Evidence map›Paper›PMID 42090841›Full record

ArticleDrug and alcohol dependence2026

Frequent police contact and nonfatal overdose among people who use drugs in rural Appalachia.

Javier A Cepeda, Talia Loeb, Zach R Salazar, Brittney Williams, Brooke Hiltz, Brandon Del Pozo, Eileen V Pitpitan, Leo Beletsky, April M Young, Jennifer R Havens

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Socioenvironmental disasters and the dialectics of overdose mortality.The International journal on drug policy · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Javier A CepedaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA. Electronic address: jcepeda2@jhu.edu.
Talia LoebDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA.
Zach R SalazarDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA.
Brittney WilliamsDepartment of Behavioral Science, College of Medicine, University of Kentucky, USA.
Brooke HiltzDepartment of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, USA.
Brandon Del PozoThe Warren Alpert Medical School of Brown University, USA.
Eileen V PitpitanSchool of Social Work, San Diego State University, USA.
Leo BeletskySchool of Law, Bouvé College of Health Sciences, and the Action Lab, Northeastern University, USA; Division of Infectious Disease and Global Public Health, UC San Diego School of Medicine, USA.
April M YoungDepartment of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, USA.
Jennifer R HavensDepartment of Behavioral Science, College of Medicine, University of Kentucky, USA.

Funding

VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SUSAN JANET LITTLE · 1994 to 2026
$78.4M
Examining the Impact of the Twin Epidemics of Methamphetamine and Opioid Use on Overdose, Risky Sex and Treatment Engagement among PWUD in Two Rural Appalachian CohortsR01DA033862 · NIDA · UNIVERSITY OF KENTUCKY · PI Jennifer R Havens · 2012 to 2026
$6.9M
Johns Hopkins HIV Epidemiology and Prevention Sciences Training ProgramT32AI102623 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Shruti H Mehta · 2013 to 2026
$5.3M
Police Training to Reduce Occupational Needlesticks and HIV among Substance UsersR01DA039073 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BELETSKY, LEO, STRATHDEE, STEFFANIE A. · 2015 to 2019
$3.2M
Kentucky Outreach Service Kiosk (KyOSK): Reducing Overdose, Hepatitis C, and Other Drug-related Risks in Rural Appalachia through Health KiosksR01DA055872 · NIDA · UNIVERSITY OF KENTUCKY · PI April Marie Young · 2022 to 2026
$2.9M
Social networks and HIV risk among rural drug usersR01DA024598 · NIDA · UNIVERSITY OF KENTUCKY · PI HAVENS, JENNIFER R · 2008 to 2012
$2.6M
Project SHIELD: Police Education to Support Public Health in KentuckyR33DA060622 · NIDA · JOHNS HOPKINS UNIVERSITY · PI LEO BELETSKY, Javier Cepeda · 2025 to 2026
$2.5M
Project SHIELD: Police Education to Support Public Health in KentuckyR61DA060622 · NIDA · JOHNS HOPKINS UNIVERSITY · PI BELETSKY, LEO, CEPEDA, JAVIER · 2024 to 2024
$901k
NIAID NIH HHS P30 AI036214NIAID NIH HHS T32 AI102623NIDA NIH HHS R01 DA024598NIDA NIH HHS R01 DA033862NIDA NIH HHS R01 DA039073NIDA NIH HHS R01 DA055872NIDA NIH HHS R33 DA060622NIDA NIH HHS R61 DA060622
6 · The paper itself

Abstract

introductionPolice contact shapes subsequent health practices and outcomes among people who use drugs (PWUD). However, the relationship between police encounters with overdose remains under-researched. We evaluated how police stop-and-search was associated with nonfatal overdose and identified correlates of frequent police contact among PWUD in rural Kentucky.

methodsFrom May 2023 - April 2024, 774 PWUD were enrolled in the Social Networks of Appalachian People and KyOSK studies. The exposure of interest was self-reported police stop-and-search in the past 6 months (0, 1-3, ≥4 times). The primary outcome was self-reported nonfatal overdose in the past 6 months. We evaluated the association between police stops and nonfatal overdose using multivariable logistic regression, adjusting for sociodemographic, housing, polysubstance use, and mental health covariates.

resultsNearly all participants were non-Hispanic White (99%), 52% were female, and 45% used both opioids and methamphetamine in the past 6 months. Thirty-seven percent reported being stopped and searched; 17% experienced a nonfatal overdose. PWUD who were stopped and searched by police ≥ 4 times in the past six months had more than double the odds of nonfatal overdose (adjusted odds ratio: 3.19, 95% CI: 1.60, 6.32) compared to PWUD with no police contact, controlling for other factors. PWUD reporting frequent police contact were significantly more likely to be unstably housed and less likely to be on medications for opioid use disorder.

conclusionPolice stop-and-search was associated with elevated subsequent overdose risk among PWUD. Efforts to improve PWUD health should recast police encounters as opportunities for harm reduction.

Indexed as

Drug OverdosePoliceRural PopulationSubstance-Related DisordersAdultAppalachian RegionFemaleHumansKentuckyMaleMiddle AgedLaw enforcementOverdoseRural health

Identifiers

PMID42090841
PMCPMC13178224

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.