Trying to Avoid an Overdose.

Author:Harrison, Rachel

PEOPLE WHO USE DRUGS have adjusted their behaviors to avoid overdose, relates a study by the Center for Drug Use and HTV/HCV Research at New York University College of Nursing and NYU College of Global Public Health. The findings, published in the International Journal of Drug Policy, demonstrate a high level of understanding among people who use drugs regarding ways to prevent an overdose and some adoption of these methods, but the researchers assert that more needs to be done to prevent overdoses.

Fentanyl, a category of synthetic opioids that is 50 to 100 times more potent than morphine, increasingly is being added to heroin in the U.S. Between 2015-16, the number of illicit drug seizures by the Drug Enforcement Administration that contained fentanyl increased by 694%.

People who use heroin or other illicit drugs often are unaware that they are being "cut" or mixed with fentanyl. As a result, the use of heroin and other drugs containing fentanyl has been linked to sharp increases in opioid mortality.

For instance, prior to 2015, fentanyl accounted for less than three percent of New York overdose deaths annually; by 2016, it was 44%. Further, while the majority of overdose deaths involving fentanyl in New York were mixed with heroin (61%) in 2016, 37% were a combination of cocaine and fentanyl (without heroin), an increase from 11% in 2015. Moreover, recent drug seizure data indicates that, in addition to heroin and cocaine, fentanyl has been detected as an additive in methamphetamine, ketamine, and counterfeit opioid analgesics and benzodiazepines. This suggests that fentanyl may be reaching individuals who are opioid naive, which could increase overdose risk further.

In this study, the researchers conducted in-depth interviews with 55 people who use drugs at three New York syringe exchange programs. The researchers asked about drug use, perceptions of fentanyl, overdose experiences, and whether they have adapted their drug-using practices in response to the increased prevalence of fentanyl.

Study participants reported apprehension about the potency of fentanyl and the need to use drugs more cautiously in case they contain fentanyl. As a result, many people who use drugs employ a variety of harm-reduction strategies to prevent overdose, including test shots, buying drugs from a consistent source, reducing drug use, utilizing fentanyl test strips, carrying naloxone (a medication used to reverse opioid overdoses), and doing drugs in the...

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