NYU Langone’s Center for Opioid Epidemiology and Policy (COEP) invites you to join our mailing list to receive our monthly newsletter, which features news in the field, center updates (including upcoming events, grant programs, and new faculty and student announcements), and research and media highlights. The newsletter presents our research findings alongside actionable approaches that policymakers, advocates, and the broader research community can incorporate into their work addressing the opioid overdose crisis.

Here are some recent research findings and highlights from our center’s investigators.

COEP to Study Ability of Overdose Prevention Centers to Counter Unprecedented Overdose Crisis

COEP members, led by Magdalena Cerdá, DrPH, MPH, were awarded a National Institute on Drug Abuse (NIDA) grant to study the COVID-19 pandemic as a Big Event that may have impacted overdose alongside researchers at Brown University. Over the next four years, they will conduct a multi-method, individual- and community-level evaluation of overdose prevention centers (OPCs) in New York and Rhode Island. In doing so, they will investigate whether enrolled participants who visit OPCs experience lower rates of fatal or nonfatal overdoses, drug-related health problems, and emergency department visits, and whether they are more likely to enter treatment for substance use disorders compared to people who use drugs but do not visit OPCs; examine the community impact of OPCs by assessing whether neighborhoods surrounding OPCs experience a greater change in overdoses, public disorder such as drug-related litter, arrests, and noise complaints, and economic activity compared to similar neighborhood blocks that do not have an OPC; and estimate the operational costs of OPCs and the potential cost savings to the healthcare and criminal justice systems associated with OPC use. Learn more about this study.

One-Year Association of Drug Possession Law Change with Fatal Drug Overdose in Oregon and Washington

In this cohort study, COEP members Spruha Joshi, PhD, Bianca Rivera, MPH, Magdalena Cerdá, DrPH, MPH, and Corey Davis, JD, used synthetic control analysis to evaluate whether decriminalization of drug possession in Oregon and Washington was associated with changes in either direction in fatal drug overdose rates. The average rate difference in Oregon post change was 0.268 fatal drug overdoses per 100,000 state population, while the average rate difference in Washington post change was 0.112 fatal drug overdoses per 100,000 state population. These rate differences were not statistically significant; there was no evidence of an association between legal changes that removed or substantially reduced criminal penalties for drug possession in Oregon and Washington and fatal drug overdose rates. Additional research could examine potential other outcomes as well as longer-term associations with fatal drug overdose overall and across racial and ethnic groups. Time magazine reported on the findings of the study, quoting Dr. Joshi and Davis. Read the paper in JAMA Network.

State-Level History of Overdose Deaths Involving Stimulants in the United States, 1999‒2020

In this study, COEP members Amanda M. Bunting, PhD, Magdalena Cerdá, DrPH, MPH, Noa Krawczyk, PhD, Ariadne Rivera-Aguirre, MPP, and colleagues used death certificate data from the National Center for Health Statistics to categorize deaths into four groups of interest: cocaine with and without opioids, and psychostimulants with and without opioids. They used a Bayesian multiple change point model to describe the timing and magnitude of changes in overdose death rates involving stimulants for each state and year. There was little change in the death rates of cocaine without opioids. Death rates involving cocaine and opioids sharply increased around 2015, particularly in the Northeast and Mid-Atlantic. They also observed steady increases in deaths involving psychostimulants without opioids just before 2010, particularly in states in the West and South. Deaths involving psychostimulants with opioids increased around 2015 with largest increases concentrated in Appalachian states. There is significant geographic heterogeneity in the co-involvement of stimulants in the U.S. overdose crisis. Results can inform public health efforts to inform state-level overdose efforts such as naloxone distribution. Read more in the American Journal of Public Health.

Organizational Access Points and Substance Use Disorder Treatment Utilization Among Black Women: A Longitudinal Cohort Study

Health and social service organizations, including the emergency department and public assistance programs, constitute a social safety net that may serve as an “access point” for substance use treatment utilization. Racialization of substance use disorder (SUD) and gender disparities in access to treatment contribute to differences in health and social service utilization, including substance use treatment for Black women. In this study, COEP member Amanda M. Bunting, PhD, Sugy Choi, PhD, Charles J. Neighbors, PhD, and colleagues explored the role of various access points in facilitating the use of substance use treatment among Black women with substance use and involvement in the criminal justice system. They used data from the Black Women in the Study of Epidemics (B-WISE) project (2008–2011), which recruited Black women who use drugs from community, probation, and prison recruitment settings in Kentucky. For the community and prison samples, the use of an emergency department in the six months prior decreased women’s likelihood of subsequent substance use treatment use. For the probation sample, receiving support from public assistance (i.e., food stamps, housing, cash assistance) increased the likelihood of subsequent substance use treatment use. Interactions with health and social service organizations predicted Black women’s use of substance use treatment services and varied based on their involvement in the criminal justice system. As such, public assistance venues for Black women on probation may be a point of intervention to increase their access to and use of substance use treatment. Read more in Health & Justice.

Sociopolitical Diagnostic Tools to Understand National and Local Response Capabilities and Vulnerabilities to Epidemics and Guide Research into How to Improve the Global Response to Pathogens

The AIDS and COVID-19 pandemics demonstrated that nations at similar economic development levels varied widely in their capacity to protect the health of their residents. Reflecting on the response to these and other global pandemics, and on the failure of the existing Global Health Security Index to explain how well countries did, COEP member Samuel R. Friedman, PhD, and colleagues assert that the World Health Organization (WHO), national and local governments (including public health agencies), researchers, the media, and the public lack an adequate scientific base on which to base decision-making and public messaging, and thus that research is sorely needed. Specifically, they call for research and institutional development to establish and then to study sociopolitical diagnostic systems that develop and validate a broad range of sociopolitical and cultural diagnostic measures that can be used to help understand which countries are most at risk and how to strengthen their ability to weather pandemics. Such measures ought to include patterns of public health and medical funding, social influence networks in various population subgroups, social norms towards altruism and solidarity, patterns of social cohesion and schism, stigmatizations of and in different subpopulations, patterns of social conflict, and attitudes and political approaches to the validity of science. Read more in Pathogens.