Brown University research aims to tackle opioid crisis

Brown University’s School of Public Health has an idea that might impact Rhode Island’s opioid crisis. The school’s researchers have received a five-year $6.8 million grant from the National Institutes of Health for a two-pronged project.

The first part will focus on determining at-risk neighborhoods while the second part will be administering test strips to determine if drugs have been tainted by fentanyl. Ultimately, the hope is that this action can reduce the number of drug-related deaths in the state.

“Both projects are trying to bring innovative technologies to help solve the overdose crisis,” said Brandon Marshall, an associate professor of epidemiology at Brown and principal investigator for both projects, in a released statement. “That’s the long-term goal—to reduce the risk of overdose and to save lives.”

But not everyone agrees with the use of fentanyl test strips, which are similar in function to an over-the-counter pregnancy test, as a suitable way to combat opioid addiction.

In a blog post on the Substance Abuse and Mental Health Services Administration website last October, Elinore McCance-Katz, MD, Ph.D, assistant secretary for mental health and substance abuse, acknowledges the high rates of death due to opioids and recognizes, on the surface, that using these strips seems like a valid solution.

However, she believes it is more likely that drug users will only want their next fix to avoid withdrawal.

“Although I know that there are self-reported data that may suggest otherwise,” stated McCance-Katz, “at the moment before they’re about to use, based on my clinical experience, it is hard to imagine that drug users will not use the substance despite its apparent danger.”

Testing for tainted drugs is one thing. Knowing which neighborhood you’ll find those drugs is another. Brown University researchers, in collaboration with New York University and UC Berkeley, will parse statistics and other data from a “machine-learning” model to better pinpoint at-risk areas in Rhode Island.

Because Rhode Island’s overdose rate is 1.5 times the national average, the hope is that this identification will not only highlight problematic areas now but how they will be affected in the future.

Magdalena Cerda, DrPH, associate professor in the department of population health at New York University School of Medicine, said the data will come from multiple sources—hospitalizations due to opioids, Emergency Medicine Foundation data, opioid treatments, the number of opioid prescriptions, naloxone distribution, and socio-economic status. (Prior studies have shown that the overdose rate is higher in lower income neighborhoods).

“I hope this will be a valid tool to determine at-risk neighborhoods and to be able to develop it with higher accuracy,” she said. “It’s a tool we hope to generalize so that we can replicate it elsewhere. “

The collaborative research will also look at all overdose drug information and then more specifically pinpoint the opioid use. Cerda said that death certificates have a code that denotes the cause of death which will show the overdoses as well as the ones specific to opioids.

She pointed out Rhode Island has a supportive response system and “access to a wonderful amount of data,” so it made it the perfect place to start this kind of research.

Cerda is hoping in the future to look into her own state of New York.