Abstract
Despite evidence linking perceived social isolation (PSI) with substance use disorders (SUDs), limited research has examined its effect on fentanyl use among people who inject drugs (PWID). Cross-sectional data of 350 PWID in Appalachian Kentucky were utilized to examine the association between PSI and lifetime fentanyl use. Study findings highlighted a significant association between PSI and lifetime fentanyl use. Additionally, PWID with higher scores on the PSI scale tend to use fentanyl less frequently, suggesting that social isolation may serve as a protective factor against fentanyl use within our PWID sample. This raises a concern regarding PWID forming support networks that inadvertently contribute to increased fentanyl use rather than promote recovery. Examining networks among at-risk PWID can offer valuable insights into patterns of fentanyl use and related overdoses. This can aid the design of effective policies and interventions to promote behavior change, harm reduction, and SUD treatment engagement among PWID.