Research led by people who use drugs: centering the expertise of lived experience.

BACKGROUND: Research collaborations between people who use drugs (PWUD) and researchers are largely underutilized, despite the long history of successful, community-led harm reduction interventions and growing health disparities experienced by PWUD. PWUD play a critical role in identifying emerging issues in the drug market, as well as associated health behaviors and outcomes. As such, PWUD are well positioned to meaningfully participate in all aspects of the research process, including population of research questions, conceptualization of study design, and contextualization of findings. MAIN BODY: We argue PWUD embody unparalleled and current insight to drug use behaviors, including understanding of novel synthetic drug bodies and the dynamics at play in the drug market; they also hold intimate and trusting relationships with other PWUD. This perfectly situates PWUD to collaborate with researchers in investigation of drug use behaviors and development of harm reduction interventions. While PWUD have a history of mistrust with the medical community, community-led harm reduction organizations have earned their trust and are uniquely poised to facilitate research projects. We offer the North Carolina Survivors Union as one such example, having successfully conducted a number of projects with reputable research institutions. We also detail the fallacy of meaningful engagement posed by traditional mechanisms of capturing community voice. As a counter, we detail the framework developed and implemented by the union in hopes it may serve as guidance for other community-led organizations. We also situate research as a mechanism to diversify the job opportunities available to PWUD and offer a real-time example of the integration of these principles into public policy and direct service provision. CONCLUSION: In order to effectively mitigate the risks posed by the fluid and volatile drug market, research collaborations must empower PWUD to play meaningful roles in the entirety of the research process. Historically, the most effective harm reduction interventions have been born of the innovation and heart possessed by PWUD; during the current overdose crisis, there is no reason to believe they will not continue to be.

Sustained reduction of diversion and abuse after introduction of an abuse deterrent formulation of extended release oxycodone.

BACKGROUND: The development of abuse deterrent formulations is one strategy for reducing prescription opioid misuse and abuse. A putative abuse deterrent formulation of oxycodone extended release (OxyContin®) was introduced in 2010. Early reports demonstrated reduced abuse and diversion, however, an analysis of social media found 32 feasible methods to circumvent the abuse deterrent mechanism. We measured trends of diversion, abuse and street price of OxyContin to assess the durability of the initial reduction in abuse. METHODS: Data from the Poison Center Program, Drug Diversion Program, Opioid Treatment Program, Survey of Key Informant Patients Program and StreetRx program of the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS®) System were used. The average quarterly rates of abuse and diversion for OxyContin were compared from before reformulation to the rate in second quarter 2015. Rates were adjusted for population using US Census data and drug availability. RESULTS: OxyContin abuse and diversion declined significantly each quarter after reformulation and persisted for 5 years. The rate of abuse of other opioid analgesics increased initially and then decreased, but to lesser extent than OxyContin. Abuse through both oral and non-oral routes of self-administration declined following the reformulation. The geometric mean difference in the street price of reformulated OxyContin was 36% lower than the reformulated product in the year after reformulation. DISCUSSION: Despite methods to circumvent the abuse deterrent mechanism, abuse and diversion of OxyContin decreased promptly following the introduction of a crush- and solubility- resistant formulation and continued to decrease over the subsequent 5 years.

Opioid Overdose Prevention Programs Providing Naloxone to Laypersons - United States, 2014.

Drug overdose deaths in the United States have more than doubled since 1999. During 2013, 43,982 drug overdose deaths (unintentional, intentional [suicide or homicide], or undetermined intent) were reported. Among these, 16,235 (37%) were associated with prescription opioid analgesics (e.g., oxycodone and hydrocodone) and 8,257 (19%) with heroin. For many years, community-based programs have offered opioid overdose prevention services to laypersons who might witness an overdose, including persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of programs provide laypersons with training and kits containing the opioid antagonist naloxone hydrochloride (naloxone) to reverse the potentially fatal respiratory depression caused by heroin and other opioids. In July 2014, the Harm Reduction Coalition (HRC), a national advocacy and capacity-building organization, surveyed 140 managers of organizations in the United States known to provide naloxone kits to laypersons. Managers at 136 organizations completed the survey, reporting on the amount of naloxone distributed, overdose reversals by bystanders, and other program data for 644 sites that were providing naloxone kits to laypersons as of June 2014. From 1996 through June 2014, surveyed organizations provided naloxone kits to 152,283 laypersons and received reports of 26,463 overdose reversals. Providing opioid overdose training and naloxone kits to laypersons who might witness an opioid overdose can help reduce opioid overdose mortality.

Spectroscopic imaging for detection and discrimination of different E. coli strains.

Food contaminations with E. coli bacteria are a major concern for public health. Current techniques for detection are based on sample extractions, time-consuming sample preparations, and labor intensive analyses. Because some strains can be toxic at a level of tens of bacteria and some are not harmful at all, a method of colony localization and strain classification must be developed. In this study we present first results that are based on Fourier transform infrared (FT-IR) spectroscopy and FT-IR imaging. Due to the chemical similarity of different E. coli strains, the acquired spectra show a strong resemblance. It is demonstrated here that based on a correlation analysis samples of the same strain are classified as such and that different strains can be discriminated. The next step is to move from single-spot analyses towards spectroscopic imaging--a technique that facilitates detection of localized bacteria colonies. However, the sheer amount of data acquired in short periods of time prevents many chemical imaging techniques from being feasible for online sensing or for screening extended areas. To improve the time resolution, a data compression approach based on three-dimensional wavelet compression has been applied. It is shown that even with slight compression computation times can be cut down by over an order of magnitude while preserving enough information for localization and classification.

Augmenting spectroscopic imaging for analyses of samples with complex surface topographies.

Spectroscopic imaging has become a widely used tool for analyses of heterogeneous samples. Focal plane array detectors are incorporated into spectrometers that acquire a large number of spectra from different sample locations in parallel. This sensing technique facilitates analyses of spatial distributions of chemical information in an X-Y plane at high time resolution. In many cases, chemical reactions proceed in three spatial dimensions (X-Y-Z) and require the acquisition of spectroscopic information in an X-Y plane plus topographic (Z-dimension) information. However, capturing two-dimensional (2D, i.e., X-Y) images from three-dimensional (3D, i.e., X-Y-Z) samples inherently loses Z-dimension information. This technical note describes an augmented spectroscopic imager that gains both types of data, i.e., spatially resolved spectroscopic information and topography. For the latter purpose, a regular light pattern is generated and projected onto a sample. Due to its 3D topography, this light pattern is distorted. After extracting these distortions, the topography can be determined since the height structure is encoded in the light pattern. Because topographic probing must not affect infrared measurements, different wavelength ranges are used. Here spectroscopic information is acquired in the mid-IR while the light pattern probing the topography is generated in the visible. For relating distortions to physical height structures, the setup needs to be calibrated. For this purpose, calibration objects of known dimensions have been manufactured onto which the light pattern is projected. Determining distortions introduced by objects of known height derives a transform from distortions to topographies. Due to mechanical restrictions, the light pattern can only achieve a certain spatial resolution. In order to enhance the spatial resolution the topography is probed with, scanning the light pattern in X- and Y-direction is proposed.