Overdose Data to Action: Prevention Strategies

These principles are woven into all prevention strategies across both cooperative agreements:

• Strong, multisectoral partnerships, such as those between public health, public safety, harm reduction, and health systems, and the involvement of people who use drugs, to leverage resources and expertise to prevent and respond to overdoses.
• Use of data to identify disproportionately affected populations and high burden geographic areas that will be prioritized within each prevention strategy to reduce health inequities and have an immediate impact on reducing overdoses.

Linkage to Care

Linkage to care initiatives use nonfatal overdose and other data from different potential data sources—emergency medical services, emergency departments/health systems, justice systems, harm reduction services— to identify people who are at risk for overdose or have recently experienced a nonfatal overdose and link them with evidence-based treatment options, services, and supports. These may include medications for opioid use disorder; harm reduction strategies; and wraparound services, such as transportation to treatment and housing assistance. Linkage to care may occur in a variety of settings, like a doctor’s office, emergency room, home, school, and virtually through telephone or online resources, and at any point along the recovery continuum.

Harm Reduction

Harm reduction is a public health approach that focuses on mitigating the harmful consequences of drug use, including infectious disease transmission and overdose, by providing care that is free of stigma and centered on the needs of people who use drugs. Harm reduction programs also offer critical linkages to treatment for substance use disorders and other resources for populations with less access to care. Examples include safer drug use education, naloxone distribution, and syringe services programs.

Stigma Reduction

Stigma can negatively affect access to health care, such as initiation of medications for opioid use disorder (MOUD). Stigma is a process where people with certain social identities are labeled, stereotyped, and devalued, leading to discriminatory behavior and internalized shame. Rates of stigma toward people who use drugs are high and well documented among healthcare providers and the public but confronting stigma at multiple levels and creating a culture of change is possible and necessary. Stigma reduction is embedded in all OD2A in States prevention strategies. A subset of OD2A: LOCAL jurisdictions are funded specifically to conduct stigma reduction activities, but nearly all jurisdictions participate in stigma reduction activities regardless of specific funding designations.

Public safety partnerships/ interventions

Public health and public safety collaborations strengthen and improve efforts to reduce drug overdoses. Each of these sectors offers unique opportunities and resources for effective intervention strategies. Public safety agencies hold real-time data on overdoses, arrests, and emerging drug threats in the community, and have frequent, front-line contact with individuals at high risk of overdosing. Public health agencies bring a data-driven and scientific approach to investigating and responding to public health crises by collecting timely and comprehensive data and using these data to inform locally relevant prevention activities. Each sector can help strengthen and improve the other’s efforts to reduce overdose deaths, but a lack of coordination may limit each sector’s ability to fulfill its roles.

Interventions to engage clinicians and health systems and enhance health IT/PDMPs 

Clinician/Health system engagement interventions are required strategies for all OD2A in States and OD2A: LOCAL jurisdictions. This includes activities like ensuring that clinician education efforts lead to change aligned with the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain, and increasing positive interactions between clinicians and people who live with pain or are at high risk of overdose.

OD2A in States jurisdictions are required to use strategies to enhance health information technology and/or Prescription Drug Monitoring Programs (PDMPs).  PDMPs can provide timely and complete information about prescribing and patient behaviors to improve patient care and facilitate a targeted response. Health departments, in conjunction with the entity in which the PDMP is managed (if different), work to make the PDMP easier to use and a better tool for clinicians use in managing patient care. Such enhancements include making access to the PDMP easier (e.g., single sign-on, delegate access); encouraging clinicians to consult the PDMP before prescribing; making PDMP data easier to use to improve clinical practice through dissemination and alert systems; and integrating PDMPs with electronic health records. A subset of OD2A: LOCAL jurisdictions are selected to conduct activities to enhance health information technology.