Grant: CIHR Fellowship

North America is in the midst of a drug overdose epidemic, and the number of drug overdose deaths (ODs) has surpassed motor vehicle incidents and homicide deaths combined. Opioid-related fatal overdoses account for most drug ODs. Significant surges in opioid-related ODs in the past few years have been particularly attributed to the influx of North America's illicit drug supply with fentanyl and its analogues. While several studies have tried to assess individual-level risk factors of fatal and non-fatal overdoses, there is a need for neighborhood-level studies on opioid-related overdoses to identify neighborhoods at highest risk of opioid-related overdose and inform the implementation of targeted overdose prevention interventions. The objectives of this study are: 1) Summarizing the literature on neighborhood-level predictors of fatal and non-fatal opioid-related overdoses; 2) Characterizing the spatial trends and predictors of opioid-related fatal and non-fatal overdoses from 2014-2020 in Rhode Island, USA (i.e., a setting with one of the highest rates of drug ODs in North America); 3) Identifying neighborhoods vulnerable to future illicit fentanyl-involved ODs in Rhode Island, USA. Question 1 will be addressed through a systematic literature review and data synthesis of neighborhood-level risk factors of opioid-related overdose by searching several electronic scientific databases. Question 2 will be addressed using a large, linked, statewide dataset, and exploratory spatial data analysis. Question 3 will be addressed using spatial machine learning methods and timely surveillance data. This study will be conducted in collaboration with Rhode Island's Department of Health, the Governor's overdose task force, and representatives from treatment programs and community-based agencies. Ultimately, this study will inform the implementation of harm reduction and other public health interventions aimed at reducing opioid-related overdoses in North America.