Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

North America is in the midst of dual epidemics of opioid misuse and fatal overdose, further complicated by the emergence of illicit fentanyl use. According to the British Columbia (BC) Coroners Service, between January and July 2016, fentanyl was detected in 264 overdose deaths - a 222% increase in the number of deaths due to fentanyl during the same period in 2015. Drug checking can provide crucial information on the discrepancy between what people who inject drugs (PWID) think they are taking and what they are actually taking. It can also provide PWID with information about the risks of being exposed to fentanyl and encourage the uptake of other harm reduction measures. Despite the immense potential individual and public health benefits of drug checking, there exists almost no peer-reviewed literature on drug checking in the context of opioid use. Further, no feasibility studies have been undertaken to inform the implementation of such services. Using data from two ongoing CIHR and NIH funded cohorts of over 2500 PWID in Vancouver, BC my doctoral research seeks to: 1) investigate the prevalence of, and individual and social-structural factors associated with willingness to use a fentanyl drug checking service; 2) identify barriers to use of, and design preferences for a fentanyl drug checking service; 3) characterize the prevalence of, and the discrepancy between self-reported and actual fentanyl exposure as confirmed by urine test; and 4) evaluate the factors associated with intentional and unintentional fentanyl exposure. Cohort participants will complete semi-annual interviewer-administered questionnaires and qualitative interviews, in addition to providing urine samples for drug checking. Ethno-epidemiological approaches combining qualitative and multivariate quantitative techniques will be employed to meet aforementioned study objectives.