CE24-013 - Reducing Overdose and Substance Use-related Stigma on Chicago's West Side by Training Non-substance-using Friends and Family Members of People who Use Opioids to Be Harm Reduction Champions

PROJECT SUMMARY/ABSTRACT Fatal opioid overdoses are more frequent among populations with low access to harm reduction (HR) services and with high substance use-related stigma (a major barrier to accessing HR services). One such population is older Black people who use drugs (PWUD) on the West side of Chicago. In 2022, Black adults aged 55-64 in Illinois had an opioid fatality rate ten times higher than that of non-Hispanic white adults of the same age, and four times higher than younger adults of any racial/ethnic group. Over 34% of Chicago's opioid-related EMS responses in 2023 were located in predominately Black communities on the West side, but Black adults in Chicago access HR services at lower rates than do other racial/ethnic groups (e.g., they comprise only 15% of regular clients at the West side site of our community partner organization Community Outreach Intervention Projects [COIP]), likely due to stigma and other barriers. To help address these barriers and increase HR service access among this population, the proposed clinical trial will evaluate a novel intervention that will recruit non-substance-using friends and family members of people who use opioids and live on the West side of Chicago, educate them on HR tools and services, and train them to become peer HR support champions. We will ask them to recruit one friend or family member who uses opioids to the study, who we will also provide with an educational training on overdose risk reduction and available HR tools and services. The intervention will then facilitate a counselor-led initial conversation between peer HR support champions and their friend or family member who uses opioids to help establish HR support, and provide all participants with naloxone and fentanyl test strip kits. This intervention will not only provide another mechanism through which PWUD can access HR tools and services, thereby reducing logistical barriers, but should also reduce stigma and increase social support by facilitating and normalizing open conversations about HR between PWUD and their non- PWUD HR support champions. Participants of a focus group we conducted among West side PWUD thought this intervention would be helpful, said they would be willing to participate in it, and said they knew someone who could participate as their non-PWUD peer HR support champion. To facilitate recruitment of older adults, we will work with local faith-based and service organizations (with which our consultant from Breakthrough Urban Ministries will help us build relationships) and educate them about the importance of HR. We will evaluate the intervention's efficacy for a) increasing uptake/use of HR services, b) decreasing overdose frequency, and c) decreasing stigma and other barriers to accessing HR services, both i) by examining change over time among intervention participants, and ii) by using propensity-score matching methods to compare outcomes between intervention participants and a comparison group of PWUD who have recently accessed HR services from one of our community partners (COIP or West Side Heroin and Opioid Task Force).