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. 2022 Jul 22:10:882421.
doi: 10.3389/fpubh.2022.882421. eCollection 2022.

"It's my frenemy": A qualitative exploration of knowledge and perceptions of fentanyl use during the COVID-19 pandemic in people who use drugs at a syringe services program in Philadelphia, PA

Sarah Bauerle Bass  1   2 , Patrick J A Kelly  2 , Sphoorti Pandit-Kerr  3 , Jenine Pilla  1 , Katherine Morris  3 , Erin Larsen  3 , Jennifer P Wisdom  3 , Phillip R Torralva  3
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"It's my frenemy": A qualitative exploration of knowledge and perceptions of fentanyl use during the COVID-19 pandemic in people who use drugs at a syringe services program in Philadelphia, PA

Sarah Bauerle Bass et al. Front Public Health. .

Abstract

Background: Exacerbated by the COVID-19 pandemic and the proliferation of fentanyl and fentanyl analogs, overdose deaths have surged in the United States, making it important to understand how individuals who use drugs experience and perceive the risks of fentanyl use and how it has changed during the COVID-19 pandemic.

Methods: Twenty clients from a Philadelphia syringe services program completed a questionnaire and in-depth interview about their fentanyl experiences from January to March 2021. These interviews were transcribed and analyzed using thematic analysis methods.

Results: Sixty percent of participants were female and racial/ethnic minority. Participants indicated they believed fentanyl use accounted for most Philadelphia opioid-related overdoses and understood that fentanyl was different from other opioids. Fentanyl use was characterized as "all-consuming" by taking over lives and inescapable. While most perceived their risk of fentanyl overdose as high, there was low interest in and reported use of harm reduction strategies such as fentanyl test strips. The COVID-19 pandemic was noted to have negative effects on fentanyl availability, use and overdose risk, as well as mental health effects that increase drug use.

Conclusions: The divide between perceived risk and uptake of protective strategies could be driven by diminished self-efficacy as it relates to acting on and engaging with resources available at the syringe services program and represents a potential intervention target for harm reduction intervention uptake. But the COVID-19 pandemic has exacerbated risks due to fentanyl use, making an effective, accessible, and well-timed intervention important to address the disconnect between perceived overdose risk and use of preventive behaviors.

Keywords: COVID-19; fentanyl; harm reduction; overdose; qualitative in-depth interviews.

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References

    1. Centers for Disease Control Prevention National Center for Injury Prevention Control. Drug Overdose Deaths. (2021). Available online at: https://www.cdc.gov/drugoverdose/deaths/index.html (accessed November 03, 2021).
    1. Hedegaard H, Bastian BA, Trinidad JP, Spencer M, Warner M. Drugs most frequently involved in drug overdose deaths: United States, 2011 – 2016. National Vital Statistics Reports, Vol. 67, Hyattsville, MD: National Center for Health Statistics (2018). - PubMed
    1. Wilson N, Kariisa M, Seth P, Smith H IV, Davis NL. Drug and opioid-involved overdose deaths – United States, 2017-2018. MMWR Morb Mortal Wkly Rep. (2020) 69:11. 10.15585/mmwr.mm6911a4 - DOI - PMC - PubMed
    1. O'Donnell J, Gladden RM, Mattson CL, Hunter CT, Davis NL. Vital signs: characteristics of drug overdose deaths involving opioids and stimulants – 24 states and the District of Columbia, January – June 2019. MMWR Morb Mortal Wkly Rep. (2020) 69:35. 10.15585/mmwr.mm6935a1 - DOI - PMC - PubMed
    1. Centers for Disease Control Prevention,. Drug Overdose Deaths in the U.S. Top 100,000 Annually. (2021). Available online at: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm (accessed January 23, 2022).

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