In the absence of an opioid overdose-specific appropriation, NCIPC proactively dedicated $6 million through our injury prevention activity line, which we use for cross cutting and emerging topics. Boost for State Prevention (Prevention Boost) was an initiative where CDC’s Injury Center equipped five of the hardest hit states – Kentucky, Oklahoma, Tennessee, Utah, and West Virginia – with resources and scientific assistance to prevent prescription drug overdoses. This work focused in three key areas: (1) maximizing the use of prescription drug monitoring programs (PDMPs); (2) improving public insurance mechanisms to protect patients; and (3) evaluating policies to identify prevention that works.

The omnibus awarded CDC’S Injury Center $20 million to combat the opioid crisis. Through a competitive application process, we selected 16 states to receive funds through the Prevention for States program. Participating states began executing and evaluating prevention strategies to improve safe prescribing practices and prevent prescription drug overuse, misuse, abuse, and overdose.

Congress appropriated $70 million to CDC for opioid overdose prevention. CDC’s full Overdose Prevention for States (PfS) program supported 44 states and Washington, DC. PfS added 13 states, growing to 29 states total. Including supplemental funding, states received $42.2 million in 2016 through PfS. CDC launched the Data-Driven Prevention Initiative (DDPI), supporting 13 states and Washington, DC, with a total of $6 million. DDPI was meant to support states with less capacity and/or a lower burden to help them build their capabilities to engage in a more robust response. The main difference between the PfS and DDPI programs was level of capacity of the states and funding.
These programs equipped states with tools to respond to the opioid overdose crisis. Activities included enhancing prescription drug monitoring programs (PDMP) and leveraging them as public health tools, improving health system and insurer practices for safer opioid prescribing, and evaluating policies that may impact the opioid crisis (e.g., naloxone distribution, Good Samaritan laws).
Congress also appropriated $5.6 million to CDC to start a surveillance program for opioid overdoses. With funding for surveillance, CDC launched Enhanced State Opioid Overdose Surveillance (ESOOS). It funded 12 states to continue to address the rising rate of overdoses attributable to opioids, including a specific focus on heroin and synthetic opioids such as illicitly manufactured fentanyl.

CDC received $111.8M for combatting the opioid overdose crisis, and $13.5M for its illicit opioid surveillance program. The surveillance program grew to 32 states and D.C. and CDC was able to give supplemental funding to Prevention states.

CDC gave over $88 million dollars to states to increase their prevention activities and enhance their surveillance capabilities.

With the additional supplement, CDC invested nearly $245 million in states – almost tripling their support.

CDC launched a Notice of Funding Opportunity, Overdose Data to Action (OD2A), which builds on previous surveillance and prevention programs to foster an interdisciplinary, comprehensive, and cohesive public health approach to the complex and changing nature of the overdose crisis. One of these efforts required funded recipients to collect surveillance information on all drug overdose deaths. In addition, all funded recipients collected nonfatal overdose data on all suspected drug, opioid, heroin, and stimulant overdoses from 75% of a state’s emergency departments. CDC collected data on more substances and from more facilities, to rapidly disseminate the data to inform prevention and response efforts. OD2A supports states, territories, cities, and counties to obtain higher-quality, more comprehensive, and timelier data on overdose morbidity and mortality.

The COVID-19 pandemic greatly impacted programs dedicated to drug overdose surveillance and prevention. Funded jurisdictions faced multiple priorities and had to determine when and where to divert time and resources to address COVID-19 in their communities. CDC provided flexibilities in funding requirements where possible to support recipients’ abilities to address the multiple demands faced during the pandemic.

CDC’s congressional appropriations language was expanded to include prevention activities that address stimulants, such as cocaine and methamphetamine, in addition to opioids. Additionally, CDC announced that overdose funding could be used to purchase rapid fentanyl test strips (FTS) in an effort to help curb the dramatic spike in drug overdose deaths largely driven by the use of strong synthetic opioids, including illicitly manufactured fentanyl.