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Examining the Impact of the Twin Epidemics of Methamphetamine and Opioid Use on Overdose, Risky Sex and Treatment Engagement among PWUD in Two Rural Appalachian Cohorts

Award Number: R01DA033862
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2012
PERIOD OF PERFORMANCE END DATE: 11/30/2027

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Examining the Impact of the Twin Epidemics of Methamphetamine and Opioid Use on Overdose, Risky Sex and Treatment Engagement among PWUD in Two Rural Appalachian Cohorts - ABSTRACT The goal of this R01 renewal is to examine the impact of methamphetamine (MA) use on fatal and nonfatal overdose, engagement in injection- and sex-risk behaviors, and treatment for opioid use disorder (OUD) and other substance use disorders (SUD) among people who use drugs (PWUD) from two Appalachian cohorts. MA use among people who use opioids is increasing. Several recent publications have coined this increase in MA/opioid co-usage as the “twin epidemics”, as new onset methamphetamine use has been reported in areas particularly hard hit by the opioid epidemic. This application builds on work from two established cohort studies located in the epicenter of the opioid crisis - the Social Networks Among Appalachian People (SNAP) cohort and GATEWAY2HOPE (G2H). These cohorts will be combined to increase both geographic scope and statistical power and to examine the following aims: 1) To characterize use of methamphetamine in the context of continued opioid use (twin epidemics), initiation of meth use, and social networks of PWUM. Building on the data we have gathered for opioid use over time, additional prospective data will be collected on initiation and use patterns for methamphetamine, including route of administration; 2) To examine longitudinal changes in sex- and injection-risk behaviors as a result of initiation of meth use. Measures specific to this aim include fatal and non-fatal overdose, sharing of syringe and other injection paraphernalia, and unprotected sexual encounters. HIV, HCV and STI testing, as well as death certificate reviews will be conducted to complement self-reported behavioral data; and 3) determine impact of MA use on SUD/OUD treatment seeking, treatment initiation and long-term engagement in SUD treatment. While the data collected to date from the SNAP and CARE2HOPE cohorts have been invaluable in informing the opioid epidemic in rural Appalachia, it is important that this renewal be positioned to fill additional gaps in the literature. Currently, there is little information on the “twin epidemic” phenomenon and its potential impact on fatal and non-fatal overdoses, the SUD treatment cascade, and harm reduction services, especially in resource-deprived areas such as rural Appalachia. The proposed renewal will address these gaps and provide data that are integral to addressing drug-related harms in the rural U.S.


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: 2026 ( Subtotal = $482,290 )
2026	2026	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	12	1/29/2026	NON-COMPETING CONTINUATION	$482,290
														Subtotal = $482,290

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	11	3/5/2025	NON-COMPETING CONTINUATION	$0
2025	2024	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	001	11	8/15/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $548,474 )
2024	2024	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	11	4/24/2024	NON-COMPETING CONTINUATION	$548,474
														Subtotal = $548,474

Issue Date FY: 2023 ( Subtotal = $558,874 )
2023	2023	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	10	3/21/2023	NON-COMPETING CONTINUATION	$558,874
2023	2022	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	003	9	3/31/2023	COMPETING CONTINUATION	$328,774
2023	2021	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	002	8	3/31/2023	SUPPLEMENT FOR EXPANSION	-$78,098
2023	2021	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	001	8	3/31/2023	NON-COMPETING CONTINUATION	-$250,676
														Subtotal = $558,874

Issue Date FY: 2022 ( Subtotal = $576,874 )
2022	2022	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	001	9	6/15/2022	COMPETING CONTINUATION	$576,874
2022	2021	UNIVERSITY OF KENTUCKY RESEARCH FOUNDATION, THE	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	8	6/15/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $576,874

Issue Date FY: 2021 ( Subtotal = $660,918 )
2021	2021	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	001	8	8/12/2021	SUPPLEMENT FOR EXPANSION	$156,997
2021	2021	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	8	2/5/2021	NON-COMPETING CONTINUATION	$503,921
														Subtotal = $660,918

Issue Date FY: 2020 ( Subtotal = $529,108 )
2020	2020	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	7	11/19/2019	NON-COMPETING CONTINUATION	$476,196
2020	2020	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	001	7	2/10/2020	NON-COMPETING CONTINUATION	$52,912
														Subtotal = $529,108

Issue Date FY: 2019 ( Subtotal = $537,587 )
2019	2019	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	6	12/24/2018	NON-COMPETING CONTINUATION	$537,587
														Subtotal = $537,587

Issue Date FY: 2018 ( Subtotal = $0 )
2018	2017	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	5	2/15/2018	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2017 ( Subtotal = $831,662 )
2017	2017	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	002	5	9/13/2017	SUPPLEMENT FOR EXPANSION	$275,701
2017	2017	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	001	5	5/22/2017	NON-COMPETING CONTINUATION	$55,595
2017	2017	UNIVERSITY OF KENTUCKY	500 S LIMESTONE 109 KINKEAD HALL	LEXINGTON	KY	40526	FAYETTE	USA	Drug Use and Addiction Research Programs	000	5	3/10/2017	NON-COMPETING CONTINUATION	$500,366
														Subtotal = $831,662

Issue Date FY: 2016 ( Subtotal = $558,014 )
2016	2016	UNIVERSITY OF KENTUCKY, RESEARCH FOUNDATION	105 KINKEAD HALL	LEXINGTON	KY	40506	FAYETTE	USA	Drug Use and Addiction Research Programs	001	4	4/22/2016	COMPETING CONTINUATION	$558,014
2016	2014	UNIVERSITY OF KENTUCKY, RESEARCH FOUNDATION	105 KINKEAD HALL	LEXINGTON	KY	40506	FAYETTE	USA	Drug Use and Addiction Research Programs	000	3	4/21/2016	NON-COMPETING CONTINUATION	$0
														Subtotal = $558,014

Issue Date FY: 2014 ( Subtotal = $514,183 )
2014	2014	UNIVERSITY OF KENTUCKY, RESEARCH FOUNDATION	105 KINKEAD HALL	LEXINGTON	KY	40506	FAYETTE	USA	Drug Use and Addiction Research Programs	000	3	8/12/2014	NON-COMPETING CONTINUATION	$514,183
														Subtotal = $514,183

Issue Date FY: 2013 ( Subtotal = $530,750 )
2013	2013	UNIVERSITY OF KENTUCKY, RESEARCH FOUNDATION	105 KINKEAD HALL	LEXINGTON	KY	40506	FAYETTE	USA	Drug Use and Addiction Research Programs	000	2	8/20/2013	NON-COMPETING CONTINUATION	$530,750
														Subtotal = $530,750

Issue Date FY: 2012 ( Subtotal = $565,845 )
2012	2012	UNIVERSITY OF KENTUCKY, RESEARCH FOUNDATION	105 KINKEAD HALL	LEXINGTON	KY	40506	FAYETTE	USA	Drug Use and Addiction Research Programs	000	1	8/13/2012	NEW	$565,845
														Subtotal = $565,845

Grand Total All Awards = $6,894,579

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Examining the Impact of the Twin Epidemics of Methamphetamine and Opioid Use on Overdose, Risky Sex and Treatment Engagement among PWUD in Two Rural Appalachian Cohorts

Award Number: R01DA033862

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2012

PERIOD OF PERFORMANCE END DATE: 11/30/2027

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