JMIR Publications

ABSTRACT

Background:

In 2018, 2 million Americans met the DSM-5 diagnostic criteria for an opioid use disorder and 9.9 million had misused prescription pain relievers the previous year. Despite a rapid increase in opioid misuse, opioid use disorders, and overdoses, data is limited on the behavioral and contextual risk as well as protective factors fueling the opioid epidemic in some of the hardest hit U.S. cities – Atlanta, Los Angeles, and Las Vegas. Almost 70% of the 67,367 drug overdose deaths in the U.S. in 2018 involved an opioid. That same year, Georgia reported that over 60% of drug overdose deaths involved opioids (866), while California reported that 45% of those deaths involved opioids (> 2,400) and Nevada a total of 372 of those deaths involved an opioid.

Objective:

To describe characteristics and health behaviors of people who use opioids to inform public health practice, policy, and future research to mitigate the risks faced by this population experiencing multiple vulnerabilities.

Methods:

We implemented a community-engaged research strategy that involved development and implementation of a two-stage purposive sampling plan involving selection of partner organizations (syringe exchange programs in urban settings), and recruitment and enrollment of participants ages 18-69 years served by these organizations in Atlanta, Los Angeles, and Las Vegas from 2019-2020. The survey included a variety of measures, including those to assess general health behaviors, drug use and misuse, syringe exchange utilization, sex exchange, histories of interpersonal violence, and vaccine confidence.

Results:

The protocol was successfully implemented despite challenges like real-time technology issues and rapidly finding and surveying a difficult to reach population. We sampled 1,127 unique participants (248 in Atlanta, 465 in Los Angeles, 414 in Las Vegas).

Conclusions:

The establishment and utilization of strong community partnerships enabled the rapid collection of data from a typically difficult to reach population. Local efforts like these are needed to develop policies and practices that promote harm reduction among people who use opioids.