he opioid overdose epidemic in the United States is among the worst public health crises in American history. Highly potent synthetic opioids have exacerbated these epidemics. As fatal and nonfatal opioid overdose events increase across the country, a greater burden of the response is placed on community members. Responding to overdose events—calling for medical assistance, administering naloxone, and performing rescue breathing—may traumatize layperson responders (e.g. people who use drugs, their family or friends, and community members). Progression from trauma exposure to trauma and stressor-related disorders (e.g. post traumatic stress, acute stress, and adjustment disorders) is well characterized for other types of traumatic events (e.g., exposure to natural disasters); however, it is poorly defined in the context of the ongoing drug overdose epidemics. In this cross-sectional study, we will evaluate the feasibility of recruiting subgroups of layperson responders in the community using distinct recruitment strategies, examine the prevalence and correlates of stressor-related disorders in this population, and explore specific stressors and traumatic experiences associated with responding to overdose events. We will recruit 100 people in Rhode Island aged greater than 18 years who responded to an overdose event in the past six months, obtaining participant sociodemographic characteristics, trauma exposure history, substance use history, possible psychiatric disorders, and detailed description of recent overdose events. The primary goal of this pilot study is a preliminary exploration of trauma associated with overdose events to inform future R-series grants. The specific aims of this study are to: 1) demonstrate feasibility to recruit a broad range of layperson opioid overdose responders and describe subgroup characteristics; and 2) examine the prevalence and correlates of traumatization (both related to responding to overdoses and from other experiences) and stressor-related disorders among participants.
Our study is highly significant because it will provide preliminary data on the natural history of stressor related disorders associated with responding to overdose events, highlighting secondary effects of the drug overdose epidemics. The study will be among the first in the United States to examine and characterize stressor-related disorders related to overdose exposure in community members. In sum, the results from this research will significantly enhance public health efforts to prevent and treat adverse, downstream mental health outcomes associated with the overdose crisis in the community.