# A Longitudinal Qualitative Study of Fentanyl-Stimulant Polysubstance Use Among People Experiencing Homelessness (Administrative supplement)

> **NIH NIH R01** · YALE UNIVERSITY · 2023 · $161,497

## Abstract

Project Summary
We propose a one-year, Administrative Supplement to our parent grant (R01DA05672) to qualitatively examine
the
use
homelessness
relationship between experiences of community supervision (i.e., probation and parole) and polysubstance
patterns, overdose vulnerability, and substance use t reatment in a sample of people experiencing
with fentanyl-stimulant polysubstance use. People experiencing homelessness who use drugs
are disproportionately engaged the criminal legal system and those who are racially minoritized are most
impacted by the negative consequences of this engagement (e.g., arrest and incarceration). In 2020,
approximately 4 million people in the US were on community supervision, which includes limitations on
freedom of movement, time, and social contacts, as well as mandatory urine toxicology screening during the
period of probation and parole. Formerly incarcerated people experience higher rates of homelessness, but the
role that community supervision plays in shaping access to housing post-release is not well understood.
Overdose vulnerability increases in the period immediately following release from jail and/or prison, due to
decreased tolerance, changes to the drug supply, and atrophied social networks. However, little is known
about the relationship between community supervision and overdose vulnerability, especially for people
experiencing homelessness who co-use stimulants and fentanyl. In addition, the relationships between
fentanyl-stimulant polysubstance use, community supervision, and access to substance use disorder treatment
has yet to be studied. Extending the scope of the parent grant and building on our extensive experience
studying drug use, homelessness, and community supervision, we propose the following specific aims:
CLS.SA1: To characterize how community supervision shapes fentanyl-stimulant polysubstance use among
people experiencing homelessness, including polysubstance use patterns and drug use practices. CLS.SA2:
To explore how community supervision impacts overdose
disorder
vulnerability, access to housing, and substance use
treatment among people experiencing homelessness with fentanyl-stimulant polysubstance use.
Informed by the equity-focused Intersectional Risk Environment framework, we will conduct qualitative
interviews with enrolled parent study participants who are on community supervision in San Francisco (n=25),
and analytically compare those experiences to parent study participants not engaged in community
supervision. Data garnered from this administrative supplement will generate emergent lines of inquiry for
future R01 proposals and be used to offer recommendations for this population that are scalable and adaptable
to other US cities through the parent study's extensive community stakeholder engagement processes. This
study is aligned with priorities of the current Notice of Special Interest (NOT-OD-23-011) by examining the
relationship between criminal legal system involvement,...

## Key facts

- **NIH application ID:** 10841820
- **Project number:** 3R01DA057672-01S1
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Kelly Ray Knight
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $161,497
- **Award type:** 3
- **Project period:** 2023-11-01 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10841820

## Citation

> US National Institutes of Health, RePORTER application 10841820, A Longitudinal Qualitative Study of Fentanyl-Stimulant Polysubstance Use Among People Experiencing Homelessness (Administrative supplement) (3R01DA057672-01S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10841820. Licensed CC0.

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