# Reducing Opioid Mortality in Illinois (ROMI)

> **NIH NIH UG1** · UNIVERSITY OF CHICAGO · 2021 · $2,232,396

## Abstract

PROJECT ABSTRACT
More than 2,700 Illinois residents died of opiate overdose in 2017—a number that surpassed the state’s
combined fatalities from road accidents and gun homicide. Individuals leaving jail and prison may be at highest
risk of fatal overdose and other drug-related harms. Severely vulnerable men and women face these risks at
precisely the moment they cross boundaries of fragmented criminal justice, social service, and public health
systems, and are thus most vulnerable to lost follow-up and disengagement from services, or to have other
basic needs left unattended. The challenge may be most acute for detainees who rapidly flow through jail
settings, where unpredictable departures hinder discharge planning and care coordination, and where justice
stakeholders may hold attitudes that stigmatize substance use or resistant to harm reduction interventions.
Individuals returning to Chicago communities of color are near relatively rich resources for both treatment and
harm reduction. Yet they must navigate epicenters of illicit narcotics distribution that feature particularly high
incidence of fatal overdose from heroin, fentanyl, and other synthetic opioids. Rural individuals in Southern
Illinois, may have long travel distances from any methadone facility or any DEA-waivered physician available to
prescribe buprenorphine. Rural patients also face geographic barriers to the provision of naloxone and SSPs.
Many harm reduction services have been designed and implemented to serve urban populations in traditional
centers of opioid use. The acceptability and cultural competence of such rural services remains understudied.
Our proposed multi-site ROMI trial (Reducing Opioid Mortality in Illinois) seeks to address this public health
challenge through improved supports and service linkages to medication-assisted treatment (MAT), naloxone
distribution, and syringe support services (SSPs) provided to justice-involved individuals living with opioid use
disorders. We seek to test whether a unified case management approach that includes peer recovery coaches
can improve treatment engagement and retention in five diverse urban and rural contexts that all experience
high rates of opioid disorders, overdose, and related harms.
We request funds to implement a five-site Randomized Controlled Trial, enrolling at least 1,000 individuals
living with OUD. The ROMI trial will be carried out using a hub-and-spoke model, with centralized long-
standing social services infrastructure at the Community Outreach Intervention Projects (COIP) hosted at the
University of Illinois at Chicago (UIC). COIP provides case management/transition of care services to justice-
involved opioid users, extending resources and technical assistance to less-populated rural areas hardest-hit
by the opioid epidemic. Using a hybrid type-one effectiveness implementation design, we propose a simple but
effective package of treatment and harm reduction interventions to reduce subsequent opioid us...

## Key facts

- **NIH application ID:** 10148749
- **Project number:** 5UG1DA050066-03
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** HAROLD Alexander POLLACK
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $2,232,396
- **Award type:** 5
- **Project period:** 2019-07-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10148749

## Citation

> US National Institutes of Health, RePORTER application 10148749, Reducing Opioid Mortality in Illinois (ROMI) (5UG1DA050066-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10148749. Licensed CC0.

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