“How I Found My Research” is an occasional series in which VCU students share their journeys as researchers.
David T. Zhu is an MD/PhD. candidate in health policy at Virginia Commonwealth University School of Medicine. Dr. Zhu recently demonstrated that the widespread prevalence of fentanyl (fentanyl-related overdose deaths increased 100-fold among non-Hispanic blacks between 2010 and 2022) has contributed to racial and ethnic differences in substance use disorders. published a paper in the journal JAMA Psychiatry that shows that this is causing the disparity in patients.
This study aligns with Zhu’s extensive research work that highlights critical gaps that must be addressed to advance social justice and health equity. In September, he wrote an explanatory piece for the Richmond Times-Dispatch about rethinking the “war on drugs.”
Zhu spoke to VCU News about the ideas driving his research and how he has honed his skills to become a better researcher.
Please tell us the focus of your research…and why it is important/impactful to us all.
My work explores why certain communities, such as racial and ethnic minorities, people experiencing homelessness, and people living below the federal poverty line, bear a disproportionate burden of drug overdoses and substance use disorders. It is driven by a core question: “Do I carry this burden?” This exploration inspires my research, which I approach from two complementary angles. On the one hand, I seek to delve into population health trends and examine the underlying social and structural factors that perpetuate overdose disparities. On the other hand, I evaluate the implementation of harm reduction strategies regarding health outcomes and access to care. I strongly believe that addictions like diabetes and cardiovascular disease must be recognized as treatable chronic health conditions that deserve empathy and advocacy. More broadly, I believe these harm reduction policies lead to a fundamental belief that the overdose epidemic should be addressed as a public health concern rather than a criminal justice issue.
What inspired you to continue research in this field?
When I joined VCU’s medical school, I became involved in research analyzing regional differences in opioid prescribing, overdose rates, hospitalizations, and access to treatments such as suboxone in Richmond’s diverse census tracts. Our data revealed clear disparities. We found that overdose rates and access to treatment varied widely in neighborhoods separated by just one street or bus stop. Witnessing these inequalities up close has deepened my commitment to public health research, focusing on the pervasive social determinants that drive these outcomes.
My goal is to use this data to shape meaningful health policy and social programs to support people suffering from substance use disorders. Additionally, having grown up in Canada where harm reduction programs such as supervised consumption facilities, needle exchange programs, and safer supply initiatives have been in place for decades, I have learned how these strategies reduce the harms of drug use. I’ve seen firsthand how it can reduce the risk of cancer and save lives. This international experience fueled my passion to advocate for harm reduction policies in the United States, leveraging global best practices to drive systemic change to combat the escalating overdose crisis in our country. .
When I stand at the intersection of medicine and research, I am deeply humbled by the reminder that my work transcends data and has the potential to bring about meaningful change through “social medicine.” That my research can ultimately shape policies that support recovery for people suffering from addiction by informing clinical interventions, closing gaps in care, promoting harm reduction, and reducing stigma. I hope.
Please tell us about something that surprised you during your research journey.
What struck me most about this research process was how impactful the stories I encountered, the stories of real people struggling with addiction and those who had lost someone to overdose, How it energizes my advocacy work. The truth is, when you work with public health data, you become immersed in a sea of numbers, p-values, and statistical models, and it’s easy to get caught in the middle of it all and see them as abstractions. But these numbers aren’t just data points; they represent human life. They represent the patients I have met directly through clinical shadowing and volunteer work at the VCU School of Medicine and further my commitment to engage in research to improve health outcomes at the systemic level.
When I stand at the intersection of medicine and research, I am deeply humbled by the reminder that my work transcends data and has the potential to bring about meaningful change through “social medicine.” That my research can ultimately shape policies that support recovery for people suffering from addiction by informing clinical interventions, closing gaps in care, promoting harm reduction, and reducing stigma. I hope.
Please tell us about any obstacles or challenges you have had to overcome in your career.
