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Multi-level associations between opioid use and overdose: Individual, clinical, and population-based risk factors for fatality

Award Number: K01DA049950
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 07/01/2020
PERIOD OF PERFORMANCE END DATE: 06/30/2025

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Multi-level associations between opioid use and overdose: Individual, clinical, and population-based risk factors for fatality - PROJECT SUMMARY: Over the past two decades, high rates of opioid prescribing have led to widespread opioid use and epidemic levels of adverse opioid-related outcomes. Early interventions focused on reducing opioid prescribing through the development of practice guidelines and implementation of programs and policies to increase prescription opioid management and monitoring. While overall opioid prescribing has declined in recent years and may have contributed to reductions in prescription opioid-involved overdose death rates in 2012 and 2013, the rate has since risen to a new high, comprising 40% of all opioid-related deaths in 2016. Furthermore, prescribing remains elevated in disadvantaged groups and areas, highlighting a need to better understand how individual characteristics intersect with health system and population-level factors in the pathways from opioid use to fatal and non-fatal overdose. Using a multi-level approach, the proposed project examines trajectories from opioid treatment for chronic non-cancer pain to opioid overdose and fatality, accounting for: 1) individual sociodemographic and clinical characteristics (e.g. sex, age, race/ethnicity, comorbidities), 2) opioid treatment patterns (e.g. dosage, duration, formulation), 3) county-level health system (e.g. facilities, services) and population characteristics (e.g. percent poverty, minority, unemployed, disabled), and 4) state-level policies (e.g. Medicaid policies, Prescription Drug Monitoring Programs). Opioid treatment patterns will be assessed using national Medicaid Analytic Extract (MAX) data, adjusting for individual characteristics. Risk of overdose based on individual characteristics and treatment patterns will be assessed using MAX data for medically treated non-fatal opioid overdose and National Death Index (NDI) data for fatal opioid overdose. Overdose outcomes will be further assessed using county-level Area Health Resource File (AHRF) data and state-level policy measures. Contextualizing individual outcomes within wider health care systems and social and geographic settings supports NIDA’s strategic plan to increase the public health impact of research. Additional substantive and methodological training will contribute to the applicant’s long-term goal to develop an independent academic research career and generate and disseminate robust evidence to inform effective interventions to reduce opioid-related morbidity and mortality. The training aims include advanced study and application of: 1) innovative methods to characterize clinical care patterns over time, 2) social and spatial epidemiology theory and methods to study multilevel influences on health, 3) policy drivers of health and health care, and 4) professional development for conducting ethical, independent research. The research and training are supported by an interdisciplinary mentorship team of Columbia University researchers with expertise in substance use and policy research, clinical and spatial epidemiology, and statistics with additional support from external collaborators in health services and policy research methods. This project and career development plan will prepare the applicant to secure R01 funding to extend this line of research.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $196,106 )
2024	2024	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Drug Use and Addiction Research Programs	003	5	6/20/2024	NON-COMPETING CONTINUATION	$196,106
2024	2023	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Drug Use and Addiction Research Programs	002	4	2/28/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$38,962
2024	2022	RUTGERS, THE STATE UNIVERSITY	83 SOMERSET ST	NEW BRUNSWICK	NJ	08901	MIDDLESEX	USA	Drug Use and Addiction Research Programs	001	3	2/28/2024	NON-COMPETING CONTINUATION	-$38,962
2024	2022	RUTGERS, THE STATE UNIVERSITY	83 SOMERSET ST	NEW BRUNSWICK	NJ	08901	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	3	1/10/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $196,106

Issue Date FY: 2023 ( Subtotal = $196,106 )
2023	2023	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Drug Use and Addiction Research Programs	000	4	6/16/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$196,106
														Subtotal = $196,106

Issue Date FY: 2022 ( Subtotal = $196,106 )
2022	2022	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	83 SOMERSET ST	NEW BRUNSWICK	NJ	08901	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	3	6/22/2022	NON-COMPETING CONTINUATION	$196,106
														Subtotal = $196,106

Issue Date FY: 2021 ( Subtotal = $196,106 )
2021	2021	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	83 SOMERSET ST	NEW BRUNSWICK	NJ	08901	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	2	6/2/2021	NON-COMPETING CONTINUATION	$196,106
														Subtotal = $196,106

Issue Date FY: 2020 ( Subtotal = $196,106 )
2020	2020	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	83 SOMERSET ST	NEW BRUNSWICK	NJ	08901	MIDDLESEX	USA	Drug Use and Addiction Research Programs	001	1	6/30/2020	NEW	$0
2020	2020	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	83 SOMERSET ST	NEW BRUNSWICK	NJ	08901	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	1	6/26/2020	NEW	$196,106
														Subtotal = $196,106

Grand Total All Awards = $980,530

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Multi-level associations between opioid use and overdose: Individual, clinical, and population-based risk factors for fatality

Award Number: K01DA049950

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 07/01/2020

PERIOD OF PERFORMANCE END DATE: 06/30/2025

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