Overdose Prevention
Increasing fatal and non-fatal overdoses, particularly those related to opioids, dominated headlines related to public health as drug-induced fatalities have totaled over 932,000 since 1999.
Public focus on this tragedy has understandably lessened somewhat during the ongoing COVID-19 pandemic, but deaths from the overdose epidemic have accelerated in the intervening two years.
In November 2021, the National Center for Health Statistics reported that, over the 12-month period ending in April, over 100,000 people died after overdosing–an almost 30% increase over the previous year.
This grim milestone underscores the urgency with which we must act– not least by better supporting those providing overdose prevention and response (OPR) services on the ground. Often, much of this day-to-day work is accomplished by local health departments (LHDs) that play an integral role in planning, coordinating, and implementing services in response to the epidemic.
New Resource: Overdose Spike Response Framework Communities and Local Health Departments
NACCHO announces a new tool titled OVERDOSE SPIKE RESPONSE FRAMEWORK FOR COMMUNITIES AND LOCAL HEALTH DEPARTMENTS. This resource will help local health departments (LHDs) plan for, respond to, and evaluate public health responses to overdose spikes. LHDs play a leading role in detecting spikes and responding to them; but they are not alone. Much of their role requires coordination with other response partners in the planning, execution, and evaluation of an overdose spike response. This unique role of convening multi-sector partners is even more critical when co-occurring crises, such as the COVID-19 pandemic, or other natural disasters, limit organizations’ capacity to prepare for and respond to an overdose spike event. Find more information in the Framework here: “OVERDOSE SPIKE RESPONSE FRAMEWORK FOR COMMUNITIES AND LOCAL HEALTH DEPARTMENTS"
NACCHO's Local Opioid Prevention and Response: A Primer for Local Health Departments serves to inform local health departments about the domestic opioid epidemic and share success stories from LHDs currently engaged in opioid-related efforts, as well as resources and informative sidebars. To download a copy from NACCHO’s bookstore, go to https://eweb.naccho.org/prd/?NA826PDF, and sign in to your free myNACCHO account.
Please visit our toolkit for additional resources to assist local health departments build their own local and community-focused prevention and response efforts.
Have more questions, or know of a resource that could help other local health departments? Email us [email protected]!
Overdose Response Resources During the COVID-19 Pandemic
The COVID-19 pandemic has caused an unprecedented disruption to the normal operating procedures of local health departments (LHDs) and their partners. Understandably, staff capacity has been shifted as local public health staff work to arrest the spread of the virus and keep a worried public up to date as they are confronted with confusing mix of official announcements, news reports, and misinformation.
Unfortunately, the necessity for overdose prevention and response has not abated during the pandemic. Indeed, the substance use community faces increased risk as support services shutter or slow down operations, hospitals face severely increased caseloads, and people who use drugs are asked to socially distance from their support or safety groups.
Many LHDs have reached out to NACCHO for resources related to the pandemic and guidance about how to ensure their overdose response work can continue safely. Below is a curated list of resources for LHDs, the public, clinicians, harm reduction workers, and people who use drugs.
Please refer additional resource requests to [email protected] and we will attempt to assist you as soon as possible.
NACCHO is engaged in opioid prevention and response efforts in many counties and cities.
Academic Detailing and Harm Reduction
Academic detailing is an established educational outreach strategy that uses one-on-one interactions between a provider and a trained academic detailer to drive changes in a clinician’s behaviors.
Harm reduction is a noncoercive, nonpunitive, and nonjudgmental approach to drugs and drug use that prioritizes health, safety, and positive change by centering the experiences, needs, desires, and dignity of people who use drugs themselves. It is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs. - National Harm Reduction Coalition
With the support of CDC and assistance of NaRCAD and 5 pilot sites (University of New Hampshire, University of South Carolina, Alosa Health, University of Arkansas for Medical Science, and Linn County Health Department) NACCHO developed key messages for detailers to use with primary care providers on how to incorporate harm reduction into the services they provide. NACCHO also created a detailing aid that can be used to supplement the detailing sessions by providing primary care providers with additional context, tools, and resources on the overdose crisis and importance, value, and impact of centering harm reduction in each and every interaction with their patients.
Key Messages
Purpose and Intended Use
The harm reduction and primary care key messages are intended to be guiding points to make when meeting with providers during detailing sessions. They can and should be adapted, as needed, to best meet the needs of the community. For example, detailing visits are more effective when the detailer can clearly highlight and identify relevant data (e.g., local or state overdose data, HIV and Hep C transmission rates, etc.), guidelines (e.g. CDC opioid prescribing or tapering guidelines), and resources (e.g. a list of community organizations offering harm reduction services).
Academic Detailing Aid
Purpose and Intended Use
Similar to the key messages the detailing aid can and should be adapted based on the needs of the community and providers receiving the detailing. This can be used as a comprehensive resource to leave with primary care providers after detailing sessions, or individual sections can be provided as standalone resources to support providers on specific topics that arise during the sessions. Resources included in this aid are:
- Background on the Scope of the Overdose Crisis
- The Overlap between Harm Reduction and Trauma Informed Care
- Driving Factors of Substance Use and the Socio-Ecological Model
- Disproportionately Affected Populations
- Conversations Starters for Providers
- Impact and Outcomes of Harm Reduction Strategies
- Resources/Additional Information
Check out our recent blog posts related to the opioids epidemic in Stories from the Field.
Use the resources below to learn more about MRC projects that address the opioid epidemic and find other resources about local responses.
NACCHO has several policy statements related to the Opioid Epidemic and its infectious disease consequences:
NACCHO also provides letters to Congress and the administration to influence policy in order to best support local health departments' response to the opioid epidemic, and advocates for sufficient funding to combat the opioid epidemic.
Legislative Actions
In March 2018, Michael E. Kilkenny, MD, MS Physician Director, Cabell-Huntington (WV) Health Department testified before the House Energy and Commerce Health Subcommittee in a hearing "Combating the Opioid Crisis: Prevention and Public Health Solutions." Watch the full video to see Dr. Kilkenny describe how his health department has successfully led community efforts to combat the dual epidemics of opioid misuse and infectious diseases associated with opioid addiction, or read NACCHO's recap of the hearing on Twitter.
On November 13, 2017, NACCHO hosted a Congressional briefing "Tackling the Opioid Epidemic and its Hidden Casualties: Local Health Departments on the Frontlines" with cosponsors National Association of Counties and U.S. Conference of Mayors, with panelists that represented a range of local stakeholders in the fight against opioid use and abuse.
If you have a resource you’d like to share, questions to ask, or you’d like to learn more and be part of the conversation around local response to the opioid epidemic, please complete the following form.