Overdose from Unintentional Fentanyl Use when Intending to Use a Non-opioid Substance: An Analysis of Medically Attended Opioid Overdose Events.

Autor: Bazazi AR; Division of Substance Abuse and Addiction Medicine at San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA. alexander.bazazi@ucsf.edu., Low P; Division of Substance Abuse and Addiction Medicine at San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA., Gomez BO; Division of Substance Abuse and Addiction Medicine at San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA., Snyder H; Department of Family and Community Medicine, University of California San Francisco, 995 Potrero Ave, San Francisco, CA, 94110, USA., Hom JK; Population Behavioral Health, Behavioral Health Services Division, San Francisco Department of Public Health, 101 Grove St, San Francisco, CA, 94102, USA., Soran CS; Division of Substance Abuse and Addiction Medicine at San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA.; Division of General Internal Medicine at San Francisco General Hospital, Department of Medicine, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA., Zevin B; Street Medicine and Shelter Health, San Francisco Department of Public Health, 555 Stevenson St, San Francisco, CA, 94105, USA., Mason M; Community Paramedicine Division, San Francisco Fire Department, 698 2nd St, San Francisco, CA, 94107, USA., Graterol J; Community Paramedicine Division, San Francisco Fire Department, 698 2nd St, San Francisco, CA, 94107, USA., Coffin PO; Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.; Center On Substance Use and Health, San Francisco Department of Public Health, 101 Grove St, San Francisco, CA, 94102, USA.
Jazyk: angličtina
Zdroj: Journal of urban health : bulletin of the New York Academy of Medicine [J Urban Health] 2024 Apr; Vol. 101 (2), pp. 245-251. Date of Electronic Publication: 2024 Apr 03.
DOI: 10.1007/s11524-024-00852-0
Abstrakt: Fentanyl-mixed and substituted heroin is well-documented, but less is known about unintentional fentanyl use among people using stimulants. To determine the prevalence of and racial and ethnic disparities in unintentional fentanyl use among people experiencing a medically attended opioid overdose, we reviewed 448 suspected non-fatal overdose cases attended by a community paramedic overdose response team in San Francisco from June to September 2022. We applied a case definition for opioid overdose to paramedic records and abstracted data on intended substance use prior to overdose. Among events meeting case criteria with data on intended substance use, intentional opioid use was reported by 57.3%, 98.0% of whom intended to use fentanyl. No intentional opioid use was reported by 42.7%, with most intending to use stimulants (72.6%), including methamphetamine and cocaine. No intentional opioid use was reported by 58.5% of Black, 52.4% of Latinx, and 28.8% of White individuals (p = 0.021), and by 57.6% of women and 39.5% of men (p = 0.061). These findings suggest that unintentional fentanyl use among people without opioid tolerance may cause a significant proportion of opioid overdoses in San Francisco. While intentional fentanyl use might be underreported, the magnitude of self-reported unintentional use merits further investigation to confirm this phenomenon, explore mechanisms of use and disparities by race and ethnicity, and deploy targeted overdose prevention interventions.
(© 2024. The Author(s).)
Databáze: MEDLINE
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