{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:18:51Z","timestamp":1789730331435,"version":"4.0.1"},"reference-count":28,"publisher":"American Public Health Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Objectives. To measure risk of fatal opioid overdose within 1 year of engagement with Relay\u2019s nonfatal overdose response initiative and characterize differences in demographics, substance use, and overdose risk factors by service engagement.<\/jats:p>\n                  <jats:p>Methods. We assessed the mortality status of 5006 patients who presented to Relay\u2019s partnered emergency departments (EDs) in New York City for a suspected nonfatal opioid overdose (2017\u20132022) and accepted peer-delivered overdose prevention services in the ED, grouped by agreement to and subsequent receipt of post-ED follow-up.<\/jats:p>\n                  <jats:p>Results. Compared with those declining follow-up, the risk of fatal overdose was not significantly higher among those consenting (adjusted hazard ratio [AHR]\u2009=\u20091.24; 95% confidence interval [CI]\u2009=\u20090.94, 1.65). Among those accepting follow-up, risk was lower for those who were reached (AHR\u2009=\u20090.64; 95% CI\u2009=\u20090.48, 0.84) compared with those who were not.<\/jats:p>\n                  <jats:p>Conclusions. Peer-delivered ED interventions such as Relay may be effective in reducing fatal overdose risk for individuals with fewer risk factors, and post-ED services are essential for those at higher risk. Approaches should be tailored to more effectively deliver post-ED services to this group. ( Am J Public Health. 2026;116(1):113\u2013123. https:\/\/doi.org\/10.2105\/AJPH.2025.308270 )<\/jats:p>","DOI":"10.2105\/ajph.2025.308270","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:00:08Z","timestamp":1760644808000},"page":"113-123","source":"Crossref","is-referenced-by-count":2,"title":["Opioid Overdose Mortality Among Patients Receiving a Peer-Delivered, Emergency Department\u2013Based Nonfatal Opioid Overdose Intervention in New York City, 2017\u20132022"],"prefix":"10.2105","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0209-6686","authenticated-orcid":false,"given":"Kelsey L.","family":"Kepler","sequence":"first","affiliation":[{"name":"Kelsey L. Kepler, Alice E. Welch, Ellenie Tuazon, Dominique Chambless, and Angela Jeffers are with the Bureau of Alcohol and Drug Use, Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, New York, NY. Joseph Kennedy is with the Bureau of Vital Statistics, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9157-4987","authenticated-orcid":false,"given":"Alice E.","family":"Welch","sequence":"additional","affiliation":[{"name":"Kelsey L. Kepler, Alice E. Welch, Ellenie Tuazon, Dominique Chambless, and Angela Jeffers are with the Bureau of Alcohol and Drug Use, Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, New York, NY. Joseph Kennedy is with the Bureau of Vital Statistics, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8779-1604","authenticated-orcid":false,"given":"Ellenie","family":"Tuazon","sequence":"additional","affiliation":[{"name":"Kelsey L. Kepler, Alice E. Welch, Ellenie Tuazon, Dominique Chambless, and Angela Jeffers are with the Bureau of Alcohol and Drug Use, Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, New York, NY. Joseph Kennedy is with the Bureau of Vital Statistics, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Chambless","sequence":"additional","affiliation":[{"name":"Kelsey L. Kepler, Alice E. Welch, Ellenie Tuazon, Dominique Chambless, and Angela Jeffers are with the Bureau of Alcohol and Drug Use, Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, New York, NY. Joseph Kennedy is with the Bureau of Vital Statistics, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Kelsey L. Kepler, Alice E. Welch, Ellenie Tuazon, Dominique Chambless, and Angela Jeffers are with the Bureau of Alcohol and Drug Use, Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, New York, NY. Joseph Kennedy is with the Bureau of Vital Statistics, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Jeffers","sequence":"additional","affiliation":[{"name":"Kelsey L. Kepler, Alice E. Welch, Ellenie Tuazon, Dominique Chambless, and Angela Jeffers are with the Bureau of Alcohol and Drug Use, Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, New York, NY. Joseph Kennedy is with the Bureau of Vital Statistics, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib1","first-page":"1","volume":"142","author":"Tuazon E","year":"2024","journal-title":"Epi Data Brief."},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001168"},{"key":"bib3","unstructured":"Gramlich J.  Recent surge in US drug overdose deaths has hit Black men the hardest. January 21, 2022. Available at: https:\/\/www.pewresearch.org\/fact-tank\/2022\/01\/19\/recent-surge-in-u-s-drug-overdose-deaths-has-hit-black-men-the-hardest. Accessed June 26, 2025."},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2022.2100926"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.02.024"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108009"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182212073"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305202"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2023.02.031"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1111\/add.16581"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.3614"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1177\/29767342231221054"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.09.027"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-024-00445-x"},{"key":"bib15","unstructured":"Brand D.  Drug overdoses continue to rise inside New York City homeless shelters. June 30, 2022. Available at: https:\/\/citylimits.org\/drug-overdoses-continue-to-rise-inside-nyc-homeless-shelters. Accessed June 26, 2025."},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112585"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1177\/0163278715605883"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.1080\/10530789.2025.2473760"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.110985"},{"key":"bib20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.0477"},{"key":"bib21","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104127"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-024-00995-y"},{"key":"bib23","unstructured":"Substance Abuse and Mental Health Services Administration.\n                      Medications for Opioid Use Disorder\n                      . Treatment Improvement Protocol (TIP) Series 63 Publication No. PEP21-02-01-002. Rockville, MD; 2021. Available at: https:\/\/library.samhsa.gov\/sites\/default\/files\/pep21-02-01-002.pdf. Accessed September 26, 2025."},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2023.107111"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.02.014"},{"key":"bib26","first-page":"1","volume":"187","author":"Spencer MR","year":"2023","journal-title":"Natl Health Stat Report."},{"key":"bib27","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2023.01.037"},{"key":"bib28","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2024.1733"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2025.308270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T21:02:00Z","timestamp":1765400520000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2025.308270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.2105\/AJPH.2025.308270"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2025.308270","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}