知识得分高,MMT持续时间较短，入院时使用苯二氮卓类药物，和目前的大麻使用情况，可能暗示芬太尼滥用的可能性。
