"You Never Know What You're Getting": Opioid Users' Perceptions of Fentanyl in Southwest Pennsylvania

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Fentanyl, heroin, prescription opioids, overdose, harm reduction

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BACKGROUND: Urban areas in the United States have experienced a dramatic surge in fentanyl overdose deaths since 2014, a trend affecting both larger and smaller metropolitan areas. Encompassing only 1.2 million residents, Allegheny County, Pennsylvania, nevertheless saw 412 fentanyl-involved deaths in 2016, a number surpassed only by New York City and Cook County (Chicago), Illinois.

OBJECTIVES: This article seeks to describe opioid users' perceptions of fentanyl in Allegheny and three adjacent counties; it further considers how the drug's emergence shapes some users' market behaviors and consumption practices.

METHODS: This article reports on qualitative interview data (N = 30) collected as part of a larger, multi-phase, mixed methods study (N = 125) among individuals reporting past-year prescription opioid misuse or heroin use in four southwest Pennsylvania Counties.

RESULTS: Most interviewees reported past-year suspected exposure to fentanyl, and many reported suffering or seeing suspected fentanyl overdoses. Where roughly one-third reported strategies for avoiding fentanyl, a small group of interviewees identified advantages to fentanyl, while still acknowledging its associated risks. Conclusions/Importance: Given users' diverse opinions around fentanyl, the distribution of fentanyl test strips may represent an effective response to the current crisis.

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Citation / Publisher Attribution

Substance Use & Misuse, v. 54, issue 6, p. 955-966