Using a mobile research facility, we enrolled 141 opioid users from a neighborhood of Philadelphia, an urban epicenter of the opioid epidemic. Nearly all (95.6%) met DSM-5 criteria for severe opioid use disorder. The prevalence of HIV infection (8.5%) was more than seven times that found in the general population of the city. Eight of the HIV-positive participants (67.0%) reported receiving antiretroviral treatment but almost all of them had unsuppressed virus (87.5%). The majority of participants (57.4%) reported symptoms consistent with major depressive disorder. Severe economic distress (60.3%) and homelessness were common (57%). Polysubstance use was nearly universal, 72.1% had experienced multiple overdoses and prior medication for opioid use disorder (MOUD) treatment episodes (79.9%), but few currently engaged in addiction care. The prevalence, multiplicity and severity of chronic health and socioeconomic problems highlight consequences of the current opioid epidemic and underscore the urgent need to develop integrated models of treatment.

使用移动研究设施，我们从阿片类药物流行的城市中心费城附近招募了 141 名阿片类药物使用者。几乎所有 (95.6%) 都符合 DSM-5 严重阿片类药物使用障碍的标准。HIV感染率（8.5%）是该市普通人群的7倍多。8 名 HIV 阳性参与者（67.0%）报告接受了抗逆转录病毒治疗，但几乎所有人都感染了未抑制的病毒（87.5%）。大多数参与者（57.4%）报告了与重度抑郁症一致的症状。严重的经济困难（60.3%）和无家可归很常见（57%）。多种物质的使用几乎是普遍的，72.1% 的人经历过多次过量用药和先前的阿片类药物使用障碍 (MOUD) 治疗发作 (79.9%)，但目前很少有人从事成瘾护理。