Current research in NYU Langone’s Center for Opioid Epidemiology and Policy aims to inform evidence-based policies to prevent opioid misuse, disorder, and overdose in populations nationally and globally. Our work extends into other areas of substance use research related to stimulants and marijuana as well as novel research on the connections between the COVID-19 pandemic and the overdose epidemic.

The following are brief summaries of select projects conducted by our researchers. To stay up to date, please join our mailing list.

Effectiveness of Harm Reduction Laws to Reduce Opioid Harm in the United States

Leveraging large data and spatiotemporal analytic models, this study aims to determine which combinations of state and local harm reduction laws have resulted in the biggest decreases in overdoses and injection-related harms in the 836 largest municipalities in the United States. This work will lead to the creation of a public use, open-source dashboard that can be used to track state and local harm reduction laws, and their impact on overdoses and related harms.

Principal Investigators: Magdalena Cerdá, DrPH, MPH and Charles J. DiMaggio, PhD
Funding: NIH

Understanding the Intersection of the COVID-19 Pandemic and the Opioid Overdose Epidemic in New York State

This study focuses on understanding the intersections of the COVID-19 pandemic and the opioid overdose epidemic in New York State. Using a cohort of New York State Medicaid beneficiaries, we evaluate whether patients with chronic pain experienced a higher incidence of COVID-19-diagnosis than other Medicaid beneficiaries. Further, among chronic patients with chronic pain, we examine whether a history of long-term opioid therapy and/or diagnosis of opioid use disorder were associated with a higher incidence of COVID-19 complications, and investigate whether there was an increase in opioid overdoses after the first COVID-19 case was documented in New York State. This study will determine necessary targets for overdose prevention strategies among people with chronic pain during the COVID-19 pandemic.

Principal Investigator: Magdalena Cerdá, DrPH, MPH
Funding: National Institutes of Health (NIH)

Reducing the Consequences of the COVID-19 Pandemic on the Opioid Overdose Epidemic

The objective of this study is to determine how policies enacted in response to the COVID-19 pandemic have impacted the use of harm reduction and substance use treatment services, and to examine the relationship between acute changes in SARS-CoV-2 diagnoses and COVID-19 hospitalizations and deaths at the community level on rates of non-fatal and fatal drug overdoses. This work will help build an urgently needed evidence base that can be used to determine how best to manage the adverse effects of COVID-19 on the overdose epidemic.

Principal Investigator: Magdalena Cerdá, DrPH, MPH
Funding: NIH, Administrative Supplement

Examining the Synergistic Effects of Cannabis and Prescription Opioid Policies on Chronic Pain, Opioid Prescribing, and Opioid Overdose

This study examines the independent and joint impact of prescription opioid (PO) policies and cannabis laws on trends in chronic pain, opioid prescribing practices, opioid misuse, and overdose. By comparing these trends in states that enacted more restrictive PO policies and less restrictive cannabis laws with states that didn't enact these measures, we aim to identify the types and combinations of policies that will lead to the greatest reduction in opioid-related harm. Read the full abstract for further details.

Principal Investigator: Magdalena Cerdá, DrPH, MPH
Funding: NIH

Administrative Supplement: Examining the Synergistic Effects of Cannabis and Prescription Opioid Policies on Chronic Pain, Opioid Prescribing, and Opioid Overdose

The first aim of this study is to develop a taxonomy of opioid policies that classifies states according to the type of provision enacted for each policy of interest, as well as the overall restrictiveness and expansiveness of policies regulating the prescription opioid supply and access to treatment for opioid use disorder. The second aim is to use machine learning to determine the types of opioid policy provisions that are the strongest predictors of opioid prescribing, initiation, misuse, and disorder. Identifying these key policy measures will inform states on which combinations of opioid policies are most effective at reducing opioid-related harm. This dataset will be made publicly available.

Principal Investigator: Magdalena Cerdá, DrPH, MPH
Funding: NIH, Administrative Supplement

Impact of COVID-19 Regulatory Changes on Medication Treatments for Opioid Use Disorder: Implications for U.S. Federal Policy

In this project, we are gathering and synthesizing evidence from the peer-reviewed clinical and public health literature about how two sets of opioid use disorder treatment regulatory flexibilities have impacted program and patient outcomes. The first flexibility is the option to supply patients with a longer take-home supply of methadone. The second flexibility is the ability to use telemedicine, including audio calls, for buprenorphine induction and ongoing treatment. The project also seeks to explain how federal regulators can use the assembled evidence to inform their upcoming rulemaking projects to extend both flexibilities beyond the pandemic.

Co-Lead Investigator: Noa Krawczyk, PhD
Funding: Pew Charitable Trusts

Joint Impact of Local Alcohol and Cannabis Laws and Outlet Densities on Violence

This study is examining how local alcohol and cannabis policies in California interact to influence self-directed and interpersonal violence in California before and after recreational cannabis legalization in 2018. Using publicly-derived data on policies, outlets, and health, we are applying spatiotemporal analyses to: (1) assess how alcohol and cannabis policies in 241 California cities and counties impact alcohol and cannabis outlet densities and geographic co-location; (2) determine the interactive effects of alcohol and cannabis outlet densities on rates of emergency department visits, inpatient hospitalizations, and deaths due to self-harm and assault throughout California; (3) evaluate how the relationships documented in the first two areas of study contribute to racial/ethnic and socioeconomic disparities in alcohol and cannabis outlet co-location, densities, and effects on self-harm and assault. Evidence from this study seeks to help state and local decision-makers select optimal models for regulation of legal cannabis across diverse communities.

