This section of the toolkit was developed using information gathered through interviews and focus groups with treatment provider stakeholders, who represent individuals working in the realm of in- and out-patient substance use disorder treatment facilities.
Below you will find the promising overdose response strategies identified by treatment providers in Genesee County. Each promising strategy is numbered, along with stakeholder identified barriers to accomplishing the proposed strategy, and how the System for Opioid Overdose Surveillance (SOS) may assist stakeholders’ ability to accomplish each promising strategy.
Promising Strategy 1: Enhancing Program Implementation and Resources
Treatment provider stakeholders emphasize the importance of understanding how opioid use and overdose is occurring in their community in order to adequately respond with limited resources. Informing the provider response with use of near real-time data helps in determining the level of staffing or resources, such as bed space, needed for providers to offer the most effective care to the community. One provider expresses that, “Being a brick and mortar facility there’s only so much you can do, but it does push us to ensure that we have the right response available. I think the one notification that we had, it has us look at potentially telling people that this isn’t the week to take off just in case that we have that spike, but other than that, it’s just about staffing and bed space.” Treatment providers across Genesee county repeatedly voice concerns over limited resources and staffing, emphasizing the need to access data to inform their care.
Barriers to Enhancing Program Implementation and Resources
Treatment provider stakeholders express two main barriers to a successful opioid overdose response:
- Acquiring adequate resources: Proper overdose response is enabled through sufficient access to staffing or funding resources. Funding for current or new projects is important to the providers and community, yet acquiring sufficient funding is an ongoing struggle. New funding applications need to be submitted before existing funding runs out and communities are often harmed when programs cannot be sustained. Given the current paucity of resources, optimal distribution of those resources is critical.
- Community perceptions of overdose: Stigma remains in communities regarding opioid use and overdose. In order for treatment programs to be most effective, those suffering need to be willing to engage with treatment. This becomes difficult if stigma in the community discourages those in need from reaching out for help.
“I’ve been to a couple of townhall meetings that have had very few attendees from the community…I think stigma plays a part. I also think that people’s viewpoints on addiction and with opiates is still quite negative…people don’t understand the disease concept of addiction…but everyone should be able to have lifesaving devices in their hand.”
Treatment Provider Stakeholder
Near Real-Time Data Impact on Enhancing Program Implementation and Resources
Through the use of SOS near real-time data, treatment provider stakeholders can improve their opioid overdose response in several ways:
- Optimal distribution of scarce resources requires knowing where, and when, to focus. One example of this is preparing their facilities and staff for a potential influx of patients in regions showing an increase in overdose. Providers express concern about having an adequate supply of resources such as bed space in their facilities, and therefore hope to use the SOS reports and dashboard to more accurately plan for space or staff (e.g. peer recovery coaches) for future needs.
- Use near real-time data in communication with the community about opioid use and overdose. As stigma about the issue persists, data provided by SOS can be used in meetings with the community or in informational messaging to better inform community members about the issue and its effect on those around them.
- Use SOS data to support grant and funding applications when stakeholders feel programs need continued funding or when they seek out new opportunities to support the community. Including timely overdose data in grant applications helps demonstrate the need for funds.
“I know that our data that we collect helped [local hospitals] over the last year, year-and-a-half, and created a medication-assisted therapy or treatment protocol for their emergency department…So, it’s not actually a new partnership, because we’ve worked with the hospitals, but I believe that it [SOS] enhanced an already started program and just encouraged it and supported it, you know, supported the need for it in our community.”
Treatment Provider Stakeholder
Promising Strategy 2: Strengthening Provider Relationships
Treatment provider stakeholders in Genesee County work closely with hospitals, emergency departments, and EMS personnel to connect those who have overdosed to support and treatment. Those who overdose are often treated by EMS personnel or are transported to the hospital and treated in the emergency department. Emergency departments are often where opioid use treatment providers, such as peer recovery coaches, are then connected with individuals in need of treatment for opioid use disorder or mental illness. This makes the relationship between emergency department providers and opioid use treatment providers vital to the recovery of those in need of help.
Barriers to Strengthening Provider Relationships
Treatment provider stakeholders describe the greatest barrier to strengthening provider relationships as limited resources compared to the high capacity needed for overdose patients in emergency departments or urgent care facilities. With a high volume of patients presenting with opioid use disorder or a mental illness, and often returning to the same hospitals or urgent care facilities, compassion fatigue begins to set in among providers. This creates a negative feedback loop resulting in patients in greatest need refraining from seeking out or being connected with help, further inhibiting treatment providers from being able to connect with these individuals.
Near Real-Time Data Impact on Strengthening Provider Relationships
Treatment provider stakeholders describe how near real-time SOS data can improve their opioid overdose response:
- Help with community messaging, either pushed out into the community by their organizations or through their affiliated hospitals. In identifying hot spots with high overdose incident numbers, providers can work on messaging specific to these areas. For example, one large hospital has released a series of billboards promoting their hospital as a safe place for newborns and preemies, which helps to support a provider that specifically cares for pregnant and postpartum mothers. This same concept can be applied to opioid overdose.
- Help create new treatment protocols within hospital emergency departments. Compassion fatigue can have a particular impact on emergency department providers who treat large amounts of overdose patients and often the same patients presenting repeatedly with overdose. Stakeholders anticipate use of near real-time data to be helpful in communicating the extent and demographics of the opioid epidemic in the community to emergency department providers. This would be done to show the reach that the opioid epidemic has and to encourage a renewed sense of purpose among providers. Stakeholders are hopeful that connections with hospital, emergency department, and EMS providers will continue to grow and use of the SOS data reports will encourage this growth.
Impacts of COVID-19 on Treatment Provider Stakeholder Response
COVID-19 required treatment provider stakeholders to adapt to how they delivered services and how they were able to connect with patients.
- Quarantine and distancing: Facilities that provide services such as detoxification had to expand available bed space to conform to new COVID-19 safety protocols (e.g., creation of quarantine areas to distance those exposed).
- Shift to virtual meetings: Peer recovery coaches were unable to respond in-person within emergency departments to connect patients with the necessary available resources. They transitioned to conducting interviews via phone or another virtual meeting platform.
Treatment provider stakeholders were one group particularly affected by the COVID-19 pandemic, but these stakeholders were also highly adaptable, finding solutions to address the areas of treatment most impacted by COVID-19.