# Examining the impact of nonfatal and fatal overdose in social networks on individual overdose risk

> **NIH NIH F31** · BROWN UNIVERSITY · 2021 · $46,036

## Abstract

PROJECT SUMMARY
The epidemic of opioid-related overdose is a persistent problem in the US. While several social network
characteristics have been found to influence individual overdose risk, the influence of overdose occurring within
one’s social network on individual overdose risk has not yet been assessed, and potential mediators or
moderators of this effect have not yet been explored. The parent project upon which this Ruth L. Kirschstein
National Research Service Award (NRSA) Individual Predoctoral Fellowship to Promote Diversity in Health-
Related Research (F31 - Diversity) application builds is a randomized clinical trial that will assess an intervention
to reduce overdose risk among persons at risk of opioid-related overdose. The objective of this proposal is to
examine the influence of nonfatal and fatal overdose in social networks (reported at baseline) on individuals’
subsequent overdose risk at 6- and 12- months post-baseline. This F31, which is undergirded by Protection
Motivation Theory, will augment the existing parent grant by developing and integrating an egocentric network
assessment tool into existing assessments in the parent project that occur at baseline; this tool will be used to
assess exposure to overdose within one’s social network as well as potential moderators of the effect under
study. Semi-structured interviews will also be conducted to probe and explore potential mediators of the effect
of nonfatal and fatal overdose in social networks on individual overdose risk, including risk perception, trauma,
grief, and disruptions in social support and drug supply. The primary outcome for the proposed project will be
the rate of self-reported overdose at 6- and 12- months post-baseline, and the primary analysis will be
supplemented with data on nonfatal overdose events occurring within 12 months post-baseline, which will
ascertained through a CDC-funded statewide overdose surveillance system. This research will be first to utilize
a mixed-methods research design to assess the effect of nonfatal and fatal overdose in social networks on
individual overdose risk and explore potential mediators and moderators of the effect under investigation. Those
who are at risk of overdose require novel, targeted, and effective overdose prevention interventions to mitigate
overdose risk, and the proposed research study is well-poised to inform network-based intervention strategies.
If successful, the current study may provide additional evidence to provide survivor-centered harm reduction and
treatment outreach to individuals who have overdosed and members of their social network.

## Key facts

- **NIH application ID:** 10140661
- **Project number:** 1F31DA052971-01
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Alexandria Macmadu
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $46,036
- **Award type:** 1
- **Project period:** 2021-03-01 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10140661

## Citation

> US National Institutes of Health, RePORTER application 10140661, Examining the impact of nonfatal and fatal overdose in social networks on individual overdose risk (1F31DA052971-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10140661. Licensed CC0.

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