{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:08:24Z","timestamp":1785402504589,"version":"3.56.0"},"reference-count":59,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["5R01DA003574"],"award-info":[{"award-number":["5R01DA003574"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Fentanyl's euphoric effects and short half\u2010life may increase infectious disease transmission risks through frequent injecting and syringe sharing. We examined fentanyl polysubstance use (PSU) patterns and associations with hepatitis C virus (HCV), skin and soft tissue infections (SSTI), and non\u2010fatal overdose among people who inject drugs (PWID) in New York City.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recruited 495 PWID between October 2021 and July 2024. Participants were tested for HCV antibody and underwent urine toxicology screenings using the Premier Biotech 13\u2010panel BioCup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fentanyl was identified in 83.6% of the sample; however, only 23.0% self\u2010reported recent intentional fentanyl use. The most common fentanyl PSU combinations were fentanyl with methadone (67.9%), opiates (66.9%), cocaine (65.9%), cannabis (45.4%), xylazine (36.7%), heroin (35.5%), benzodiazepines (32.5%) and alcohol (29.3%). Compared to no fentanyl use, intentional fentanyl use was associated with HCV antibody seropositivity (aOR 3.44, 95% CI 1.75, 6.93), SSTIs (aOR 4.75, 1.66, 17.20) and non\u2010fatal overdose (aOR 2.35, 1.15, 5.00). Co\u2010use of fentanyl with opiates (aOR 2.08, 1.16, 3.82), cocaine (aOR 2.71, 1.52, 4.97), heroin (aOR 2.06, 1.11, 3.91), benzodiazepines (aOR 2.91, 1.55, 5.63) and alcohol (aOR 3.27, 1.72, 6.37) were associated with HCV. Co\u2010use of fentanyl with benzodiazepines (aOR 2.08, 1.04, 4.34) and alcohol (aOR 2.57, 1.29, 5.37) were associated with non\u2010fatal overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>In addition to overdose, when combined with other psychoactive substances, fentanyl PSU is associated with a higher prevalence of infectious diseases. This underscores the need for tailored medication dosing for opioid use disorder and expanding access to syringe service programs and medical care for PWID in the fentanyl era.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.14093","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T03:15:37Z","timestamp":1748920537000},"page":"1543-1555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fentanyl Polysubstance Use Patterns and Their Associations With Hepatitis C Virus, Skin and Soft Tissue Infections, and Non\u2010Fatal Overdose Among People Who Inject Drugs in New York City"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9712-6221","authenticated-orcid":false,"given":"Mehrdad","family":"Khezri","sequence":"first","affiliation":[{"name":"Department of Epidemiology New York University School of Global Public Health  New York New York USA"},{"name":"HIV\/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance Institute for Futures Studies in Health, Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4995-3489","authenticated-orcid":false,"given":"Sarah","family":"Kimball","sequence":"additional","affiliation":[{"name":"Department of Epidemiology New York University School of Global Public Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3710-2831","authenticated-orcid":false,"given":"Chenziheng Allen","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology New York University School of Global Public Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8685-5381","authenticated-orcid":false,"given":"Courtney","family":"McKnight","sequence":"additional","affiliation":[{"name":"Department of Epidemiology New York University School of Global Public Health  New York New York USA"},{"name":"Center for Drug Use and HIV\/HCV Research  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0157-8168","authenticated-orcid":false,"given":"Don","family":"Des Jarlais","sequence":"additional","affiliation":[{"name":"Department of Epidemiology New York University School of Global Public Health  New York New York USA"},{"name":"Center for Drug Use and HIV\/HCV Research  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.06.010"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.06.010"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16318"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","unstructured":"M. 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