Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

Since 2016, British Columbia has faced an unprecedented opioid crisis that has claimed over 15,800 lives. In 2023, drug poisoning was the leading cause of death for people aged 10-59 in the province, with fentanyl responsible for the majority of these deaths. People who are unhoused or facing unstable housing are among the most severely impacted, with overdoses accounting for almost 90% of accidental deaths in this group. While fatal overdoses highlight the devastating toll of the crisis, many survivors live with lasting brain injuries and mental health challenges. To reduce both deaths and long-term harms, it is essential to understand the factors that put people at risk of overdose in the days and weeks before it happens. This project will use data from the Hotel Study, a long-term research project that began in 2008 and followed approximately 500 participants living in single-room occupancy units in Vancouver's Downtown Eastside. Participants were interviewed monthly about their substance use, mental health, medical history, and social circumstances. We captured overdose events using hospital records, coroner's reports, and self-reports during participant interviews. Our research has three aims. First, we will identify which changes in health, substance use, or social conditions in the prior week or month increase the likelihood of an overdose. Second, we will examine how people move along the "risk continuum," from not using opioids, to using them, to being at high risk of overdose. Third, we will assess which factors increase the likelihood of dying from an opioid overdose. By identifying these risks, our work will help guide more effective interventions, such as improved overdose prevention, mental health support, and housing policies. Ultimately, this research aims to provide the knowledge that can directly reduce the risk of opioid overdoses in individuals who are at the highest risk.