Tens of thousands of people in the United States lose their lives each year to drug overdose, and the numbers continue to mount. Since 1999, approximately 841,000 such deaths occurred in the United States, while the number of drug overdose deaths increased 120% between 2010 and 2018 and totaled nearly 70,630 per year by 2019. During the COVID-19 pandemic, drug overdose deaths increased more than 20% in 25 states and the District of Columbia. Worldwide in 2019, around 36 million people suffered from drug use disorders.
Today, overdose death is a leading cause of injury-related death in the United States. To mitigate the opioid overdose epidemic, an evidence-based approach is needed and this approach should
- target and reduce opportunities for access to illicit drugs;
- use a collaborative multidisciplinary approach to improve responses to overdose incidents; and
- have access to data for the development of mitigation strategies and the evaluation of outcomes.
Reducing the Accessibility of Opioids
Nearly 85% of drug overdose deaths involve illicit drugs such as fentanyl, heroin, cocaine, and methamphetamine, according to a recent study. Law enforcement efforts based on data from various resources are key to reducing the accessibility of illicit drugs.
Research has shown that a small number of prolific offenders control illicit drug markets and that drug-sale locations form hot spots, with a small number of addresses. Rigorous data analysis can help identify and dismantle the network of prolific offenders in the drug-sale hot spots, which in turn reduces the accessibility of opioids to experienced and novice drug users.
Collaborative and Multidisciplinary Approach
Identifying risk factors for drug overdose can lead to prevent overdose deaths. According to a recent survey, in more than 3 out of 5 overdose deaths, at least one potential opportunity to prevent the death through life-saving strategies was found.
These strategies include:
(1) providing access to health-care services, risk-reduction services, and the drug naloxone (to rapidly reverse an opioid overdose);
(2) focusing on prevention of initial drug use; and
(3) using multiple drugs to treat substance-use addiction.
Indeed, a collaborative and multidisciplinary approach is essential for the successful implementation of these outreach strategies. For instance, a recent study examined collaborative programs that involved local public health and public safety agencies in Massachusetts. These programs aimed to help overdose survivors by connecting them with harm-reduction and addiction-treatment services.
Through online surveys and interviews with police and fire departments in 351 Massachusetts communities, the researchers were able to identify four types of effective programs:
- multidisciplinary team visits (i.e., post-overdose visit to the survivor to provide information and referrals for the survivor, the survivor’s family, and the survivor’s associates),
- police visit (i.e., post-overdose visit to the survivor and to provide a referral to public health services),
- clinician outreach (i.e., post-overdose telephone-based contact with the survivor), and
- location-based outreach (i.e., media and word-of-mouth contact with the entire community, including drug-overdose survivors).
These outreach programs had in common the use of enhanced collaboration and information sharing among stakeholders to identify drug users and the use of timely and effective intervention efforts to prevent overdose deaths.
Access to Data
Access to reliable data is the key to success in an evidence-based policy. A recent study examined the core elements of successful overdose prevention activities in four states (Massachusetts, New Hampshire, New Mexico, and Utah) that managed to decrease their high rate of opioid-involved overdose deaths from 2016 to 2017 through the analysis of program narratives. The study found that access to drug-abuse data, the capacity to analyze the data, and the ability to disseminate the findings of the data analyses played vital roles in the four states’ successful overdose-prevention strategies. The findings were systematically disseminated through either web-based dashboards or quarterly reports. Drug-abuse prevention organizations in partnership with members of the local community then used the findings to create effective program models for the prevention of overdose deaths.
The Opioid Control and Reduction Model
To address the need for a novel and comprehensive approach to curbing the opioid overdose epidemic, we offer the Opioid Control and Reduction Model (OCRM), which is illustrated below. The OCRM suggests that comprehensive analysis of data from three sources (i.e., law enforcement, hospital emergency department, and pharmacies) can lead to successful collaborative outreach programs aimed at controlling the rise in and ultimately reducing overdose deaths and increasing the ability of law enforcement officials to identify prolific drug offenders.
