背景:注射药物(PWID)的人由于致命的过量服用而过早死亡的风险很高。新出现的芬太尼,比海洛因和其他阿片类药物更有效,可能会进一步增加这种风险。因此,关于注射药物的准确信息对于改进预防策略至关重要。
目的:本研究旨在分析二手注射设备中的药物残留,以确定药物和药物组合,并将发现与自我报告的信息进行比较和补充。
方法:在受监督的药物消费机构收集使用过的注射器和针头(n=766),为奥斯陆的问题吸毒者提供针头交换服务和两项低门槛医疗服务,挪威。从2019年6月至2020年6月,每三个月收集一次材料,并使用高度特异性的分析方法(超高效液相色谱串联质谱法)分析64种物质。此外,从2017年至2019年,我们采访了一名街头招募的PWID样本,了解他们的药物注射习惯(n=572).
结果:海洛因(65.5%)或苯丙胺(59.8%),通常组合(30.5%),通常在药物残留中检测到。其他阿片类药物,很少检测到兴奋剂或苯二氮卓类药物(6.1%)。仅在一个注射器中检测到芬太尼。海洛因是报告最多的药物(过去四周为77.6%,每天48.3%/几乎每天),其次是安非他明(过去四周为57.5%,每天或几乎每天23.1%)。注射美沙酮,丁丙诺啡和溶解片剂的自我报告频率高于药物残留发现。
结论:对注射设备的分析被证明是有用的,快速准确的方法,以获取有关奥斯陆注射药物的详细信息,并补充传统的PWID调查信息。
BACKGROUND: People who inject drugs (PWID) have a high risk of premature death due to fatal overdoses. Newly emerged fentanyls, much more potent than heroin and other opioids, may increase this risk further. Therefore, precise information on injected drugs is critical to improving prevention strategies.
OBJECTIVE: This
study aimed to analyse drug residues in used injection equipment in order to determine drug and drug combinations and compare and complement findings with self-reported information.
METHODS: Used syringes and needles (n=766) were collected at the supervised drug consumption facilities, the needle exchange service and two low-threshold health services for problem drug users in Oslo, Norway. The material was collected every third month from June 2019 to June 2020 and analysed for 64 substances using highly specific analytical methods (ultra-high performance liquid chromatography tandem mass spectrometry). Additionally, a street-recruited sample of PWID was interviewed from 2017 to 2019 regarding their drug injection habits (n=572).
RESULTS: Heroin (65.5%) or amphetamines (59.8%), often in combination (30.5%), were commonly detected in drug residues. Other opioids, stimulants or benzodiazepines were rarely detected (6.1%). Fentanyl was detected in only one syringe. Heroin was the most reported drug (77.6% during the past four weeks, 48.3% daily/almost daily), followed by amphetamines (57.5% during the past four weeks, 23.1% daily or almost daily). Injection of methadone, buprenorphine and dissolved tablets was self-reported more frequently than determined in drug residue findings.
CONCLUSIONS:
Analysis of the injection equipment proved useful as a non-invasive, rapid and accurate means to obtain detailed information on injected drugs in Oslo and supplement traditional PWID survey information.