Funded Projects

Despite substantial increases in overdose deaths among people who use methamphetamine, little is known about how to effectively provide harm reduction services to these individuals. This project will combine and test two harm reduction interventions for people who use methamphetamine. First, peer recovery support specialists will help identify personal harm reduction goals. The project will also test the value of incentives toward achieving these goals (a strategy known as contingency management).

This project will evaluate a previously developed harm reduction intervention that addresses the needs of women who use drugs in an urban environment. The approach uses a mobile van to offer naloxone, fentanyl test strips, and other harm reduction supplies – along with necessities such as food and clothing, brief trauma-informed counseling, and referrals to drug treatment, medical care, and social services. This research aims to test the impact of an intervention that may increase access to harm reduction services for women, as well as assess how to put it into place.

Harm reduction supplies include fentanyl test strips that allow people who use drugs to identify whether the substance(s) they plan to take contain fentanyl and sterile syringes that help to prevent the spread of infectious diseases among people who inject drugs. One potential way to increase access to harm reduction supplies is mail delivery. This project will describe state-level policies that deter the use of mail-based delivery of harm reduction services, examine characteristics of people who use mail-based harm reduction services, and assess individual preferences related to mail-based harm reduction services.

To respond quickly and effectively to the constantly changing dynamics of the opioid crisis, public health agencies and organizations need timely state and local data to make critical decisions about where to allocate resources and target responses. This project creates the Rapid Actionable Data for Opioid Response in Kentucky system, a near real-time statewide surveillance system. This resource will combine data from multiple state agencies to provide actionable and timely information to support opioid overdose prevention, harm reduction, evidence-based treatment, and recovery services. The project will also develop user-driven reporting and visualization tools (mobile and web-based apps) that provide immediate access to near real-time community or state level data, reports, and visual analytics.

A key component to addressing the current opioid overdose crisis is the ability to track dangerous opioid use in a timely manner so that public health agencies can plan accordingly. Direct reports about drug use and overdoses from social media might provide a useful early warning system that when combined with other sources, can provide policy makers and public health officials with powerful tools for monitoring this public health crisis. This project will explore the usefulness of Twitter and Reddit as a social media component of opioid use surveillance – in particular by monitoring mentions of fentanyl and synthetic opioids at various geographic levels (e.g., local or regional) and over time.

Timely and accurate surveillance of fatal and non-fatal overdoses is necessary in light of the worsening overdose crisis, but data is rarely available in real-time. Tracking non-fatal overdoses is especially important because patients who overdose once are likely to experience additional and potentially fatal overdoses. This project aims to increase the quality and timeliness of non-fatal overdose data estimates by analyzing clinicians’ notes rather than clinical codes from emergency department and emergency medical services records. The datasets and models produced from this research will be used to build an interactive dashboard with up-to-date, county-level overdose-surveillance estimates for use by Kentucky first responders to aid in rapid allocation of resources.

This project creates the HEAL Harm Reduction Network Coordination Center, which will provide support to the nine research studies in the HEAL Harm Research Reduction Network. The center will provide administrative and logistical help; support data harmonization and data sharing; involve stakeholders in all network activities; and share research findings and other products with researchers, practitioners, stakeholders, and the general public. 

Compared to people who use only one type of drug, people who use combinations of drugs, such as opioids and stimulants, are more likely to have histories of childhood trauma, including post-traumatic stress disorder (PTSD). This project will adapt an existing PTSD intervention, Skills Training in Affective and Interpersonal Regulation with Narrative Therapy, to treat individuals with polysubstance use. This research will be piloted in a methadone maintenance treatment program to assess feasibility and acceptability. If successful, the findings will lay the groundwork for a large-scale clinical trial.

Opioid overdose deaths disproportionately affect Black individuals in the United States. While the use of complementary and integrative pain treatments is effective and widely recommended, Black pain patients (especially those who also have depression) face barriers to the use of these approaches. This project will refine, test, and prepare to implement a novel approach to overcoming these treatment barriers. The research will partner with and empower Black patients to find safe, effective pain treatments that best match their values, preferences, and lifestyles.

The opioid crisis has been particularly devastating to adolescents and young adults between 16 and 25 years old. Recovery support services in community settings can help these individuals who take medications for opioid use disorder find a path to recovery. This project will develop a network of advanced researchers, recovery support specialists, adolescents and young adults in recovery, and other key community stakeholders to help rapidly advance the science of recovery support services. This research will focus in particular on continuing care services specialized for adolescents and young adults who currently take or who have taken medications for opioid use disorder.

There are currently no medications approved by the U.S. Food and Drug Administration to treat methamphetamine use disorder, even though risky patterns of methamphetamine use and overdose deaths have increased in recent years. Research using animal models shows that immune molecules that latch onto methamphetamine (anti-methamphetamine antibodies) show promise in blocking the effects of the drug. This project aims to identify a long-acting monoclonal antibody targeted to methamphetamine and conduct development and safety studies to prepare for future testing of the antibody treatment in humans.

People who take medications for opioid use disorder as part of their recovery pathway need to take these medications for extended periods of time to reduce risk of overdose. Recovery community centers, which provide a range of recovery-oriented and peer-delivered services in a welcoming environment, may be an important asset for these individuals. This project joins two recovery community centers that serve Black communities with an academic research team to inform the design of a rigorous, large-scale clinical trial to determine if clinical referral to recovery community centers improves long-term recovery outcomes.

Young adults (18 to 26) with a substance use problem have the highest rates of polysubstance use among all age groups. At the same time, individuals in this age group (especially in rural areas) are generally lacking in recovery capital: resources to help them recover from substance use, such as vocational or educational skills. This project will assess the feasibility and acceptability of “Launch,” which uses parental and peer recovery support to increase recovery capital for young adults with polysubstance use. The intervention will use coaching as well as contingency management, a treatment approach in which individuals receive tangible rewards as incentives for desired behaviors such as abstinence. If successful, the findings will inform a future large-scale trial assessing the effectiveness of this approach.