Joseph J. Palamar, Ph.D. - US grants

DESCRIPTION (provided by applicant): This Mentored Scientist Career Development Award (K01) application proposes a five-year training plan to provide the Candidate with the necessary skills and experience for a future R01 submission and transition to independent research. The Candidate, Joseph J. Palamar, PhD, MPH, has shown dedication to public health through his research on drug use in New York City (NYC) and the stigma associated with recreational drug use. He has authored/coauthored 24 peer-reviewed manuscripts on the topic he seeks to investigate in this proposed project. The scientific objective of this application is to identify se and correlates of use of new and emerging drugs in venues which promote highest risk for use (e.g., at nightclubs, dance festivals). This research is critical because of the unprecedented rise in new psychoactive drugs, not currently assessed by national surveys. It is essential for timely identification and documentation of the emergence of new drugs and associated adverse effects with short-term informing of policymakers, researchers and educators. Rapid survey data is needed to contribute to drug monitoring systems and to triangulate secondary data, which generally only focus on adverse outcomes of use (e.g., overdose). The development of a survey tool and documentation of an implementation approach will allow epidemiologists to triangulate secondary drug data to inform prevention strategies, which address use of these continually emerging drugs. Using a 3-phased mixed-methods approach, Dr. Palamar will develop, validate and implement a survey tool to monitor use of new and emerging drugs among nightclub/dance festival attendees (age 18-25) as they enter venues in NYC. Specifically, he will: 1) carry out formative research to inform survey instrument development (N=40 key informant interviews), 2) design and validate an initial (longer) survey with online follow-up (N=250), based on the key informant interviews, and 3) implement a validated rapid survey (N=500) based upon the initial survey reliability and validity results. Through these research activities, Dr. Palamar will identiy and characterize use of new and emerging drugs among nightclub and dance festival attendees. Specifically, he will aim to: 1) identify and describe the current user population and potential user population (as per intent to use), 2) identify and describe frequency of use, contexts of use, modes of administration, and perceived availability, 3) examine how use and intention to use relate to use of other drugs and perceived contact with users and dealers, and 4) examine socio-demographic and attitudinal correlates of use and intention to use, reasons for use, effects from use and perceived risk associated with use. The Candidate has developed a strong team of mentors to train him throughout the proposed grant period. His mentors and consultants are from diverse backgrounds and experts in drug epidemiology, public health, qualitative methods and biostatistics. His Mentor, Dr. Scott Sherman, and Co-Mentors, Dr. Danielle Ompad and Dr. Michele Shedlin, will be fundamental to the Candidate's development into an independent substance abuse researcher. Mentoring will take place in conjunction with coursework and participation in seminars and conferences. Throughout this training plan the Candidate will: 1) enhance his ability to develop and conduct his own independent research study; 2) expand his expertise in drug use epidemiology; 3) learn time-space and venue-based sampling methodologies; 4) expand his knowledge and experience in the design, validation and implementation of surveys, which will lead to real-time data, and 5) become more advanced in analysis and dissemination of survey data. These goals will foster the Candidate's career development and expertise in drug epidemiology and contribute to the publication of peer-reviewed manuscripts that will inform prevention science and lead to an eventual R01. The proposed project will take place at the New York University School of Medicine, Department of Population Health, which has a multidisciplinary research team and integrates ground-breaking research with training for the next generation of leaders in public health. The Department is committed to training new researchers and promoting development of independent investigators. The Candidate will collaborate with epidemiologists at the NYC Department of Health and Mental Hygiene and use their secondary data to inform and triangulate his survey data. The proposed research plan combined with the extensive resources of the institutional environment and the strong institutional support for the Candidate's professional development will assure successful implementation of this award. This carefully documented mixed-method approach will allow researchers to collect real-time data on new and emerging drug trends in nightlife scenes, and quickly inform the scientific community and the public about the use, dangers and correlates of new and emerging drugs. This information is essential to prevent increasing use and associated adverse effects and mortality associated with use of these unstudied drugs. Results will also inform prevention strategies, larger-scale studies (e.g., R01s) that compare patterns of emergence across US cities, and drug monitoring systems (e.g., local, national), enabling them to track use and associated adverse consequences of use in a more comprehensive manner.

Electronic dance music (EDM) nightclub and festival attendees are at high risk for drug use and associated adverse outcomes. EDM attendees are at high risk for using ?traditional? drugs such as ecstasy (MDMA, ?Molly?), but they are also now at high risk for use of new psychoactive substances (NPS), which are a major new drug-related public health threat. NPS are often adulterants in or replacements for ?traditional? illicit drugs such as ecstasy; thus, many users unknowingly ingest such new and dangerous substances. Ecstasy, for example, is often adulterated or replaced with NPS such as synthetic cathinones (?bath salts?) and the PI and his colleagues have detected highly potent drugs (e.g., alpha-PVP, PMMA, methamphetamine) in ecstasy users' hair despite them denying use of these drugs. Thus, ecstasy use appears to be a major delivery system of unintentional NPS use. Fentanyl and other dangerous opioid NPS are also now being detected in cocaine and in pills resembling Xanax and Percocet. Drug-related deaths at EDM festivals have become common, and with the popularity of EDM parties increasing, it is essential to focus on intentional and unintentional drug use in this at-risk population in order to prevent use, poisonings, and deaths. We have developed and validated a rapid survey (via the PI's K01) to query use of dozens of common drugs and >100 NPS in the EDM scene and we have validated hair testing methods to determine use of >100 NPS and >15 common drugs. Such biological testing can help us estimate the true prevalence of use of NPS and other drugs (e.g., ecstasy) in these high- risk nightlife scenes. The objective of this study is to systematically examine the prevalence of known and unknown drug use, risk factors for use, self-reported adverse outcomes associated with use, and trends in use and adverse outcomes over 24 months. Since many individuals unknowingly use NPS, it is essential to validate survey responses. This study is innovative as we will test hair of participants to validate responses and also determine the extent of unintentional use of NPS and other drugs. Hair testing is an ideal biological testing method because we are able to detect the presence of >100 NPS (including fentanyl and 15 of its analogues) in hair for >12 months post-use. Our validated rapid survey complemented with hair testing (for validation) will allow us to estimate the prevalence of drug use in the nightclub and festival scenes in NYC. Using time-space sampling, we will randomly select EDM parties throughout NYC, and survey 2,080 individuals entering these parties (biweekly). An exploratory longitudinal component will also help us determine whether providing a subsample of participants with feedback regarding their hair testing results influences drug use and intention to use over time (6 months post-survey). Estimating intentional and unintentional drug use and adverse consequences associated with use may allow us to detect some risky drug trends (e.g., use of [adulterated] ecstasy) before diffusing to the general public. Methods will be generalizable to other at-risk populations and results will inform prevention information to be disseminated to the public and to those at highest risk.