National Drug Early Warning System (NDEWS) COVID-19 Supplement

Parent Study: Through our parent U01, our National Drug Early Warning System (NDEWS) CoordinatingCenter aims to provide NIDA and the field with the most timely, salient, and valuable information on emergingsubstance use trends. By expanding data collection to include both former NDEWS sentinel sites as well asformer Community Epidemiology Workgroup (CEWG) sites, and by incorporating novel surveillance methodsto ensure early detection of signals of new psychoactive substances and known substances, our Early WarningNetwork extends geographic representation and provides a more complete picture of the size, direction, anddepth of substance use patterns in all US Census regions. We will use novel surveillance methods to ensureearly detection of signals indicating emerging drug trends and harmonize surveillance data across sentinel andCEWG sites. We will also conduct on-the-ground epidemiologic investigations on topics of immediate crisis orneed in order to provide functional feedback to impacted communities towards optimizing current and futureresponse, and we will disseminate results rapidly to the scientific community and the public alike. Proposed Supplement: The current COVID-19 crisis underscores a need for rapid assessments of the virus'simpact in substance-using populations throughout the NDEWS Early Warning Network, as people who usedrugs appear to be at increased risk for COVID-19-related adverse outcomes and may find it more difficult toget care during the crisis. In addition, COVID-19 may alter one's exposure to drug use, certain drugs, or mightchange patterns of drug use altogether. As an Early Warning System, NDEWS must be on the forefront of newtrends in drug use, drug-related mortality, and drug treatment utilization, all of which may be either directly orindirectly impacted by COVID-19. Although in-person human subjects research has been halted, COVID-19focused efforts that must begin now-with creative strategies that allow for immediate data to assess theimpact of COVID-19 on substance use behaviors. In this proposed study, we will (Aim 1) collect rapid responsedata on substance use-related consequences of COVID-19 from novel key informants across the country in theurban, rural, and suburban areas represented by the 18 Early Warning Network sites, focused on decedents,family members of decedents, and the community at large. Key informants will include 1) funeral directors(n=200), 2) emergency medical service personnel (n=200), and 3) syringe exchange workers (n=75). We will(Aim 2) detect trends in patterns of drug-related mortality, health services utilization, including overdosereversals, and syringe exchange services by following up with key informants at 2, 3, 4, and 5 months post-baseline. We will then (Aim 3) rapidly disseminate the data to NIDA, through media outreach, and contribute toscience through peer-reviewed publications. At a time when we cannot physically recruit or survey participantsin person due to the COVID-19 crisis, we believe this is an extraordinary opportunity to collect rich data fromkey informants nationwide. Results will provide targets for new research strategies and prevention efforts.