AJPH Article Discusses the Importance of Including People Who Use Drugs in order to Contextualize Research

People who use drugs + Research = Essential

This post is written by Mary Figgatt, a first-year doctoral student in the Department of Epidemiology at UNC-Chapel Hill. We thank Mary for her contributions and work as part of the Opioid Data Lab team.

People who use drugs (PWUD) hold a perspective that cannot be captured through commonly employed research strategies, like the use of “big data”. Oftentimes, substance use research points to emerging trends, ineffective or effective policies, or factors associated with health outcomes; but less often does research actually contextualize these findings in terms of lived experience. Research collaborations with PWUD can undercover nuances previously unknown to the research community.

In an article recently published by Alexandridis et al., the authors respond to another article (Nesoff et al.), which presents an analysis of spatiotemporal clusters of fentanyl-involved drug overdose deaths. Alexandridis et al. provide as alternative discussion for the Nesoff et al. article, while highlighting how the lack of PWUD or community member involvement led to an incomplete picture. Alexandritis et al. provide an interesting case study and important justification for PWUD collaborations in research.

Alexandridis AA, Doe-Simkins M, Scott G. A Case for Experiential Expertise in Opioid Overdose Surveillance. American Journal of Public Health. 2020;110(4):505-507. doi:10.2105/ajph.2019.305502.

Nesoff ED, Branas CC, Martins SS. The Geographic Distribution of Fentanyl-Involved Overdose Deaths in Cook County, Illinois. American Journal of Public Health. 2020;110(1):98-105. doi:10.2105/ajph.2019.305368.


“A synthesis of the Nesoff et al. results serves as an important case study in the shortcomings of omitting people who use drugs and local expertise when interpreting findings, a common omission in ‘big data’ opioid surveillance research. The authors’ findings are not a revelation in comparison with the 2007 study. For example, the authors were unable to explain why the communities hardest hit by opioid overdoses in 2002 were nearly the same as those identified in 2014 to 2018 data, whereas a 2017 report by Chicago-area experts revealed underlying disparities and their roots.

Content and experiential expertise among researchers results in discussion sections more robustly oriented toward solutions in research and practice. In large epidemiological studies, the input of people who use drugs may drive analyses considering complex and structural factors that influence disproportionate deaths. When a participatory approach is used, the findings can be discussed in the context of the effects of racialized drug policies, structural violence, and policing on people who use drugs, particularly people of color.”