One of the hurdles I encountered during the research process was gaining expertise in coding and statistics. As an undergrad, I approached coding reluctantly, perceiving it as a tedious task and struggling to find a broader purpose for it. However, once I became involved in research projects that required these skills, my perspective changed and I gained the motivation and sense of purpose to learn the skills through practice.
For example, one of my recent studies analyzed trends in private equity acquisitions of opioid treatment programs in the United States. Learning to code through online courses and guidance from mentors has given me critical skills to map geographic trends in these acquisitions over time. This work will have a direct impact on state-level policies aimed at better regulating the influence of private equity on the nation’s addiction treatment clinical infrastructure, ensuring that opioid use disorder treatment is not financially driven but patient-centered. Guaranteed to stay centered. Additionally, coding enabled statistical analyzes to explore disparities across race, ethnicity, income, and health insurance, revealing broader social inequalities in health care access and outcomes. . Coding and statistics, which once felt like a burden, are now a very rewarding and purposeful part of my job.
Are there any memorable partnerships or lessons learned along the way?
During my medical school interview, I had the opportunity to participate in three virtual lab visits where I discussed my research aspirations with faculty. These conversations were pivotal in solidifying my decision to pursue an MD degree. At VCU. The wonderful faculty I met, including Dr. Andrew Burns, Dr. Peter Cunningham, Dr. Derek Chapman, and Dr. Caitlin Martin from the VCU School of Medicine and VCU School of Public Health Department of Health Policy, emphasized positive research. The culture and supportive environment that thrives here. But what makes a good mentor? One of my favorite quotes about mentorship comes from Dr. Suzanne Coven of Harvard Medical School. “A mentor is someone who has more imagination about you than you have about yourself.” This insight reflects my own experience.
When I first embarked on my research journey, I was unfamiliar with basic things like how to conduct a literature review, plan a study, or even identify a good research question. My mentors not only provided me with the scientific and technical expertise I needed, but also pushed me to think critically, embrace curiosity, and build confidence. They fostered an environment where I could learn from my mistakes, while at the same time helping me discover potential in myself that I didn’t yet realize. Their belief in me was truly transformative and shaped my growth not only as a medical student and researcher, but as a leader who can lift up those around me.
David T. Zhu said he finds research rewarding because it “allows us to advance advocacy beyond the four walls of the clinic.” (Kevin Morley, Enterprise Marketing and Communications)
What do you find rewarding about the research process?
What makes research truly rewarding is the ability to advance advocacy beyond the four walls of clinical practice. I am trapped in a system that limits my access to care due to financial barriers, lack of access to treatment, pervasive social stigma, lack of support systems, and struggles with addiction and substance use disorder. I have often heard patients talk about this. Despite offering words of compassion and connecting it to the clinic’s social services, I found myself always wanting to do more and was drawn to research. There, we can expand the evidence base to inform policies that address upstream social determinants of health.
For example, some of my recent research has shown that fentanyl is increasingly being mixed with stimulants such as cocaine and methamphetamine, resulting in deadly “polysubstance” drugs that disproportionately impact racial and ethnic minorities. It emphasizes that it is causing an overdose epidemic. These data will expand access to critical harm reduction resources such as naloxone, with the goal of reducing disparities and ensuring compassionate, evidence-based care reaches the communities that need it most. Provide further scientific evidence to support efforts.
What advice would you give undergraduate students to start their research journey?
Be persistent and remain open to learning. We all start out naive and inexperienced, but that’s part of the journey. Feel free to contact faculty at VCU or other institutions to see if they would be interested in participating in your research. No task is too small. Learn from your lab seniors and graduate students. Be insatiably curious. For every good research question I come up with, there are 20 more that don’t apply. Focus on the burning questions that keep you up at night, the ones that make you want to learn more and drive real change. And always kind and cooperative. Research thrives on collaboration, and improving others will pay dividends in the long run.
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