#PO12: Fentanyl And Overdose: Experiences And Behaviors In Young People Who Inject Drugs (PWID)

Author: Carli Salvati Honoria Guarino Ramona Alemenana Elizabeth Goodbody Pedro Mateu-Gelabert

Theme: Social Science and Policy Research Year: 2021

Background: Opioid overdose rates among young people in NYC are steadily rising. Fentanyl in the drug supply increases overdose risk. Methods: A purposive sub sample (n=21) of young PWID were chosen for semi-structured interviews from a total of 169 participants enrolled in an RCT evaluating a harm reduction intervention to prevent HCV transmission and overdose. Qualitative interviews lasted about 30-60 minutes and took place between three and nine months post intervention. Interviews discussed intervention experiences and behavior changes. Urine toxicology was performed at the time of screening. All participants completed a structured baseline assessment upon enrollment. Results: Mean age of interviewed participants was 24.5 years. Racial makeup of the interviewees was: thirteen Caucasian; five multiracial; and three other races. Eleven men, nine women and one nonbinary individual were interviewed. Of eighteen participants whose urine was screened for fentanyl, eight were positive at enrollment. Twelve participants reported at baseline having experienced at least one overdose in their lifetime. Seventeen of the interviewees stated they received overdose prevention training at some point prior to enrollment. Young opioid users do have knowledge of overdose risks, and have some comfort administering naloxone. Participants report the fentanyl high as noticeably more intense than heroin only. Many PWID describe knowing they’re injecting fentanyl immediately upon using, even without confirmation. Several individuals report tailoring behaviors to avoid buying fentanyl (e.g. open communication with their dealers and others in their networks). However, some PWID seek it out specifically for its effects, despite knowing the associated overdose risks. Conclusion: Young PWID are willing to respond to overdose and consistently take measures to mitigate risks for themselves and their networks. Increased naloxone distribution and overdose prevention specifically tailored to fentanyl use (e.g. increased accessibility to fentanyl test strips) is critical for reducing overdose deaths in young opioid users. Disclosure of Interest Statement: The collaborators received funding from the National Institute of Health (NIH), grant R01DA041501. There are no conflicts of interest declared.

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