Principal Investigator: Ellicott C. Matthay, PhD, MPH
Funding: NIH, National Institute on Alcohol Abuse and Alcoholism

Preventing Overdose Using Information and Data from the Environment (PROVIDENT) Grant

The aim of PROVIDENT is to develop a forecasting tool to identify fatal overdoses and neighborhoods at high risk of future overdose outbreaks. Through an ensemble machine learning approach, the PROVIDENT model seeks to use geospatial data on overdose fatalities in Rhode Island since 2014 to forecast future overdose hotspots. The model also aims to determine whether targeted interventions towards high-risk neighborhoods are more effective at reducing overdose burden than nontargeted interventions. This project seeks to inform how state and local resources can be allocated for the greatest reduction in overdose mortality and enable other states to identify high-risk neighborhoods and target overdose prevention efforts accordingly. Read the full abstract.

Co-Principal Investigator: Magdalena Cerdá, DrPH, MPH
Funding: NIH

Trends in Psychosis-Related Hospitalizations Following Cannabis Legalization in Colorado

This study aims to characterize trends in psychosis-related emergency department (ED) visits and hospitalizations across the Denver health system. We will evaluate whether laws that lowered restrictions on cannabis sales in Colorado were associated with changes in rates of ED visits and hospitalizations for psychosis with and without comorbid cannabis use disorder diagnoses. We also assess associations between cannabis dispensary density in Denver and rates of ED visits and hospitalizations for psychosis.

Principal Investigator: Noa Krawczyk, PhD
Funding: Laboratory for Early Psychosis (LEAP) Center

Bloomberg Opioid Initiative

This multidisciplinary overdose prevention initiative aims to collaborate with government and community partners to develop, implement, evaluate, and distribute evidence-based solutions to reduce overdose deaths in states and communities that have been hard hit by the opioid crisis. Major partners in the project include Vital Strategies, The Pew Charitable Trusts, CDC Foundation, and Johns Hopkins Bloomberg School of Public Health. Read more about the partnership.

Lead Investigator: Noa Krawczyk, PhD
Funding: Bloomberg Philanthropies

Development of a Novel Polysubstance Assessment Tool for Vulnerable Subpopulations

This project addresses the real-world complexities of substance use through a focus on the high-risk and complex phenomenon of polysubstance use, a behavior that substantially increases the risk of overdose mortality. We adopt a rigorous mixed-method approach to develop and validate a novel polysubstance use assessment tool for use with underserved subpopulations, such as justice-involved people who inject drugs, and identify correlates and motivations of polysubstance use behaviors among this population to inform the development of future targeted interventions.

Principal Investigator: Amanda M. Bunting, PhD
Funding: NIH

Adaption of the STAIR-NT Trauma Intervention for Polysubstance Populations

This project will adapt an existing evidence-based post-traumatic stress disorder (PTSD) intervention, skills training in affective and interpersonal regulation with narrative therapy (STAIR-NT), via a massed treatment model (i.e., condensed treatment schedule) for patients in methadone maintenance treatment who are engaged in illicit opioid–stimulant polysubstance use. A small-scale randomized control trial will examine implementation (i.e., feasibility and acceptability) and short-term polysubstance use and PTSD symptomology outcomes.

Principal Investigator: Amanda Bunting, PhD
Funding: NIH

The Center for Drug Use and HIV Research (CDUHR)

The Center for Drug Use and HIV Research (CDUHR) is an allied and collaborating research center with the Center for Opioid Epidemiology and Policy that focuses on public health issues related to HIV, hepatitis C, and drug use. Several faculty members at the Center for Opioid Epidemiology and Policy also conduct research at CDUHR, including Magdalena Cerdá, DrPH, MPH, and Samuel R. Friedman, PhD.

Past Projects

Prescription Drug Monitoring Programs and Opioid-Related Harm

This project used latent transition analysis to identify the prescription drug monitoring program (PDMP) best practice models that are most effective at reducing prescription opioid overdoses, and that minimize unintended consequences in illegally manufactured opioids. We also examined sources of heterogeneous policy effects within states, notably focused on medical need for opioids, access to medication-assisted treatment, and socioeconomic characteristics in local (zip code level) areas. Read the full abstract.

Principal Investigator: Magdalena Cerdá, DrPH, MPH
Funding: NIH

Health and Social Consequences of National Marijuana Legalization

The center worked on an impact evaluation of the health and social consequences of marijuana legalization in Uruguay. In 2013, Uruguay became the first country in the world to legalize recreational marijuana use and regulate the sale, cultivation, and distribution of marijuana. In this study, we used a synthetic control group approach to compare changes in marijuana use, other types of substance use, and traffic injuries among adolescents and adults in Uruguay from 2002 to 2018. Read the full abstract.

Principal Investigator: Magdalena Cerdá, DrPH, MPH
Funding: NIH

Metropolitan Trajectories of HIV Epidemics and Responses in U.S. Key Populations

Hannah L. Cooper, Samuel R. Friedman, and colleagues investigated how HIV/AIDS-related health outcomes and programs in one key population (KP) can affect HIV/AIDS-related health outcomes and programs in other KPs. They examined these variables in 3 KPs (men who have sex with men, people who inject drugs, and heterosexuals) using a longitudinal cohort of the 96 largest metropolitan statistical areas (MSAs) in the United States. By comparing these variables across time and MSAs, the study aimed to determine the fundamental dynamics of HIV/AIDS epidemics and to inform the development of programs and policies that can prevent HIV/AIDS transmission across KPs. Read the full abstract.

Co-Principal Investigator: Samuel R. Friedman, PhD
Funding: NIH