# Strategies to improve Utilization of Post-overdose Evidence-based Risk mitigation among Non-fatal Overdoses in VA (SUPER NOVA)

> **NIH VA I01** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2023 · —

## Abstract

Background: Drug overdose is a leading cause of death, accounting for 70,630 deaths in the United States
(US) in 20193. The majority of drug overdoses involve opioids, and opioid-involved stimulant deaths are rising
with 3 out of every 4 cocaine-related deaths involving opioids and 53% of psychostimulant-related deaths
involving opioids7. Drug overdose mortality among Veterans mirror these trends5,6. In Massachusetts, among
individuals who died of an opioid overdose, 1 in 6 had a non-fatal overdose in the preceding 12 months17.
These non-fatal overdoses serve as a promising target for opioid overdose prevention efforts, especially for
evidence-based treatments such as medications for opioid use disorder (MOUD). The increase in stimulant-
involved opioid overdoses also highlights the need to investigate strategies to improve uptake of evidence-
based treatments for stimulant use disorders.
Significance: In March 2019, the VHA Office of Mental Health and Suicide Prevention released a national
clinical note template, the Suicide Behavior and Overdose Report (SBOR). The SBOR standardizes the
reporting process, enhances the visibility of suicide and overdose events in the medical record, and is intended
to improve clinical care after these events (e.g., by incorporating risk factors for overdose and strategies to
mitigate risk, including referrals for care). However, the SBOR is currently mandated for intentional overdose
and only recommended for unintentional overdose. Moreover, it is unclear the extent to which it is being used
and whether its use improves post-overdose care as intended.
Innovation and Impact: The proposed study will characterize non-fatal opioid-, stimulant-, and combined
opioid and stimulant overdoses among VHA patients and the extent to which they receive recommended post-
overdose care. Given that the SBOR will soon be mandated for all overdoses, and to ensure that VHA is doing
everything it can to prevent overdose mortality among Veterans, it is critical to understand whether the SBOR
is improving post-overdose care as intended and if additional strategies may be needed.
Specific Aims: The proposed study will pursue the following specific aims:
Aim 1: Characterize non-fatal opioid and/or stimulant overdoses within VHA and patient-, prescriber-, and
setting-related factors associated with post-overdose treatment utilization.
Aim 2: Describe utilization of the SBOR among providers of patients with non-fatal opioid and/or stimulant
overdoses and associations between SBOR use, post-overdose treatment utilization, and treatment outcomes.
Aim 3: Identify barriers and facilitators of post-overdose care and ways to improve it via interviews with VHA
patients, patients’ concerned others, and treatment providers.
Methodology: The Reach, Effectiveness, Adoption, Implementation, and Maintenance—RE-AIM—framework
will guide our study. Aim 1: VHA patients with non-fatal overdoses will be identified using Corporate Data
Warehouse (CDW), Commun...

## Key facts

- **NIH application ID:** 10425936
- **Project number:** 1I01HX003403-01A1
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** Elizabeth M. Oliva
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-02-01 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10425936

## Citation

> US National Institutes of Health, RePORTER application 10425936, Strategies to improve Utilization of Post-overdose Evidence-based Risk mitigation among Non-fatal Overdoses in VA (SUPER NOVA) (1I01HX003403-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10425936. Licensed CC0.

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