Explore the vast range of titles available.

Background The veterinary sedative xylazine is increasingly found in illicit fentanyl and has been associated with numerous health harms. Xylazine test strips (XTS) are an emerging technology that can theoretically assist consumers in avoiding xylazine, but they require real-world validation. We leverage community-based drug checking program data to compare real-world XTS performance to ‘gold standard’ methods. Methods Samples were initially assessed by dissolving 1 mg of drug product in 1 mL water and dipping an XTS (“first generation” Wisebatch™) in the sample. Subsequently, confirmatory testing was performed by sending samples to the National Institute of Standards and Technology for qualitative analysis using direct analysis in real-time mass spectrometry (DART-MS). A subset was analyzed quantitatively with liquid chromatography gas spectrometry (LC–MS) to quantify xylazine, fentanyl, and other compounds. Results A total of n = 1570 drug samples were analyzed between June 2023 and May 2025, and a total of n = 801 XTS were used. N = 715 comparisons between xylazine test strips and mass spectrometry results could be made, including n = 333 among samples that tested positive for fentanyl. Of these, n = 63 samples were confirmed to contain xylazine by mass spectrometry, of which the majority contained low concentrations (average concentration 2.3%; 78% of samples contained less than < 1% xylazine by weight). Of the 63, n = 34 were correctly identified as positive by XTS, yielding sensitivity of 54.0 %. Of n =  270 xylazine negative samples, n = 235 were correctly categorized (specificity = 87.0%). Most false positives occurred with lidocaine present. Conclusions In our sample, with a large percentage of low concentration xylazine samples, “first generation” Wisebatch XTS had a relatively low sensitivity, but higher specificity. This highlights the value of confirmatory testing and the complicated and often confusing nature of point-of-care test strips for novel substance detection. Lot testing and validation studies are needed to improve quality control in this area.

Background The unpredictable and toxic nature of the unregulated drug supply poses overdose and other health risks for people who use drugs (PWUD). Drug checking services can reduce risks by identifying adulterants in individuals’ drug supplies. In the United States (U.S.), DCS are increasingly offered through community harm reduction services that provide evidence-based risk reduction services for PWUD, such as syringe services programs (SSPs). However, PWUD face several multi-level barriers to consistently utilizing DCS and engaging in post-DCS safer drug use behaviors (e.g., discard, use less, avoid using alone, etc.). Staff from a San Diego-based mobile SSP and researchers drew from Social Cognitive Theory and the Social Ecological Model to develop a motivational-interviewing adjunctive intervention (MI-CHANCE) led by peers with lived substance use experience to address multi-level barriers and promote DCS engagement and adoption of post-DCS safer drug use behaviors among PWUD. Methods We employ a hybrid type-1 effectiveness–implementation trial with a primary goal of determining effectiveness of the MI-CHANCE adjunctive intervention in increasing DCS utilization (primary behavioral outcome) and safer drug use behaviors (secondary behavioral outcome), leading to reduced overdose risk (primary health outcome) and HIV/HCV incidence (secondary health outcome). We will recruit, consent, conduct a baseline interview, and randomize 588 PWUD who used opioids or stimulants within the week prior to receive either MI-CHANCE or an attention-control standard-of-care condition. All participants will be offered DCS following exposure to the intervention or control condition. We will conduct six-month follow-up with participants over a 30-month period to collect outcomes and hypothesized predictors, mediators and potential confounders. Our secondary goal is to assess MI-CHANCE implementation considerations guided by the RE-AIM/PRISM framework via annual in-depth interviews over the course of the trial with SSP staff ( N  = 5) and participants ( N  = 20), focusing on acceptability and feasibility, and the potential for scalability via interviews with a broad sample of diverse U.S. SSPs ( N  = 20). Discussion This hybrid trial will advance crucial knowledge on the effectiveness and implementation of an adjunctive intervention to promote DCS engagement and safer drug use behaviors to reduce overdose risk among PWUD. Trial registration ClinicalTrials.gov, NCT06855836. Registered February 28, 2025. https://clinicaltrials.gov/study/NCT06855836?term=NCT06855836/rank=1 .

Background Unstable housing has tremendous harms on health and well-being and people who use drug experience significant barriers to housing. The objectives of this study were to estimate the prevalence of housing assistance among people who use drugs experiencing unstable housing in Oregon and explore factors associated with obtaining housing assistance. Methods We used cross-sectional survey data collected between March and November 2023 from people who were unstably housed and used drugs across eight counties in Oregon ( N  = 425). Unstable housing was defined as experiencing unsheltered or sheltered homelessness in the past year. Participants reported whether they obtained housing assistance in the past year. We explored associations between sociodemographic characteristics and housing assistance using multivariable log-binomial models. Results There were 133 participants (31.3%) who reported obtaining housing assistance in the past year. There was a lower prevalence of housing assistance for cisgender men (versus cisgender women and gender expansive participants) (PR = 0.73, 95% CI: 0.55–0.98) and those interviewed in non-urban counties (versus urban counties) (PR = 0.72, 95% CI: 0.53–0.98). Using opioids 21 or more days (versus 0–20 days) was associated with a lower prevalence of obtaining housing assistance (PR = 0.67, 95% CI: 0.48–0.94) Community supervision was associated with a higher prevalence of housing assistance (PR = 1.70, 95% CI: 1.27–2.27). Conclusion We found a large gap in housing assistance for people who use drugs in Oregon and identified several factors associated with obtaining housing assistance. Our findings can inform future interventions to connect people who use drugs with stable housing.

\"While Americans have focused on the COVID-19 pandemic, another epidemic has also been killing people across the country in unprecedented numbers: overdose deaths. And the two crises aren't unconnected. Higher levels of social isolation and instability during the pandemic have added fuel to an already serious overdose crisis.\" (Los Angeles Times) Read more about the opioid epidemic.