# A social diffusion fatal overdose prevention intervention: Assessing the effectiveness of people who use opioids as peer educators in training using & non-using networks on overdose & stigma reduction

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $754,011

## Abstract

Project Summary
Fatal overdose is a major cause of mortality among people who use opioids (PWUO). Yet, fatal overdose can
be prevented when naloxone is promptly administered. Bystanders of an overdose are well positioned to
administer naloxone and can include both people who use and do not use drugs. In our prior work, we have
shown that PWUO can be peer educators (PEs) for overdose prevention. In previous interventions we have
focused on training network members who use drugs to respond to an overdose. Yet, pilot data suggests that
overdoses are also often witnessed by people who do not use drugs. Drug user stigma may impact PWUO
engaging in conversations about overdose prevention with non-using networks as well as non-using network
members’ willingness to always carry naloxone. Based on pilot data, we propose expanding an overdose peer
education intervention to focus on non-using network members and to address drug user stigma. The
intervention seeks to prepare network members to respond to an overdose and normalize discussion about
overdose prevention planning between PWUO and their network members. Using an RCT study design, 300
index PWUO will be recruited along with 450 network members. The indexes will be randomly assigned to the
(1) standard of care (SOC) or (2) an experimental peer education condition (PEC). The proposed design allows
examination of the effectiveness of the intervention to train non-using network members and enhance
communications among PWUO and their network members. We will use mHealth to assess geographic
coverage of peer education and geospatially situated stigma in order to understand factors associated with the
geospatial coverage of the PEs. The RE-AIM framework will guide the collection of qualitative interview data to
identify barriers and facilitators to intervention implementation. Participants will be assessed every 6 months for
2 years. The proposed design also will allow for the longitudinal examination of pathways between social and
psychological, and mental health factors and overdose behaviors which can guide future interventions.
 Aim 1: Implement and evaluate an equal attention 2-group RCT PWUO peer educator intervention that
 focuses on training network members, especially non-drug using network members, to encourage overdose
 prevention and response behaviors.
 Aim 2: Assess factors associated with geospatial coverage of peer outreach and geospatially/socially
 situated drug user stigma using EMA/mHealth.

## Key facts

- **NIH application ID:** 10850901
- **Project number:** 5R01DA058659-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** CARL A LATKIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $754,011
- **Award type:** 5
- **Project period:** 2023-06-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10850901

## Citation

> US National Institutes of Health, RePORTER application 10850901, A social diffusion fatal overdose prevention intervention: Assessing the effectiveness of people who use opioids as peer educators in training using & non-using networks on overdose & stigma reduction (5R01DA058659-02). Retrieved via AI Analytics 2026-05-30 from https://api.ai-analytics.org/grant/nih/10850901. Licensed CC0.

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