# Navigating the Fentanyl Age with Community Drug Checking

> **NIH NIH UG3** · RHODE ISLAND HOSPITAL · 2022 · $381,649

## Abstract

Project Summary
The drug supply is in enormous flux with illicitly manufactured fentanyl (IMF) and analogs creating a deadly
environment for people who use drugs (PWUD). Claiming 93,311 lives in 2020, IMF is the underlying driver of
the current crisis. Its fast onset leaves little time for emergency intervention and its presence as the dominant
opioid in circulation undermines evidence-based treatments. Rhode Island (RI) is a site of early IMF
devastation, subject of much epidemiologic investigation about IMF, and an innovation hub for expanded
access to lifesaving naloxone and medications for opioid use disorder (MOUD) and structures to better provide
them. Two recent innovations show promise even with IMF’s endemicity and the COVID-19 pandemic because
they address the illicit drug supply head-on: non-traditional MOUD induction pathways and community drug
checking. But treatment success may be undermined by the illicit drug supply unless we learn how to navigate
it. One novel approach to doing so is with community drug checking. Drug checking gives insights into what
drugs people use, engages PWUD in relevant exchange of health information, and generates data that could
inform treatment. Application of these data for epidemiologic research to help better understand exposure,
identify risk, measure consequence and consideration of their role in a clinical setting to inform treatment have
not been examined. We propose an observational study that leverages recently acquired devices and capacities
to carry out research on drug checking, multiple linkable individual level datasets, and state law and public
health leadership supportive of drug checking. Consistent with the RFA, we seek to uncover how characteristics
of IMF in the drug supply influence treatment regimens and ongoing drug use and risk in people intentionally
or unwittingly using polysubstances (topics 2 and 4). Specific aims are to: Aim 1) Examine the anatomy of the
illicit drug supply by establishing a community drug checking cohort (n=600) to learn how: a) IMF’s presence,
form (i.e., powder, counterfeit pill), and potency in the opioid supply affect ongoing use and overdose risk; b)
IMF’s presence in non-opioid drugs like stimulants affects use, overdose risk and clinical severity of health
consequences; and c) use of drug checking affects uptake of MOUD. [UG3 and UH3]. Aim 2) Document
clinicians’ perceptions about drug checking, and their experiences, innovations, barriers and facilitators of
induction of patients onto MOUD, including micro- and macro-dosing, in RI. [UH3] Aim 3) Assess among
community drug checking cohort members a) which drug supply characteristics are associated with ongoing
drug use, overdose and MOUD interest; b) what drug supply factors impact incidence of induction problems
like precipitated withdrawal and successful retention in buprenorphine care using administrative data. [UH3]
Findings will help inform prevention and intervention approaches to the drug supp...

## Key facts

- **NIH application ID:** 10524801
- **Project number:** 1UG3DA056881-01
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** TRACI C GREEN
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $381,649
- **Award type:** 1
- **Project period:** 2022-09-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10524801

## Citation

> US National Institutes of Health, RePORTER application 10524801, Navigating the Fentanyl Age with Community Drug Checking (1UG3DA056881-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10524801. Licensed CC0.

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