# The Rhode Island Young Adult Prescription and Illicit Drug Study (RAPIDS): Responding to Fentanyl and Associated Harms

> **NIH NIH R01** · BROWN UNIVERSITY · 2022 · $751,010

## Abstract

PROJECT SUMMARY
 The United States is experiencing the worst drug overdose epidemic in history. This crisis has been greatly
exacerbated by the emergence of potent synthetic opioids, particularly fentanyl and related analogs. Fentanyl
is now the most common adulterant in heroin and has been identified in counterfeit prescription pills and illicit
drugs such as cocaine. Only a small amount of fentanyl (the equivalent of several grains of salt) can lead to a
fatal overdose. Its presence in the illicit drug supply thus poses great risk to those who unknowingly consume
the substance. Over 30% of all drug overdose deaths in the US are due to synthetic opioids (mostly fentanyl),
yet few strategies aimed at reducing risk of fentanyl overdose have been developed. In this randomized
controlled trial, we will test the efficacy of a novel, theory-based fentanyl overdose education and counseling
intervention that incorporates “take-home” rapid fentanyl testing strips in reducing rates of overdose. The study
will be conducted in Rhode Island, a state with the tenth highest overdose rate in the nation and in which over
half of drug-related deaths are due to fentanyl. We will recruit a community-based sample of 500 young adults
aged 18 to 35 who use heroin or illicit stimulants, counterfeit prescription pills, or inject drugs. In the
intervention arm, individuals will participate in the RAPIDS intervention, a novel fentanyl overdose education
and counseling program that provides information about the dangers of fentanyl, motivational interviewing to
increase willingness to use rapid fentanyl test strips and engage in harm reduction behaviors, hands-on
training on how to use the strips, and opportunities to discuss and role-play how to implement harm reduction
behaviors. Individuals randomized to the control arm will receive standard overdose education and naloxone
distribution. The primary outcome will be the rate of self-reported overdose observed over the 12-month follow-
up period. We will supplement the primary endpoint with data on fatal and non-fatal overdose events
ascertained through a CDC-funded statewide overdose surveillance system. The Specific Aims of this study
are to: 1) Assess efficacy of the RAPIDS intervention in reducing rates of overdose among young adults who
use drugs; 2) Examine the degree to which reductions in rates of overdose are mediated by increases in
information, motivation, behavioral skills, and self-efficacy regarding fentanyl, rapid fentanyl testing, and harm
reduction practices; and 3) Explore whether there is heterogeneity of treatment effect related to key participant
characteristics. Our study is highly significant because it directly addresses crucial knowledge gaps in how to
best reduce risk of overdose among young adults in the face of an escalating fentanyl epidemic. The study is
highly innovative because it will be the first in the United States to test the efficacy of a novel overdose
education and counseling interve...

## Key facts

- **NIH application ID:** 10411973
- **Project number:** 5R01DA047975-04
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Brandon David Lewis Marshall
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $751,010
- **Award type:** 5
- **Project period:** 2019-08-15 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10411973

## Citation

> US National Institutes of Health, RePORTER application 10411973, The Rhode Island Young Adult Prescription and Illicit Drug Study (RAPIDS): Responding to Fentanyl and Associated Harms (5R01DA047975-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10411973. Licensed CC0.

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