# Evaluating opioids and suicide prevention in  health care settings through the System of Safety

> **NIH NIH R01** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2020 · $453,350

## Abstract

PROJECT SUMMARY/ABSTRACT
 Significance: Suicide and opioid misuse are related epidemics that are both increasing and devasting. The
parent R01 System of Safety (SOS) is studying implementation of the Zero Suicide Essential Elements of Care
across the emergency departments, inpatient medical and behavioral health units, and primary care clinics of a
large healthcare system. It has created a rich repository of suicide-related and other clinical electronic health
record (EHR) and vital statistics data. The proposed revision will expand that repository and use natural language
processing to detect opioid problem-related encounters, allowing us to (1) explore the relation between suicide
risk and opioid misuse and (2) test whether the Zero Suicide model's intervention effect is moderated by opioid
misuse and whether it can also help to reduce opioid-related harm.
 Investigators: The team proposing this revision has extensive expertise in suicide risk screening,
assessment, intervention, and care transitions (Boudreaux, Larkin); opioid misuse (Boudreaux, Carreiro, Davis-
Martin); implementation science, healthcare systems change, and effectiveness trial design (Kiefe, Wang); and
data science and natural language processing (Liu, Yu). This complimentary, transdisciplinary team is very well
prepared to answer the important research questions posed in this proposal.
 Innovation: The SOS pioneers the implementation of system-wide suicide risk identification and prevention
efforts and has gathered rich data on suicidal ideation, attempts, and suicide-related care processes on hundreds
of thousands of patients. This proposal will use innovative methods to validate and extract opioid-related data
from the EHR to enhance the SOS repository to create a singular database available to the SOS investigators
and, eventually, public access through the NIMH archive.
 Approach: Aim 1 will extract opioid-related EHR data using a combination of diagnostic codes and natural
language processing, validated by structured manual chart review using a standardized procedure. Aim 2 will
analyze the interplay between suicide risk and opioid problems in encounters and patients within the repository.
Aim 3 will assess the effect of Zero Suicide implementation on prospective fatal and non-fatal suicidal behavior
in patients with an opioid problem and examine whether the implementation had an effect on the incidence of
opioid-related outcomes, including intentional overdose.
 Environment: Having supported successful, NIH funded studies in the domains of suicide, opioid use
disorders, data science, and natural language processing, UMass has clearly established its capability of
successfully supporting this revision.
 Impact: The combined innovation of the parent SOS and this revision positions it for a significant impact on
the fields of suicide prevention, opioids, and effectiveness trial design and analysis. The deliverables will have
broad significance across care settings, medica...

## Key facts

- **NIH application ID:** 10156633
- **Project number:** 3R01MH112138-05S1
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Edwin D Boudreaux
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $453,350
- **Award type:** 3
- **Project period:** 2020-09-21 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10156633

## Citation

> US National Institutes of Health, RePORTER application 10156633, Evaluating opioids and suicide prevention in  health care settings through the System of Safety (3R01MH112138-05S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10156633. Licensed CC0.

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