Effect of positive urine fentanyl screen on attitudes toward heroin use. Drug Alcohol Depend 2020 Apr 01;209:107934
Date
03/04/2020Pubmed ID
32126456DOI
10.1016/j.drugalcdep.2020.107934Scopus ID
2-s2.0-85080079031 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: It is unknown if targeted risk reduction counseling in the health care setting, after documented exposure to fentanyl, can affect behavior change to reduce risks and increase utilization of evidence-based overdose prevention strategies.
METHODS: We conducted a retrospective analysis of results (7/2018-6/2019) from questionnaire-facilitated counseling by recovery coaches in the emergency department (ED) and primary care settings following disclosure of a urine toxicology positive for fentanyl.
RESULTS: Seventy-five percent of N = 101 respondents were neither aware of nor expecting fentanyl in their substances of use. Fifty-three (70 %) of those initially unaware answered that learning about exposure to and the risks from fentanyl changed their thoughts about reducing or abstaining from use. A greater proportion of patients seen in the ED expressed desire to stop or reduce opioid use as compared to ambulatory clinic patients (91 % vs. 46 %, p < 0.001). Of those not already engaged in treatment, 18 % and 15 % were interested in medication and behavioural health treatment, respectively, and each of them indicated a change in thought based on the counseling. Forty-five percent of individuals not yet receiving naloxone endorsed interest in receiving it, and 22 % of all respondents were somewhat or very interested in access to safe consumption sites.
CONCLUSION: This study suggests a novel clinical utility in toxicology screens to inform behavior in the setting of illicit fentanyl exposure. In addition to linkages to evidence-based treatment, linkages to harm-mitigating strategies associated with ongoing substance use may be critical to a comprehensive overdose prevention strategy in the clinical setting.
Author List
Nowinski Konchak J, McGurk K, Hinami K, Vacchiano M, Aks SAuthor
Kevin J. Mcgurk MD Assistant Professor in the Emergency Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAnalgesics, Opioid
Drug Overdose
Emergency Service, Hospital
Female
Fentanyl
Health Knowledge, Attitudes, Practice
Heroin
Heroin Dependence
Humans
Male
Middle Aged
Naloxone
Opioid-Related Disorders
Retrospective Studies
Risk Reduction Behavior
Surveys and Questionnaires
Young Adult
