# Risk and Protective factors of Polydrug Overdose in North Carolina

> **NIH ALLCDC R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $349,978

## Abstract

ABSTRACT
 From April 2020, the start of the COVID-19 pandemic in the US, to April 2021, there were more than
100,000 drug overdose deaths in the US. It is estimated that the drug overdose epidemic currently costs the
US about $1 trillion each year. Over the past 5-7 years, drug overdoses involving multiple drugs (polydrug) has
increased especially rapidly. More than 60% of all drug overdose deaths in the US now involve multiple drugs,
especially illicit fentanyl mixed with prescription opioids, cocaine, benzodiazepines, and stimulants. In North
Carolina (NC), the state where the proposed study focuses, more than 70% of overdose deaths involve
polydrug overdoses, including 53% which involve at least one opioid and 19% which involve multiple non-
opioids. Polydrug overdoses are also increasing disproportionately among racial/ethnic minority Americans.
 Systems like healthcare, insurers, and corrections, which have the potential to implement large prevention
initiatives, lack the linked data to establish benchmarks of polydrug overdose incidence in their populations and
define risk and protective factors. Many people who die from polydrug overdose have had recent contact with
healthcare, insurance, or correctional systems. In fact, drug overdose death rates from individuals on Medicaid
and those released from correctional settings are much higher than the general population. Further, the role of
prescription opioids for acute, post-surgical, or chronic pain in leading to polydrug use and overdose is not
understood. It is important to understand pathways to polydrug use and barriers to substance use disorder
treatment through the lens of lived experience of persons who use drugs and treatment providers.
 Therefore, in this mixed-methods study, we will define polydrug overdose rates and trends in four large
populations representing publicly and privately insured individuals, health system patients, and those released
from incarceration over a 16-year period; identify demographic, clinical, and short- and long-term care access
patterns and factors that predict risk of fatal polydrug overdoses in each of the four populations; identify
prescription opioid pain management trajectories in longitudinal cohorts of patients with acute, post-surgical,
and chronic pain that are associated with increased risk of fatal polydrug overdoses; and elucidate the
pathways to polydrug use and overdose people with lived experience and understand barriers to effective
substance use disorder treatment and linkage to such treatment from providers and harm reduction
professionals. We will also examine racial disparities and racial algorithmic bias in prediction models and
develop tools that may aid clinicians and corrections officers to identify people at high risk for polydrug
overdose deaths and connect them with appropriate treatment options. This work will leverage data resources
and linkages developed from our prior and ongoing studies, thereby maximizing resources, and ...

## Key facts

- **NIH application ID:** 10579463
- **Project number:** 1R01CE003471-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Brian W Pence
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $349,978
- **Award type:** 1
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10579463

## Citation

> US National Institutes of Health, RePORTER application 10579463, Risk and Protective factors of Polydrug Overdose in North Carolina (1R01CE003471-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10579463. Licensed CC0.

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