Fentanyl Test Strips for Harm Reduction: A Scoping Review.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-07-01 Epub Date: 2024-05-31 DOI:10.1097/ADM.0000000000001321
Eric Kutscher, Marco Barber Grossi, Fred LaPolla, Joshua D Lee
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Abstract

Background: High potency synthetic opioids like fentanyl have continued to replace or contaminate the supply of illicit drugs in North America, with fentanyl test strips (FTSs) often used as a harm reduction tool for overdose prevention. The available evidence to support FTS for harm reduction has yet to be summarized.

Methods: A search of PubMed, Ovid Embase, and Web of Science was conducted in March 2023. A 2-stage review was conducted to screen by title and abstract and then by full text by 2 reviewers. Data were extracted from each study using a standardized template.

Results: A total of 91 articles were included, mostly from North America, predominantly reporting on FTS along with other harm reduction tools, and all conducted after 2016. No randomized controlled trials are reported. Robust evidence exists supporting the sensitivity and specificity of FTS, along with their acceptability and feasibility of use for people who use drugs and as a public health intervention. However, limited research is available on the efficacy of FTS as a harm reduction tool for behavior change, engagement in care, or overdose prevention.

Conclusions: Though FTSs are highly sensitive and specific for point of care testing, further research is needed to assess the association of FTS use with overdose prevention. Differences in FTS efficacy likely exist between people who use opioids and nonopioid drugs, with additional investigation strongly needed. As drug testing with point-of-care immunoassays is embraced for nonfentanyl contaminants such as xylazine and benzodiazepines, increased investment in examining overdose prevention is necessary.

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用于减少危害的芬太尼试纸:范围审查。
背景:芬太尼等高效力合成阿片类药物不断取代或污染北美的非法药物供应,芬太尼试纸(FTS)经常被用作预防用药过量的减毒工具。支持芬太尼试纸用于减少伤害的现有证据尚有待总结:方法:2023 年 3 月对 PubMed、Ovid Embase 和 Web of Science 进行了检索。由两名审稿人对研究进行了两阶段审查,首先通过标题和摘要进行筛选,然后通过全文进行筛选。使用标准化模板从每项研究中提取数据:共收录了 91 篇文章,大部分来自北美,主要报告了 FTS 以及其他减低伤害的工具,并且都是在 2016 年之后进行的。未报告随机对照试验。有大量证据支持FTS的灵敏度和特异性,以及其对吸毒者和作为公共卫生干预措施的可接受性和可行性。然而,关于 FTS 作为减少危害的工具在改变行为、参与护理或预防用药过量方面的有效性的研究还很有限:结论:尽管FTS在护理点检测中具有高度灵敏性和特异性,但仍需进一步研究以评估FTS的使用与用药过量预防之间的关联。在使用阿片类药物和非阿片类药物的人群中,FTS 的有效性可能存在差异,因此亟需开展更多调查。随着对非芬太尼污染物(如甲苯噻嗪和苯并二氮杂卓)采用床旁免疫测定进行药物检测,有必要增加对预防用药过量的投资。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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