Overdose Prevention Strategies

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Overdose Prevention Strategies

National statistics indicate that the overdose fatality rate has quadrupled since 1999, including a sharp uptick in 2013, coinciding with the proliferation of synthetic opioids like fentanyl. Over the past year, the COVID-19 pandemic has coincided with another surge in fatal overdoses. State health agencies can work to prevent overdoses by strengthening economic supports; identifying and supporting people at risk; implementing Prescription Drug Monitoring Programs; collaborating with hospital, healthcare, and emergency systems; distributing naloxone and using naloxone tracking and administration data to identify hot spots; expanding access to substance use treatment and supporting linkages to care; implementing mass media awareness campaigns; increasing the capacity of medical examiners, coroners, and toxicologists; supporting and providing education around public safety and first responders; and teaching coping and problem-solving skills. Using the Suicide, Overdose, and Adverse Childhood Experiences Prevention Capacity Assessment Tool (SPACECAT) can assist with determining your state's level of capacity to implement overdose prevention strategies. Below is a list of beginner, intermediate, and advanced actions your organization can take based on your SPACECAT results.

Beginner Action Ideas

  • Conduct a scan of current state policies that strengthen economic support (e.g., unemployment benefit programs) and assess gaps.
  • Examine how your state uses data to identify people at risk for overdose.
  • Assess your state's Prescription Drug Monitoring Program (PDMP). Determine where it is located and research the laws and regulations that govern how PDMPs operate in your state.
  • Determine how overdose data is shared between the health department, hospitals, healthcare, and emergency systems in your state.
  • Identify funding sources in your state that contribute to overdose prevention efforts and which agencies oversee them.
  • Build cross-sector partnerships to address substance use disorder prevention, treatment, and recovery.
  • Identify where and how naloxone is distributed in your state and assess any gaps.
  • Research access to substance abuse treatment methods for overdose prevention (e.g., integrating MAT into primary care, buprenorphine waiver, accessibility, co-locating treatment in high-risk settings), including health insurer and payer approaches (e.g., removing prior authorization, lock-in programs, coverage of non-opioid pain management treatment) and linkage to care techniques (e.g., peer support, transportation, housing services).
  • Ascertain how your agency communicates with the public about overdose prevention.
  • Explore strategies for increasing the capacity of medical examiners, coroners, and toxicologists related to overdose prevention (e.g., training on standardization of drug-related death classification, increasing forensic workforce).
  • Investigate approaches for supporting and providing education around public safety and first responders in overdose prevention (e.g., trainings on naloxone administration, good samaritan laws, or substance use disorder).
  • Create a list of state programs that teach coping and problem-solving skills (e.g., social-emotional learning, healthy relationship programs).

Intermediate Action Ideas

  • Research the benefits of policies that strengthen economic support (e.g., unemployment benefit programs) that are not currently legislated in your state. Find examples of policy language used in other states.
  • Reach out to partner organizations that collect data used to identify people at risk of dying by overdose. Ascertain how you can work together to create a more robust data set of data.
  • Determine who in your state has access to PDMP data and if a memorandum of understanding or data use agreement is necessary. If a memorandum of understanding or data use agreement is necessary and not already in place, research examples in place in other states.
  • Reach out to hospitals, healthcare, and emergency systems in your state to discuss how to improve access to overdose data (g., access to timely data, EHR/PDMP integration, E.D. data, Emergency Medical Services data, quality improvement initiatives, CDC guideline concordance).
  • Track naloxone usage in your state and use this data to identify hot spots.
  • Identify access to substance abuse treatment methods for overdose prevention (e.g., integrating MAT into primary care, buprenorphine waiver, accessibility, co-locating treatment in high-risk settings) available in your state, including health insurer or payer approaches (e.g., removing prior authorization, lock-in programs, coverage of non-opioid pain management treatment) and linkage to care techniques (e.g., peer support, transportation, housing services) and assess gaps.
  • Find examples of overdose prevention mass media awareness campaigns other states have successfully used. Determine which message(s) would resonate with the public in your state.
  • Contact medical examiners, coroners, or toxicologists in your state and discover ways you can help them increase their capacity related to overdose prevention (e.g., training on standardization of drug-related death classification, increasing forensic workforce).
  • Engage public safety workers and first responders in your state to determine how best to support and educate them on overdose prevention (e.g., training on naloxone administration, Good Samaritan laws, or substance use disorder).

Advanced Action Ideas

  • Reach out to state legislators with information about the benefits of policies that strengthen economic support (e.g., unemployment benefit programs) that are not currently legislated in your state. Create factsheets or infographics to support your case.
  • Create data-sharing agreements with organizations that identify people at risk of dying by overdose using data sources other than the ones used in your health agency.
  • If a memorandum of understanding or data use agreement is necessary and not already in place, create one to ensure better access to PDMP data. If a memorandum of understanding or data use agreement is already in place or not necessary, identify a point person who will regularly review the data.
  • Actively support hospitals, healthcare, and emergency systems in your state to gain access to and share overdose data through resource sharing, data sharing agreements, training, and ongoing quality improvement initiatives.
  • Prioritize areas identified as hot spots through naloxone tracking with evidence-based overdose prevention strategies.
  • Create a strategic plan for increasing access to substance abuse treatment methods for overdose prevention (e.g., integrating MAT into primary care, buprenorphine waiver, accessibility, co-locating treatment in high-risk settings) in your state, including partners to engage, data sources needed, strategies for creating leadership buy-in, and tools for communicating with the public.
  • Adapt successful overdose prevention mass media awareness campaign(s) from other states to fit your audience's needs, implement as necessary, and promote the campaign(s) in your community.
  • Depending on the needs of medical examiners, coroners, or toxicologists in your state, establish trainings or resource sharing that allows them to increase their capacity related to overdose prevention (e.g., training on standardization of drug-related death classification, increasing forensic workforce).
  • Based on their own assessment, provide public safety/first responders in your state with targeted support and education in overdose prevention (e.g., training on naloxone administration, Good Samaritan laws, or substance use disorder).

Resources

Health Equity Questions to Consider